How the State can partner with private sector on healthcare

While service coverage has improved in the last 20 years, the proportion of people facing financial hardship due to out-of-pocket health spending has increased. [iStockphoto]

With most countries in Sub-Saharan Africa still struggling to provide affordable healthcare, it is increasingly evident that traditional health provision models are no longer tenable.

Based as they are principally on public financing, which is supplemented by charity and philanthropy, Universal Health Coverage (UHC) demands involvement of more actors, particularly the private sector, to help bolster health systems.

Robust health delivery structures are a prerequisite for facilitating access to all, particularly those at the bottom of the pyramid. Available data shows 29.98 per cent of healthcare expenditure across sub-Saharan Africa is financed through out-of-pocket payments. This is worrying considering that the number of people living below the poverty line increased to 424 million in 2019 from 420 million in 2018, accounting for 38.5 per cent of the region's population. The region accounts for two thirds of the world's extremely poor.

The World Health Organisation (WHO) estimates that half of the healthcare facilities globally lack basic hygiene services. Similarly, half of the world's population - the vast majority living in the region - is unable to access essential health services. A significant part of this population is forced into extreme poverty by healthcare spending.

While service coverage has improved in the last 20 years, the proportion of people facing financial hardship due to out-of-pocket health spending has increased.

There is, therefore, an urgent need to accelerate healthcare affordability through innovative service delivery approaches. A viable alternative is co-creating fit-for-purpose solutions to drive affordability and access to medicine and healthcare by those at the bottom. This can establish a foundation for innovative solutions that would facilitate realisation of UHC.

Public Private Partnerships (PPPs) are an innovative way to include the private sector in health systems strengthening and sustainability over time. They enable governments to collaborate with the private sector in pooling resources, combining the managerial and technical skills to improve healthcare delivery. They have potential to make UHC possible by bridging gaps in healthcare access and affordability. PPPs create environments for innovation and technology which can spur growth and provide easy access not only to information but also to health services. PPP approach models such as those adopted by companies such as Novartis AG, which centre around effective last-mile distribution of medicines and commodities, may be worth emulating.

They target bottom of the pyramid and are undergirded by innovations on financing health for the poor; and facilitating services that include screening and diagnostics; continuous education; and upskilling of patients, healthcare providers and doctors.

If similar models are implemented in collaboration at a national scale, realisation of UHC and access to affordable healthcare will be within reach. However, this can only be achieved if systemic challenges are addressed.

The writer is the Cluster Head at Novartis, East and Southern Africa