Public-Private Mix

Towards A Dynamic Concept of Health - CPRN Report

Sholom Glouberman, Director of Canadian Policy Research Networks, May 2001
One characteristic stands out above all in the history of our developing understanding of health, - its complexity. "We now realize that health is shaped by numerous, perhaps countless, forces from many different spheres of influence, ranging from the molecular to the socioeconomic," says Sholom Glouberman, Director of CPRN's Health Network. Glouberman is the author of Towards a New Perspective on Health Policy, the final report of a three-year research project at CPRN. The report ties together a number of separate studies and the results of discussions involving some 3,500 people at more than 90 events held over the course of developing the research conclusions. Judith Maxwell, President of CPRN, says Glouberman's study points to the importance of placing the reform of the health care system in this broader context. "All of us want to feel secure in the knowledge that health care will be there for us should we need it." says Maxwell. "What Sholom's study underlines is that further investment in the health care system should consider how to regain public confidence in it. It is this interactive sense of security that has a significant impact on health along with other factors such as biological condition, social relationships, economic status, work experience and culture."

Towards a more sustainable globalisation:
the role of the public health community

DOUGLAS W BETTCHER and HEATHER WIPFLI - J Epidemiol Community Health 2001;55:617-8
In her article Fran Baum is correct in pointing out that the political complexities of our globalised world must be taken into account by public health professionals. Global health futures are directly or indirectly associated with the transnational economic, social, and technological changes taking place in the world. Issues such as poverty, equity, and justice must be firmly rooted in any discussions aimed at improving global public health. However, globalisation is a "janus faced" creature: the double face of globalisation, one promising and the other threatening, is a fact of life as humanity is being catapulted into a more interdependent future.

Towards universal health coverage: a mixed-method study mapping the development of the faith-based non-profit sector in the Ghanaian health system
Grieve A; Olivier J: International Journal for Equity in Health 17(97)1-20, 2018

This paper presents a mapping of faith-based health assets in Ghana using both qualitative and quantitative evidence to provide a visual representation of changes in the spatial footprint of the faith-based non-profit (FBNP) health sector. The geospatial maps show that FBNPs were originally located in rural remote areas of the country but that this service footprint has evolved over time, in line with changing social, political and economic contexts. The sector has had a long-standing role in the provision of health services and remains a valuable asset within national health systems in Ghana and sub-Saharan Africa more broadly. The authors observe that collaboration between the public sector and such non-state providers, drawing on the comparative strengths and resources of FBNPs and focusing on whole system strengthening, is essential for the achievement of universal health coverage.

Trade Unions and reform of public utilities: International perspective
Lobina E, Hall D: Public Services International Research Unit, 2006

Privatisation has been promoted throughout the world for the last 20 years. The advantages are supposed to be increased efficiency, lower prices, greater investment, and greater dynamism than public ownership. It has been seen as a central policy element in transforming former communist states into market economies. It has been promoted wordwide by international institutions including the IMF, the World Bank and the OECD, and by multinational companies. The EU is in principle neutral on privatisation, but in practice encourages PPPs. Privatisation has been made especially attractive because of economic policies aimed at reducing the borrowing of governments at national and municipal level. This dociment discusses futher the impact of reform on industry, workers in health and trade unions.

Transnet launches new health train in South Africa
Styan JB:, 12 March 2012

Transnet has launched its second health train in South Africa, the Phelophepa II, costing R82m (US$10.8). The first Phelophepa train has served more than six million in rural communities over the past 18 years. The trains, crewed by medical specialists including a number of final year students, provide primary healthcare, dental, psychological and optical services. Transnet’s rail engineering division, TRE, was responsible for the development of the new train with the Swiss-based pharmaceutical group F Hoffman La Roche a major sponsor of both trains. The trains operate from January to September every year and cover vast areas of South Africa where primary healthcare facilities are under pressure.

Uganda: Companies scale-up Aids campaigns
Mukombozi R, The Monitor (Kampala), 21 March 2006

Through the theme: "Saving lives, Saving money," Ugandan businesses are being sponsored with modules designed to prevent the spread of HIV/Aids through training programmes and awareness campaigns on better access to ARVs. This presents a detailed argument for the care of employees with HIV/AIDS.

Ugandan generic ARV factory overprices its drugs
Plus News: 14 March 2013

AIDS activists in Uganda have drawn attention to overpricing of medicines at a local pharmaceutical plant, Quality Chemicals Industries Limited (QCIL). The plant was started in 2007 to improve treatment access by providing cheaper ARVs locally. The authors argue that between December 2009 and October 2010, the government's National Medical Stores (NMS) paid $17.8 million more than it should have to QCIL, with a 15% mark-up on imported drugs that had been intended only for locally produced drugs. QCIL is reported in the article to be selling imported drugs manufactured by Cipla at high prices even after it started producing its own drugs. The government inspector general and civil society activists have demanded the government investigate and recover the funds.

UN must stop health-related partnerships with the baby food and junk food industry
One Million Campaign, World’s Breastfeeding Movement: August 2011

The One Million Campaign’s petition to the President of the United Nations (UN) General Assembly urges the UN to re-consider proposed partnerships with the private sector for future work in prevention of non-communicable diseases (NCDs). The UN’s draft Political Declaration, developed in preparation for the High-level Summit on Non-communicable Diseases (NCDs) in September 2011, contained proposals to allow manufacturers of unhealthy foods - including infant foods and junk foods -to influence future global and national health strategies to control NCDs. The One Million Campaign asserts that strategies to prevent NCDs should emphasise support to women to continue breastfeeding up to two years, especially exclusive breastfeeding for the first six months and end promotion of all foods for infants, and children. Research indicates that this breastfeeding regimen significantly reduces the risk of NCDs. They argue that manufactures of unhealthy foods, breast milk formula and infant foods should not be allowed to participate in developing strategies or making decisions regarding healthy foods and prevention of NCDs, as there is a clear case of conflict of interest.

Undernutrition in Tanzania – is private sector growth the answer?
Steve Lewis, Eldis, May 2014

A recent RESULTS report on nutrition and education in Tanzania, “You can’t study if you’re hungry…” found that levels of undernutrition are worryingly high, at 42% of all children under five, and, surprisingly, that buoyant economic growth levels are having little impact on nutrition figures. In Tanzania, a lack of essential nutrients in the average child’s diet is one of the key determinants of undernutrition. So it is not necessarily a lack of food, but a lack of nutritious and varied food. Micronutrient deficiency is widespread in Tanzania and contributes to the high level of stunting. Yet, Tanzania’s Gross Domestic Product (GDP) Annual Growth Rate averaged 7% from 2002 until 2013, reaching an all-time high of 11% in 2007. But the sectors which have driven Tanzania’s economic growth are mainly those which are capital intensive and urban. So while the urban middle class are expanding there is little benefit in rural areas. The fastest growing economic sectors are communications, financial services, construction, and a new natural gas sector. In a meeting with Tanzanian MPs on the Parliamentary Group for nutrition the MPs who were especially concerned were from the area of the country described as the ‘agricultural growth corridor’. Precisely the rural areas of the country that have been targeted for private sector growth are those constituencies with highest rates of stunting. One MP said that the emphasis on export-led growth means that parents are now so busy that they do not have the time to focus on the adequate nutrition of their children.

Universal Health Coverage, Primary Health Care and the role of the Private Sector
Ozano K; Simkhada P; Porcellato L; Khatri R: Health Systems Global, 2019

This report provides an overview of the discussions around Primary Health Care (PHC) and the private sector, which took place during the 5th Global Symposium on Health Systems Research 2018: Advancing health systems for all in the SDG era. Universal Health Coverage (UHC) and how health systems are working to deliver this global goal by 2030 was a major theme of the conference. Discussions were captured through session data capture and semi-structured interviews. 26 conference rapporteurs captured data in 93 sessions; and 21 interviews were conducted with policy makers, implementers and practitioners from the public and private sector. The discussions referred to initiatives to better engage, train and support small private providers such as community pharmacists to broaden their role and regulate their prescribing to develop safer PHC services. Urgent policy level exploration was called for on public-private links to achieve comprehensive PHC and UHC and clear mechanisms and legal frameworks for strategic purchasing and regulation that consider the power of purchasing medicines and supplies across countries within geographic regions.