DD: What is the role of public–private partnerships in strengthening health-care systems?  

RA: Public–private partnerships are critical in improving the health and well-being of a society, as we have seen with the global HIV response. The success of the HIV response was primarily due to global public–private partnerships and solidarity, as well as the inclusive approach taken by countries. The inclusion of non-state actors, including the private sector, and people living with HIV and affected communities was really the critical ingredient in mounting an effective HIV response. We have seen this approach replicated at a lesser extent at the global and national levels for malaria and maternal and child health.

The critical role of public–private partnerships in strengthening the broader health-care system in countries includes the following:

• Engaging beneficiaries so they feel responsible for the outcomes.
• Ensuring through an inclusive process that all the stakeholders have a voice in the planning, resource allocation and implementation or service delivery phases in order to harness ownership of the solutions developed.
• Generating innovative solutions. The private sector is in the business of innovating and therefore it is important for the health sector to tap into their expertise and effectively utilize assets and resources.
• Ensuring greater transparency and accountability.

DD: What is the added value of the recent economic growth that has been seen in many developing countries, particularly in Africa, in these kinds of partnerships?

RA: Economic growth in many countries has created many prospects for domestic and international business investment, including in the health sector. This brings tremendous opportunities for public–private partnerships to scale up services, but most importantly to identify new funding mechanisms and generate domestic capacity, local innovations and tacit knowledge or “know-how”. For example, in countries like South Africa—which is fairly well advanced in the sub-Saharan Africa context—this tacit knowledge can be used to generate local economies that benefit not only the health sector but the economy as a whole. The benefits are beyond the intrinsic health benefit that we all want to achieve—we can also see the benefits in economic growth and broader social welfare.

DD: How does the private–public partnership health-care model benefit the end user?

RA: We must focus on using available resources and assets in the most efficient and effective way. Whether the solutions are provided by state or non-state entities is pretty immaterial as long as the performance, expected outcomes and rewards are clearly defined. What is important is to utilize the assets and knowledge available both at the country level and the international level to get the best return on investment and to benefit society.

DD: What is the role of public–private partnerships in corporate social responsibility?

RA: We are talking about partnerships beyond corporate social responsibility here. This is about major system improvement or change. The private sector has the responsibility to generate value for shareholders, but that doesn’t stop it generating value for end users. It is all about getting the right balance. If the framework is set right to achieve equity, efficiency, effectiveness and responsiveness in the way we provide public health services and interventions, it will help the country attain its primary outcomes of benefiting its users. If there is an economic benefit attached to that, all stakeholders will benefit—the level of economic benefits or the reward for the country and the investors can be negotiated. It is important to understand that there are investors that are interested in providing or engaging in partnerships as long as the risk reward calculus is appropriately set and there is transparency and stability.

DD: How can this kind of partnership help countries to manage data and generate better evidence?

RA: The private sector has solid capacity in terms of data capture and, more importantly, analysis of raw data and translating them into information and reliable intelligence. These are critical for decision-making and having a better understanding of the health-care needs of society. The public sector can learn from the private sector and harness country-level capacity, including transferring underpinning technologies that will enable them capture quality data and information.

DD: Do you believe public–private partnerships bring benefit to countries with regard to resources?

RA: This is about the effective use of available resources and assets in a country. It is important to assist the government to become a strategic investor or smart contributor to solutions and a smart purchaser of services and solutions. The focus should be on working with partners that will provide the right solution—identifying country needs, planning and smart investment of resources The private sector can provide strong assistance specifically in relation to human resources, which form the largest proportion of budgets in most health-care systems, procurement of new technologies and medicines, and supply chain management to ensure equitable access to commodities and technologies.

DD: How do you see the role of public–private partnerships in the roll-out of the sustainable development goals?

RA: To achieve the sustainable development goals, we need to ensure that countries are able to manage existing and future disability and illness/morbidity. Many countries have been successful in improving longevity, but that brings with it greater disability and morbidity if the health of individuals is not appropriately managed. The sustainable development goal related to health focuses on overall health and well-being. This is a refreshing move from disease-specific targeting, which means we are now able to think about investing, improving and sustaining health outcomes. This is critical to sustainable development—not just reacting to individual diseases. Of course, we need to provide treatment for diseases, but I hope that the sustainable development goals will provide the impetus for investing in prevention, health promotion and the maintenance of well-being and the health of populations.