Using market mechanisms in the provision of health services and seeing health care as a private good are approaches that have featured prominently in health sector reforms across the world. The UNRISD research on global and local experiences of health care commercialization challenges this framework. It calls for reclaiming public policies that promote the purposes that health systems are set up to serve: population health and the provision of care for all according to need.
Public-Private Mix
Commercialisation and Globalisation of Health Care: Lessons from UNRISD Research
United Nations Research Institute for Social Development, Social Policy and Development, December 2007
Considering domestic manufacturing issues
Wanyanga, WO
This report - presented at the African Civil Society Meeting of the Intergovernmental Working Group on Intellectual Property, Innovation and Health in Nairobi, Kenya, 28-29 August 2007 - found that there are over 30 registered local manufacturers in Kenya and at least two others under construction (foreign investments). It also analysed seven private-private partnership (PPP) projects (six in Kenya & one in Tanzania). The first PPP project passed its first inspection in August 2007 and the others are due for inspection by the end of the project. The main outcome of the report was that intellectual property rights do not stimulate research and development for medicines for diseases prevalent in developing countries simply because the market in poor countries is considered to be too small or too uncertain.
NEHAWU codemns private health owners' greed
NEHAWU, 3 March 2008
The owners of for-profit private hospitals have voted themselves to maintain high-cost-high profits health care system, in defiance of the modest call by the Minister to act in favour of health before profits. NEHAWU alleges that the refusal by private hospital companies to reduce the tariff increases, at least to the CPIX level, demonstrates once again why profit maximization in health care is incompatible with the needs of society as a whole. The organisatiion further observes in their report that much of the healthcare costs in the private health sector have nothing to do with provision of quality care, but spending on unnecessary and expensive equipment, hospital and office infrastructure and profits for their shareholders. NEHAWU does not believe however that the solution lies in another effort at regulation and calls for fundamental transformation of the sector, especially in the medical schemes and for-profit private hospital sector which command huge resources required for re-distribution in favour of the majority not the minority.
South African Health Review 2007 - The Role of the Private Sector within the South African Health System
Health Systems Trust, 7 March 2008
The South African Health Review (SAHR) is an annual publication of the Health Systems Trust (HST), which has been published since 1995. The SAHR seeks to provide a South African perspective on prevailing international public health issues, to stimulate debate and critical dialogue and to provide a platform for assessing progress in the health sector.
Statement by SA Minister of Health to Parliament on Private Health Sector costs
Department of Health, South Africa, 12 March 2008
The private sector provides care for about 7 million people or close to 15% of all South Africans but consumes more than the total expenditure by the public health sector. The per capita expenditure in the private health sector is about 8 times more than that in the public health sector. Put another way, the public health sector spends about R1000 per patient per year whilst the private sector spends about R8000. The private sector spends an estimated 5.5% of gross domestic product. In addition, this sector employs more doctors, pharmacists and dentists than the public health sector. Clearly, this level of inequity cannot be left unchallenged.
The effectiveness of contracting-out primary health care services in developing countries: a review of the evidence
Liu X, Hotchkiss DR, Bose S: Health Policy Plan 23: 1-13, 2008
The purpose of this study is to review the research literature on the effectiveness of contracting-out of primary health care services and its impact on both programme and health systems performance in low- and middle-income countries. Due to the heightened interest in improving accountability relationships in the health sector and in rapidly scaling up priority interventions, there is an increasing amount of interest in and experimentation with contracting-out. Overall, while the review of the selected studies suggests that contracting-out has in many cases improved access to services, the effects on other performance dimensions such as equity, quality and efficiency are often unknown. Moreover, little is known about the system-wide effects of contracting-out, which could be either positive or negative. Although the study results leave open the question of how contracting-out can be used as a policy tool to improve overall health system performance, the results indicate that the context in which contracting-out is implemented and the design features of the interventions are likely to greatly influence the chances for success.
African Union Technical Committee meeting on Local Production on Pharmaceuticals Johannesburg, South Africa
Dr Manto Tshabalala-Msimang, MP Minister of Health of South Africa and Chairperson of the Bureau of the Third Session of the African Union Conference of Ministers of Health, 18 February 2008
As the World celebrates 30 years of the Alma Ata Declaration that launched the Primary Health as the Pillar of Quality services, there is greater need for all of us to improve access to affordable medicines. Even in rich countries, access to affordable medicines cannot be guaranteed. Of course, the problems are much greater in many developing countries, with insufficient or no manufacturing capacities in the pharmaceutical sector. In Africa we are too reliant on other countries to provide essential medicines for us. This is not strategic and correct, as we cannot guarantee availability of appropriate technologies that truly respond to our current and emerging needs.
Manto targets private health care
Fin24, 14 February 2008
Private health care has been specifically targeted for interventions by the health department in the coming year, according to South Africa Health Minister Manto Tshabalala-Msimang. She said the government was paying particular attention to 'improving accessibility and affordability of private health care.' The minister said that private hospitals were also agreeing to comply with the single exit price legislation with regard to the billing for anaesthetic gases which were previously overcharged. She said that the department was building on the progress made in regulating medicine prices to develop regulations that would allow the whole private health sector to be regulated.
SA Health Minister's meeting with Private Hospital Industry & Medical Schemes
SA Department of Health, 28 February 2008
The South Africa Minister of Health, Dr Manto Tshabalala-Msimang held separate follow-up meetings with representatives of the private hospital industry and medical schemes in Cape Town to discuss the challenge of increasing private health care costs. The Minister welcomed the efforts that have been made by some of the private hospital groups to adjust the tariff increases for 2008 towards the CPIX. However, there were concerns from schemes that adjustments announced have not translated to any savings that can be passed on to the consumer. The schemes reported on the efforts that have been made to reduce non-health costs in the medical schemes.
IFC to push private health care in Africa
Bank Information Center, 18 January 2008
The International Finance Corporation (IFC), the private sector arm of the World Bank, announced last month that it would coordinate some $1 billion in equity investments and loans to finance private sector health provision in sub-Saharan Africa. The program was explicitly linked to the results of an IFC study, financed by the Bill and Melinda Gates Foundation, which found that the private sector already provides about half of the health care in the region, and that impoverished people are just as likely as the better-off to use private providers.