By Meenakshi Gautham, Priya Balasubramaniam, Gerald Bloom, Desta Lakew, Birger Forsberg on behalf of the Private Sector in Health Thematic Working Group.
A global multi stakeholder dialogue on Private Sector Engagement initiated by the UHC2030 will bring together the key highlights of this dialogue later today – 21 May 2019 – at a WHA side event to debate ‘options for aligning business objectives of private sector with public policy objectives of improved equitable access to quality essential health services and financial protection’. In this blog post, the Private Sector in Health TWG outline their contributions to this process and their ‘asks’.
The Sustainable Development Goals(SDGs) have shifted our health goalposts from combating infectious diseases and reducing child and maternal mortality to a broader engagement with ‘good health and well-being for all’. In particular, the health target of Universal Health Coverage (UHC) underpins many of the other SDGs as well as the scope and diversity of stakeholders invested in health systems. At an aspirational level, UHC symbolizes an undying flame of hope, equity, inclusion and social justice – that no one should die or sink into poverty for want of good quality and affordable healthcare. At a pragmatic level UHC is an acknowledgement of the need to make health systems stronger and more capable of delivering health for all. It calls for leveraging a range of health and non-health stakeholders to achieve this goal.
The diversity of private health providers
While many low- and middle-income countries (LMICs) have made significant progress in improving health coverage, key gaps remain. A multitude of non-government actors fill these gaps and are dominant providers of health care in many countries. This is the private health sector, and its scale, diversity and enterprise make it an indispensable stakeholder for achieving UHC. There are different types of providers along the spectrum of qualifications and skills: from less qualified informal providers and drug sellers to highly qualified specialists and super specialists; from practitioners of western systems to many different traditional systems; and from solo practitioners to small and medium enterprises and large corporate hospitals. Providers also include health technologists, business innovators and pharmaceuticals.
Globally we are seeing a proliferation of entrepreneurs with a vision to create social impact at scale. Several developments are creating opportunities for increasing access to health services: from wide-scale availability of generic drugs; development of inexpensive diagnostic technologies; increasing access to mobile phones and the internet; and growing availability of treatment algorithms and use of artificial intelligence to address common health problems.
The role of the private sector in achieving UHC
How can governments engage with this sector without appearing to abdicate their responsibility? More importantly, what can the private sector do to extend a hand towards UHC partnerships? As governments continue to embrace UHC, they will need to invite the private sector to join key conversations, to build trust and ensure that partnerships, innovations and initiatives provide evidence-based support for long-term health system goals and are also responsive to private sector interests. ‘Doing good’ and ‘doing good business’ however, should not be mutually exclusive. The private sector can be an advocate and partner to the global UHC movement, and should be encouraged to put the SDGs at the core of their mission. Both for-profit and not-for-profit private providers bring a unique set of skills and resources that can complement the public sector to improve access and outcomes particularly for vulnerable, poor and rural communities.
Image caption: Glaucoma mobile monitor by Aurolabs; Image credit: PHFI
Ensuring UHC through novel private sector partnerships and commitments
A global multi stakeholder dialogue on Private Sector Engagement initiated by the UHC2030 will bring together the key highlights of this dialogue later today, at a WHA side event to debate ‘options for aligning business objectives of private sector with public policy objectives of improved equitable access to quality essential health services and financial protection’.
The Private Sector in Health TWG has contributed to this dialogue by drawing on the rich experience of our members who work with for-profit and not-for-profit providers, informal and formal providers, health technology providers, small and medium enterprises and large hospitals, health service innovators and health start-ups, with insurers and health market investors and with pharmaceuticals and medicine suppliers. Through our statement at the WHA side-event we urge this diverse community of private sector stakeholders to move out of their individual silos and work together not only as competitors but also as collaborators to achieve UHC goals. We ask for private sector commitments for effective partnerships and agreements that embrace the wider targets enshrined in the SDGs of ‘good health and well-being’ for all. These could involve:
New primary care partnerships between formal and informal private providers bridged by digital platforms and technology to ensure continuous, good quality basic healthcare. This calls for the private sector’s medical ‘elite’ to rise above their turf protection biases and come forward to support programmes and partnerships with non-physician cadres including informal providers and other professionally trained mid-level cadres.
New partnerships between for-profit and not-for-profit entities that move beyond Corporate Social Responsibility (CSR) type models and combine impact at scale with business viability.
Mutual agreements by private sector stakeholderson adhering to basic quality standards for ensuring the safety, quality and affordability of private health care. This could include, for example, agreements by pharmaceutical companies to ensure drug promotional materials acknowledge the risk of anti-microbial resistance and advise the rational use of drugs. It would also include agreements by private enterprises for assuring their employees a comprehensive employment benefits package.
Agreements by private enterprises to share knowledge and valuable public health data to build health system capacity and protect patient interest.
Transforming private sector health partnerships and commitments in non-traditional ways will go a long way towards ensuring good quality UHC in every corner of the world. This involves both risks and caution in developing sustainable partnerships and an expanded view of the private sector as one that goes beyond corporate hospitals, global pharma and high end medical device companies to other actors providing public health and primary care. Can we achieve ‘health for all’ this time? Yes of course, together we can!
Blogs of interest:
Banner image credit: Dr. Meenakshi Gautham, London School of Hygiene and Tropical Medicine