Public-Private Mix

Global health problems require global solutions, and public-private partnerships are increasingly called upon to provide these solutions. Such partnerships involve private corporations in collaboration with governments, international agencies, and non-governmental organizations. They can be very productive, but they also bring their own problems. This volume examines the organizational and ethical challenges of partnerships and suggests ways to address them. How do organisations with different values, interests, and worldviews come together to resolve critical public health issues? How are shared objectives and shared values created within a partnership? How are relationships of trust fostered and sustained in the face of the inevitable conflicts, uncertainties, and risks of partnership? This book focuses on public-private partnerships that seek to expand the use of specific products to improve health conditions in poor countries. The volume includes case studies of partnerships involving specific diseases such as trachoma and river blindness, international organizations such as the World Health Organization, multinational pharmaceutical companies, and products such as medicines and vaccines. Individual chapters draw lessons from successful partnerships as well as troubled ones in order to help guide efforts to reduce global health disparities.

This reference guide on public-private partnerships (PPP) theory and practice is intended for senior policy-makers and other public sector officials in developing countries. The guide, available on order from the Commonwealth Secretariat, focuses on the key lessons learned and emerging best practice from successful and failed PPP transactions over the past thirty years. The guide provides a background to PPPs: concepts and key trends; the infrastructure PPP project development process; constraints to infrastructure PPPs and measures to alleviate them; donor initiatives to support infrastructure PPPs; recent PPP experience in Commonwealth developing countries and lessons learned and emerging best practices on PPPs.

The ability of health organizations in developing countries to expand access to quality services depends in large part on organizational and human capacity. Capacity building includes professional development of staff, as well as efforts to create working environments conducive to high levels of performance. The current study evaluated an approach to public-private partnership where corporate volunteers give technical assistance to improve organizational and staff performance. From 2003 to 2005, the Pfizer Global Health Fellows program sent 72 employees to work with organizations in 19 countries. This evaluation was designed to assess program impact.

This presentation looks at Public-Private Partnerships (PPPs) in infrastructure through the lens of inequality, as wealth becomes concentrated in fewer and fewer hands and as the gap between rich and poor widens globally, regionally and within countries. PPPs are now used in more than 134 developing countries, are on the rise in the aftermath of the 2008 global financial crisis, and have moved from physical infrastructure into the provision of “social infrastructure,” such as schools, hospitals and health services. For the private sector, a PPP project needs to provide a stable, guaranteed income stream. Projects are devised to create multiple avenues for a flow of money that is transformed into private profit through loans, derivatives, shares, securitised income streams, and contract sales that anyone can buy and sell. The author argues that a PPP project enables millions of dollars worth of ancillary trading, mainly for the purpose of hedging risks. The choice of what infrastructure to build is thus argued to be heavily influenced by what serves the long-term profit-making interests of the private sector – and the state or public sector becomes more and more aligned with the interests of infrastructure investors and private companies. PPPs are thus reported to be not about building and providing public services but about constructing the subsidies, fiscal incentives, capital markets, regulatory regimes and other support systems necessary to transform “infrastructure” into an asset class that yields above average returns of 13-25%.