On 7 November, PharmAccess hosted a discussion at the annual Africa Day at the Royal Tropical Institute in Amsterdam. The topic of the session was ‘Making health markets work for the poor: leveraging public funds to generate private investments’. On the panel were different players with varied knowledge of healthcare in Africa, as public financiers, social innovators, academics and first-hand experience with the sector.
Professor van Tulder putting a point across in his closing remarks at the PharmAccess session during Africa Day
Guido Geerts, CEO and partner of various companies in healthcare technology, including Delft Imaging Systems and Incision Group, represented the private sector. He presented his companies’ innovative technology and how it is contributing to the provision of better quality healthcare. Furthermore, Dr. Tony Aidoo the Ambassador of Ghana to the Netherlands gave his perspective on healthcare, outlining both the challenges and opportunities within the Ghanaian healthcare sector. Chudi Ukpabi, author of the book ‘Doing Business in Africa’ and cross-cultural communication expert, gave the discussion personal perspective based on the experiences of his family in Nigeria. Mrs. Aaltje de Roos, Senior Policy Officer of the Ministry of Foreign Affairs, gave an overview of how the partnerships within the Health Insurance Fund had helped drive a holistic approach to strengthening health markets and improving health outcomes for the poor.
Introducing the topic, facilitator Alexander Kohnstamm gave an overview of PharmAccess’s work and the increasing importance of public-private partnerships in contributing to accessibility of better quality healthcare. The main thrust of the discussion was the complementarity of the private sector in providing public goods, including healthcare, and how the public sector can create an enabling environment for such partnerships to work effectively.
In Ghana, the government has introduced health insurance to finance healthcare. Ambassador Tony Aidoo indicated that the challenges of theNational Health Insurance Scheme also bring along opportunities for private players. Moreover, he emphasized that the government provides health care through public hospitals, but most people get care from smaller local facilities. The other challenge, he said, is lack of human capital. Most of the trained medical professionals leave the country or are usually concentrated in urban facilities, leaving the rural facilities with a huge human resources gap.
Guido Geerts illustrated how high impact social investments can fit within the PPP model, while tackling problems such as brain drain. For instance, Incision Group has been working on a virtual reality tool that can help within the health education sector, including training surgeons in countries affected by human resource-exodus. Using simple mobile phone based technology and special glasses, medical students can learn how to do particular surgeries when there are no qualified professors to learn from. According to Geerts, there are many more opportunities for technology to reduce costs in the healthcare sector.
Drawing from his own experience, Chudi Ukpabi remarked that for most ordinary people in Africa the concept of PPPs in healthcare was well-known. “We grew up receiving care from missionary hospitals and nearby private clinics. There are government hospitals but they are often limited to primary care and sometimes out of reach”, he said. He further emphasized the importance of having private clinics and argued that people are willing to pay for them if the quality of care is good. Most people however do not know what good quality healthcare is. The success of a public private partnership therefore depends on how quality is communicated to the public and the extent to which trust in the system is built.
According to Aaltje de Roos, the governments can create enabling environments for inclusion of the private sector in providing the citizenry with accessible, affordable better quality healthcare. Furthermore, she stressed the positive outcome of prepayment and healthcare insurance schemes; they empower patients as clients who are entitled to and demand quality services.
Professor Rob van Tulder, co-founder of Rotterdam School of Management’sPartnership Resource Center and professor of Business Society Management, closed the session. He argued that markets can create financial sustainability and can create a system that is less prone to political spheres. In conclusion he argued that there are opportunities for profit – not-for-profit partnerships, which can create innovation and scaling. The role of the public sector is then to facilitate, through regulation, and not to hinder these kinds of partnerships.