Building healthcare resilience through public-private partnerships

Africa, faced with the urgent need to tackle different health challenges and progress towards universal health coverage, its governments are recognizing the critical need to effectively mobilise and partner the private health sector to strengthen healthcare systems. Some of these health challenges include emerging and re-emerging communicable diseases, high maternal and child mortality, rising healthcare costs, increasing population risk exposure, weak disease surveillance and response, among others.

The Covid-19 pandemic was an eye-opener on the need to rethink healthcare partnerships and build health systems that are resilient, equitable, data driven and of quality. As the pandemic hit the African continent, it diminished the rivalry between both private and public healthcare sectors, as everyone worked with a shared goal of ending the pandemic and mitigating its impact on public health. In Nigeria, the partnership between the private and the public sector during the pandemic was spectacular and gave an amazing result. This same result was experienced in many other African nations.

As the pandemic gradually ends, it is crucial that Africa build on this momentum in public-private partnerships (PPPs), harnessing public and private strengths to build healthcare resilience and preparedness for future pandemics.

PPPs are also often perceived, as an innovative method that can produce desired results, particularly in distributing health benefits to disadvantaged and poor people

In many African nations, the private sector is emerging as a dominant and preferred health service provider, especially in urban areas. The private sector often has the innovative business knowledge, discipline and technical capability to properly execute projects, while the public sector owns the processes, licences and pathways in which the projects can function. Harnessing the strength of the two sectors is therefore important.

In the health sector, PPPs typically involve long-term contracts between private sector entities and government entities for the provision of health-care facilities, equipment and/or services. PPPs can complement government efforts and achievements by improving project selection, enabling organisational efficiencies and enhancing the value for money of infrastructure- and service-delivery in the healthcare sector.

In primary health care (PHC), PPPs can facilitate access to healthcare services, especially in remote areas. The utilisation of PHC services provided by the public sector is low, and there is a lack of effective mechanisms to evaluate and monitor its performance. PPPs can play an important role in increasing service uptake of PHC by overcoming geographic barriers, reducing waiting times, increasing access to staff consultations and medication, and providing more confidentiality regarding disease-related symptoms. Conversely, the use of PPPs can significantly reassure and reduce the fear of privatising healthcare services.

PPPs are also often perceived, as an innovative method that can produce desired results, particularly in distributing health benefits to disadvantaged and poor people. They have been tested as a means of ensuring that the provision of comprehensive PHC service is efficient, effective, and fair.

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It is therefore not surprising that PPPs are rapidly expanding and becoming an integral part of effective health interventions. A new initiative in Nigeria called Adopt A PHC is being piloted. This is a form of PPP where a private sector entity invests in a PHC to revitalize and make health services available to the local population. This could be an easy way of increasing access to healthcare across the continent.

Also, Bloom Public Health, an indigenous African company, is building its reputation as one of the most credible technical partners to health-related innovations in Africa. Through strategic partnerships with African governments and their agencies, Bloom Public Health is providing outstanding partnership models for future public health interventions on the continent.

As a technical partner of Nigeria’s National Institute for Pharmaceutical Research and Development (NIPRD), it is in a World Bank-funded initiative, will begin support of selected local Nigerian pharmaceutical manufacturing companies in the attainment of Good Manufacturing Practices (GMP) and WHO Prequalification (WHO PQ). This PPP will provide a road map for indigenous manufacturers and position Nigeria and the continent to compete globally with the world pharmaceutical big players.

Another example is the Health Supply Chain Transformation project, where a Bloom Public Health-led consortium is partnering several states in Nigeria to make medicines available at the health facilities in the states.

To maximise the potential of PPPs in Africa’s health sector, government policymakers and their development partners need to design and implement sustainable policies that facilitate and optimise the use of PPPs, ensuring that they are well coordinated and implemented, and targeted to address long-standing deficiencies in the health sector.

Given the critical role of PHC as a cornerstone of sustainable health systems, African governments should prioritise PHC in their PPPs and should not ignore local needs and context. Also, mechanisms for external independent scrutiny, involving national and/or local auditors, are required to ensure value for money, transparency, and prevent corruption.

African governments need to fully explore the potentials of PPPs in the health sector as they provide a viable pathway to build sustainable health systems for universal health coverage and health-related Sustainable Development Goals.