Challenges in the health sector: can public private partnership proffer solution?

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Improved public health are central to the United Nations Sustainable Development Goals (SDGs). Targets for 2030 include providing universal health coverage (UHC) and eliminating the epidemics of HIV/AIDS, tuberculosis, malaria and neglected tropical diseases (NTDs).

Such an agenda would be a monumental feat even under the best of circumstances, and experts now worry the novel coronavirus pandemic will put the achievement of these health goals — and the rest of the SDGs — in jeopardy. “COVID-19 is driving us even farther off-course from achieving the vision and promise of the 2030 Agenda for Sustainable Development,” U.N. Secretary-General António Guterres said at the World health Summit, an annual global health conference.

Beyond the direct risks presented by the coronavirus, measures to control its spread are disrupting global and local health systems — putting millions at risk and hindering progress on health-related SDGs. Still, even in the midst of the pandemic, we’ve seen public and private partners achieve significant gains to advance public health. Africa was declared free of wild polio in August, after a lengthy vaccination and surveillance program led by governments, multilateral health bodies, and private-sector supporters.

And last month, the leaders of 194 countries signed on to a global strategy to eliminate cervical cancer as a public health threat. “We’re at a critical moment,” notes Trey Watkins, executive vice president of global health and corporate responsibility at GCI Health, and former health advisor in the U.N. Secretary-General’s office.

“On one hand, we see incredible progress. But on the other, COVID-19 has reiterated that we have to evolve our ways of working and collaborating if we are to truly address some of the world’s biggest challenges.” A similar message rang clear from experts at the World Health Summit in October: The piecemeal, largely siloed efforts so far employed to advance public health are no longer enough. A truly collaborative, global effort is needed not only to combat the pandemic, but also to ensure it does not erase decades of progress around health and well-being.

Public Private Partnerships – a possible solution

“Collaboration and innovation are the key ingredients to support countries’ efforts to recover from the COVID-19 pandemic and accelerate progress toward the SDGs,” Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), said at the Summit. This cannot be the sole responsibility of the public sector or multilateral bodies such as the WHO. Participation from the private sector — particularly companies in the healthcare industry — is critical, Guterres added.

“We need global solidarity every step of the way,” he said. “We must join together as governments, the private sector, civil society and all partners.” Public-private partnerships can strengthen multilateral efforts, even when government support is found wanting. Expert calls have not fallen entirely on deaf ears, as a record number of collaborative funding and programming initiatives launched in recent months to coordinate a global pandemic response.

Financial accessibility is one of the biggest barriers to health, both in Ghana and other countries, particularly for marginalized groups,” said President Akuffo Addo.  “Financial access and inclusion have to evolve from traditional corporate responsibility or philanthropy to a better way particularly in the age of COVID-19.”

To fulfill their responsibility to meet the moment, healthcare companies in particular must combine their capital with relationship-building that allows for the sharing of innovation and resources, both locally and at scale. For example, the MTN Foundation is leveraging its own network of nonprofit and government partners to maximize impact and scale during this historic time. For instance, the Mr. Senyo Hosi led private partners collaborated with the government to build the centre in the capital to help manage and curb the effects of the COVID-19.

In the midst of the pandemic, projects arranged under a public-private partnership are an essential instrument as it is evidently clear that governments alone do not have the financial and managerial resources to deliver the full range of services and expertise in the health sector and other sectorial areas in the country.

These partnerships with private investors and donors are specifically needed when the pandemic at hand is one that necessitates innovative solutions and managerial expertise that can respond to the current, rapidly changing landscape. However, while public-private partnerships are imperative, it is authoritative that during states of emergencies and times of heightened reliance on the private sector, we continue to critically examine the blurring of lines between the public and private actors, the power dynamics present in these partnerships, and finally, the level of transparency within these relationships.

In the case of an emergency or a pandemic, you need to be able to move with speed and agility. Sometimes the public sector is constrained in their ability to act quickly and to be nimble and flexible with their resources. At the same time, those simple, flexible, private-sector resources can’t reach the scale and sustainability that the public sector can. When these are able to come together, it really shows the power of collaboration.

Closing gaps in the healthcare system

Calls to “build back better” from the COVID-19 pandemic have spurred national efforts to expand the social safety net and begin to decarbonize economies in the fight against climate change. Similar rallying cries are beginning to spread across the healthcare sector, as stakeholders call for recovery plans that root out and address existing shortfalls within healthcare systems.

In markets including Ghana, for example, the pandemic has laid bare existing disparities which leave broad segments of the population — namely rural communities, people with lower incomes — underserved. Overall, people with lower income continue to be more likely to contract COVID-19 and experience adverse health outcomes.

COVID, in and of itself, is revealing the fractured way which people with lower income and underserved populations are experiencing healthcare. Even with a lot of really well-intended efforts, we still haven’t been able to make the progress we want to make in reducing disparities. This is where I think the public sector is such a critical collaborator with nonprofit organizations and the private sector …. because we need to make more progress than we’ve made.”

Conclusion

The ways in which companies, nonprofits and communities come together on a fix could prove to be a testing ground for future collaborations around public health, and stakeholders already have examples to follow in Ghana’s effort to fight the pandemic. The world is changing, and communities are demanding more of us than ever. In the face of nationalism and inequity, we must unite in solidarity and purpose to nurture meaningful engagements and identify sustainable solutions.

Importantly, the impacts of the COVID-19 crisis have highlighted certain critical aspects under PPP policy and legal frameworks that underpin the preparation and implementation of good-quality and sustainable PPP projects. To contribute to making PPP legal frameworks fit for a post-COVID-19 world, we therefore hope for broad participation from both public and private sectors, civil society, and the international development community in the consultations on the envisaged guide once an advanced draft will be available during the first quarter of 2021.

>>>the writer is a Researcher and Public Policy Analyst with considerable knowledge and expertise in Public Private Partnership, Leadership inspiration and Public Policy formulation. He is currently a Senior Management Consultant, Gimpa Consultancy and Innovation Directorate (GCID), the Consulting Division of the Ghana Institute of Management and Public Administration (GIMPA). Contact the author on 0205012686/[email protected]

 

 

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