Algeria, June 4, 2018

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Public-Private Partnerships (PPPs) in health are on the rise in Africa”

Public-Private Partnerships (PPPs) in health are on the rise in Africa as governments recognise the important role which the private sector can play in increasing access to healthcare for the African population.

Day three of the 2018 Africa Health Exhibition & Congress saw the continent’s top most echelon of leaders come together to attend the prestigious ‘Leaders Forum’ where they engaged on a model for operation to meet ever-increasing healthcare spend, and to deliver accessible and affordable healthcare in developing economies.

Under the topic of ‘Harnessing PPPs in healthcare: Imperatives for today’s leaders’, Chairman of the session, JP Labuschagne, Africa Infrastructure and Spatial Projects Leader at Deloitte in Kenya said that PPPs are one of the tools which enable governments to extend their reach in providing services to their citizens. But, he added, that it was critical that both parties understood their roles, responsibilities and risks, and that there were measurement structures in place.

Strover Maganedisa, South Africa’s Head of the PPP in the Treasury, said that there was general acknowledgement on the changing nature of PPPs and that the standard definitions relating to PPPs needed a recalibration in order to avoid a disconnect between current PPPs and those of the future.

“Traditionally, PPPs were mostly focussed on infrastructure, but this is evolving and in future we could see PPPs where the private sector could build a hospital as well as provide equipment services to government patients in that hospital for which government would pay a fee.”

Maganedisa added that new technology and innovation would change the way PPPs are developed and implemented and provided a South African case study – the Nkosi Albert Luthuli project – which is a technology driven PPP which has turned an ordinary referral hospital into a state of the art, paperless environment which has been successfully running for 15 years.

Professor Khama Rogo, Lead Health Specialist and the head of the ‘Health in Africa’ Initiative at the World Bank began by explaining that the private sector encompassed all entities that were not state. This included for-profit and not-for-profit organisations such as faith-based organisations, adding that all African leaders came into power wanting to improve health, and that none of them came in with the intention of ignoring the private sector. Where this has happened, he added, it has been a mistake and unintentional as everything in healthcare is impacted by the private sector, for example that medicines are always manufactured in the private sector.

Rogo, who listed various ‘factors for success’ stressed the need for strong and sustainable government-led public private dialogue which looks at current policy and legislation.

“We have always focussed on PPPs as a sort of legal transaction but actually they start with the engagement process. In every country that the World Bank has worked in, we have established a forum for dialogue.”

Kgomo said that as the nature of PPPs evolve so laws and policies must change to accommodate this, adding that governments must lead on policy and regulatory reforms that are needed and must be able to project the implications of these and ensure that they understood at all levels.

Rogo added that it was crucial that PPPs are linked to the national health agenda and that systems are put in place to ensure continuity and to protect the interest of the public.

“Government must see itself as the initiator, the protector and the prioritiser,” he said.

He added that governments must ensure sustainability of the project and that any PPP should speak to the priorities for the health sector.

“The private sector entering into a PPP must be committed to invest in that country and be committed to sustainability of the project”, he said.

Supporting access to healthcare

Each year, proceeds from the conferences held at Africa Health Exhibition & Congress are donated to an organisation that stands out and does exceptional work in the field of healthcare.

This year, a cheque for R 559,000 was handed over to the Rural Doctor’s Association of Southern Africa (RuDASA) who work towards improving healthcare in rural areas in South Africa. The aim of this membership-based organization is to provide adequate training for health care professions and aims to provide a long term solution for rural healthcare. Its mission is to adequately staff rural health facilities with qualified professionals and act as a mouthpiece for rural doctors when it comes to training and working conditions.

RuDASA, which has been in operation for 22 years, acts as a mouthpiece for rural health professionals and creates connections and networks between doctors.

“We are involved in a number of initiatives to advocate for and address the needs of rural doctors. Where there’s an issue that RuDASA cannot resolve, we will tap into our membership to solve it or escalate it to provincial or national government,” said Dr Mosa Moshabela, Chairperson of RuDASA.

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