Public-Private Partnerships

-Selected Experiences in the Western Pacific & Cambodia-

National Forum on Public-Private Partnership in Health

7 November, 2012

Dr. Pieter JM van MaarenRepresentative, World Health Organization in Cambodia

PPP by categories, range of partnership & funding

Source: Global Strategy for Women’s and Children’s Health, p.20

Objectives of Public-Private Partnerships

• Developing a product e.g. International AIDS Vaccine Initiative.

• Distributing a donated or subsidized product e.g. initiatives to distribute leprosy medicines (WHO-Novartis)

• Strengthening health services e.g. Eli-Lilly WHO partnership to address multi-drug resistant TB

Other PPP examples

Public sector programmes with private sector participation: • Roll Back Malaria, • Safe Injection Global Network, and • Stop TB Partnership • Global Alliance for Vaccines and Immunization

Legally independent “public interest” entities: • Global Fund to Fight HIV/AIDS, TB and Malaria

PPP Health Experiences in the Western Pacific

• Public-private mix in Tuberculosis Control – Philippines

• Malaria- Public Private Mix (PPM) for Malaria Diagnosis and Treatment in Lao PDR

• Health services contracting in Papua New Guinea under the Partnership Model (Churches & Faith-Based Organizations)

• Cambodia: Policy direction, Regulation and licensing of public and private health care professionals, facilities & pharmaceutical outlets

Public-Private Mix DOTS (PPMD) in Philippines: >10% additional TB cases detected & treated

By 2009:

• > 200 PPMD units established and operational

• Over 7000 private physicians trained

• Through PPM approach 11% additional TB cases identified in areas implementing PPM

1. Increasing access to diagnostics and treatment for the population, through private sector

2. Increasing quality of service in private sector, especially regarding adherence to treatment guidelines

3. Enhancing comprehensiveness of malaria case reporting & data, by including private sector

PPM objectives for Malaria Diagnosis and Treatment in Lao PDR

Private sector (PPM): Percentage of blood testing for malaria (P. f), 4 provinces, 8 pilot dustricts, Sep 2008 -

Aug 2010 (N=28888)

n=25489, 88%

n=3399, 12% Positive

Negative

Public Sector: Percentage of blood testing for malaria (P. f), 4 provinces, 8 dustricts, Sep

2008 - Aug 2010 (N=932982)

n=78694

84%

n= 14588,

16%

PositiveNegative

Malaria Diagnosis in public & private sectors

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PNG Health Partnership Model

1. NDoH is a steward of the unified system. 2. Health Partners: NGOs, churches, international NGOs, industry

groups and the private sector3. Government policy sets principles for partnership arrangements4. Guidelines for contracting the provision of services (outputs) –

both for for-profit and non-profit organizations5. Consistency with the national health plan & no duplication6. Capacity and accountability, focus on quality7. Contribution to universal access, equity and sustainability8. Priority on the needs of vulnerable groups

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PNG Health Partnership principles

PPP in the Health Strategic Plan 2008-2015

Promote effective public and private partnerships in service provision based on policy, regulation, legislations, and technical standards” through:

• Use of contracting and Special Operating Agency (SOA)

• Development and implementation of an accreditation system

• Strengthening joint planning between public and private sectors and coordinated HIS and surveillance reporting

• Reinforcing implementation of health laws and regulations

Regulation of Health Professional Education in Cambodia: Example of mutual advantage

• National Exam: dialogue through national committee, clear standards for graduates, capacity building opportunities through preparation of written and clinical exam

Lessons Learned for Public/Private Partnerships

• Importance of working to mutual advantage• Need opportunities for strategic dialogue to create joint

understanding, such as this PPP Health Forum• Overlap between public and private creates conflicts of

interest and silences dialogue• Few formal representative bodies of private sector which

makes dialogue difficult• Policy imperative for management of PPP to ensure Universal

Coverage, Universal Access and Quality Services

Future for PPP in Cambodia:Cambodia Mid-Term Review HSP 2008-2015

Achieve Universal Coverage and Primary Health Care service through a pluralistic health system

Strengthen regulatory frameworks for private & public providers (e.g. registering and accreditation of clinics, laboratories, hospitals and practitioners)

Strengthen regulatory frameworks for private income within the public sector (e.g. user fees & financial incentives)

Reduce out-of-pocket and catastrophic health expenditure through social health protection mechanisms

Cambodia Mid-Term Review HSP 2008-2015(continued)

• Capacity development for contracting in SOAs, Public Administrative Enterprises and the evolution of new Social Health Insurance institutions

• Strengthen joint planning between public and private sectors and coordinated surveillance and HIS

• Develop and reinforce implementation of public health laws and regulations

• Develop policy for private / public research agenda

• Regular meetings with presentations to increase understanding about private sector engagement: Malaria, TB, Health Professional Councils

• Health Forum for further understanding: learning from international experience

• Dialogue and information sharing also at Pro TWGH level; next stage reporting

• Disseminate Government policy and existing regulation• Needs to expand membership to the for profit private sector

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Cambodia sub-TWGH for PPP/ IHP+: progress and plans

PPP Health Forum: Seeking Public/Private Mutual Advantage

• Investment in mutual dialogue for achieving Universal Coverage for the Cambodian Health Service

• Share implementation experience and plans; nationally and regionally

• Disseminate government policy, strategy and regulation• Learn from private sector: creating demand; environment

needed for quality service provision• Mutual capacity building gains: training, information,

communication structures

THANK YOU