Public-Private Mix

Global Public Goods for Health
Smith R., Beaglehole R., Woodward D., Drager N. (ed.) Global Public Goods for Health: health economics and public health perspectives. Oxford, Oxford University Press, 2003. 320 p.

Global Public Goods for Health addresses the growing globalization of health from the unique perspective of the economic concept of public goods. This concept identifies where a ‘good’ or service (such as knowledge of an infectious disease outbreak) which would be of benefit globally will not be produced or disseminated if left to ‘the market’, because of a lack of incentive: no-one can be excluded from accessing the good, no charge can be levied for use and no costs recouped.

Measuring the public-health potential of new treatments for malaria in Africa

Poverty is a major factor in the continuing burden of malaria in sub-Saharan Africa. The gross national product (GNP) per capita is around US$306, or less than $1 per day. On average, these countries spend less than $20 per head of population per year on health care. Patients urgently need new therapies to combat malaria. However, malaria is not an economically viable disease for drug developers and new antimalarials are therefore usually developed within public–private partnerships.

Public health approach is key to scaling up HIV treatment, says WHO HIV/AIDS director

Speaking in December at the 14th International Conference on HIV/AIDS and Sexually Transmitted Infections in Africa (ICASA), in Abuja, Nigeria, Jim Yong Kim, Director of the World Health Organization (WHO) HIV/AIDS Department, emphasized the importance of a public health approach in promoting long-term sustainability and equity of HIV treatment access programmes in resource-limited settings.

Medical costs push millions of people into poverty across the globe

Each year 100 million people slide into poverty as a result of medical care payments. Another 150 million people are forced to spend nearly half their incomes on medical expenses. That is because in many countries people have no access to social health protection - affordable health insurance or government-funded health services. Paradoxically, people in the world’s poorest countries contribute relatively more for health care than those in wealthy industrialized nations. In Germany, for example, where the average GDP per capita is US$ 32 860 and almost everyone has social health protection, 10% of all medical expenses nationwide are borne by households.

Public health care under pressure in sub-Saharan Africa
Health Policy. 2005

Taking as point of departure the need for a strong public health care sector in developing countries the article firstly outlines how in sub-Saharan Africa enhanced scarcity has characterized the content and quality of health care in the public sector. This has eroded the trust among the public in the government as provider of health care and guardian of public health. Secondly, it describes how workers in the public health domain have dealt with the implications of scarcity by etching out a "puvate" zone in health care provision and how these informal activities need to be interpreted as "muddling through".

Public-private mix for DOTS: towards scaling up

This report from the World Health Organization summarises proceedings from an international working group meeting on public-private sector mix (PPM) programmes for expanding DOTS (directly observed treatment, short-course), the internationally recognised TB control strategy. The meeting stressed that effective scale-up of PPM DOTS must ensure access to TB care for all population groups. Key barriers to scaling up PPM DOTS included lack of capacity for technical support at national, regional and global levels, and weak advocacy and promotion.

Draft Charter on Private and Public Health Care in South Africa
Critical Health Perspectives

The Department of Health’s recently released Draft Charter of the Public and Private Health Sectors (CPPHS) aims to address the legacy of apartheid restraint on access to health care for all South Africans. It commits public and private sectors to create “a health care system that is coherent, cost-effective and quality driven … for the benefit of the entire population” and to work together “to improve the scope, accessibility and quality of care at all levels”. For these laudable goals we give our wholehearted support. The CPPHS specifies four “key areas” of transformation: access to health services, equity in health services, quality of health services, and Black Economic Empowerment (BEE). The first three – access to, equity in, and quality of health care services, are essential (though not enough) to meet the goal of health for all South Africans. The fourth area is problematic.

Further details: /newsletter/id/31148
The Impact of Privatization on developing countries
John Nellis and Nancy Birdsall, eds.

"The privatization of state-owned enterprises has been among the most controversial of market reforms. This new edited volume brings together a comprehensive set of country studies on the effects of privatization on people-and answers the overarching question: who are the winners and losers of the wave of privatizations that swept across the developing world in the 1980s and 1990s? The studies are sophisticated and careful, and address the big questions: Are the poorest households paying more for water, power, and other basic services? Did those who lost jobs suffer permanent declines in income? Were state assets sold at prices that were too low, and who benefited from the resulting windfalls? Was the process, in laypersons' terms, fair?"

Public/Private partnerships and mobilising resources
World Economic Forum

The United Nations-sponsored Financing for Development conference in Monterrey in 2002 concluded that greater cooperation between public and private actors will be required to overcome the inadequacies of development finance and achieve internationally agreed development goals. As a follow-up to this conference, the World Economic Forum's Global Institute for Partnership and Governance in cooperation with the UN Department of Economic and Social Affairs (UNDESA) and the Swiss Agency for Development and Cooperation (SDC) convened a series of nine separate practitioner-driven, multistakeholder roundtable discussions during the period 2004-05. These two day expert roundtables, supplemented by individual meetings and other research, sought to identify where the greatest opportunities and obstacles lay.

Removing user fees for primary care in Africa

User fees are once again a topic of hot policy debate in Africa. They were introduced relatively recently in many countries, but the current call is for their removal, particularly at primary care level. As analysts who have consistently argued against user fees, we broadly support this call. However, we recognise that this action cannot be introduced overnight and, if weakly implemented, may exacerbate the problems facing African health systems.

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