The role of the private sector in Africa’s new public health order

Defining the private sector cascade in the healthcare ecosystem

By Dr Allan Pamba – Executive Vice-President Diagnostics, Africa at Roche Diagnostics and Dr Amit N. Thakker, Executive Chairman at Africa Health Business (AHB)

Johannesburg (SA), 03 July 2023: The Africa Health Business (AHB) Symposium – a pan-African conference at the heart of the African healthcare scene – convened on 29 and 30 June in Johannesburg, South Africa. The Symposium assembled African healthcare leaders to discuss solutions that will harness and combat new and existing public health challenges towards attaining the Africa CDC’s New Public Health Order – a new health standard for Africa. Following the conference’s insightful discourse, we explore the private sector’s multifaceted role in this new order.

According to the World Health Organization (WHO), at least 400 million people globally lack access to one or more essential health services. Every year 100 million people are pushed into poverty and 150 million suffer financial catastrophe because of out-of-pocket expenditures on health services.1

This is the stark reality in healthcare service delivery in low-to-middle-income countries (LMICs) – and particularly, in this article’s context, African countries. The private sector plays a significant role in changing this narrative by working alongside the public sector to address the complex challenges Africa faces.

Where does the private sector fit in?

While the public sector is responsible for providing healthcare services to the population, the private sector – including private healthcare providers, pharmaceutical and diagnostics manufacturers, health information systems companies, private labs, lab chains, sample transport facilitators, insurance providers, healthcare educators and more – all play vital roles in the patient’s healthcare journey.4

The private sector is relevant to all building blocks in efficient healthcare delivery. As a result, it can be increasingly leveraged to strengthen Africa’s health systems. Working in tandem with the public sector, private stakeholders improve access and fill local and national healthcare provision gaps.4

With the cooperation of private sector stakeholders, governments must establish regulatory frameworks, guidelines and monitoring mechanisms to ensure that public-private collaborations align with the broader goal of improving healthcare access for all Africans.

There is, of course, also the question of private sector profit vs purpose. Private sector partners must maintain profitability while remaining sustainable and transparent. And as private companies are involved in every pillar of the health system, public-private partnerships must be structured symbiotically so that all parties – including patients – benefit.

Driving the healthcare value chain

The private sector has the power to boost economies as part of the greater economic engine, which rings true on many levels. In the diagnostics value chain, for example, there are several touchpoints between sample collection and delivery of results to clinicians and patients. Results from laboratory tests inform 70 percent of clinical decision-making. And new innovations from the diagnostics industry have the potential to impact patient outcomes on a global scale. But these innovations must be able to reach patients.2

If the necessary impact is to be achieved, governments’ investments in diagnostics must be more than just a line item in the budget. These investments will cultivate an enabling environment for access and will attract more private sector investment in return. Many private sector organisations also have the capacity to invest in job creation and capacity building – such as the construction and management of hospitals, clinics and diagnostics centres.

Public-private partnerships leverage the strengths of both sectors, with private entities bringing in funding, expertise, education and management efficiency; and government providing investment, robust regulatory frameworks and access.

Through partnerships with the public sector, private healthcare businesses can extend their reach to underserved populations, leveraging government resources to enhance sustainable service delivery and remain profitable.

The private sector, including pharmaceutical companies and their distributors, play a critical role in ensuring the availability of in vitro diagnostics, medicines and vaccines. Working closely with the public sector to strengthen the pharmaceutical and diagnostics supply chain, these collaborations can combat counterfeit drugs and enhance the availability of essential medications.

Additionally, private sector organisations contribute expertise, resources and funding to support the training of healthcare professionals – particularly in areas with a shortage of skilled personnel. This includes laboratory professionals, who have historically been under-supported in developing country health systems. These collaborations help strengthen the healthcare workforce, enhance clinical skills and improve overall service quality.3

The next steps

As private sector companies, it falls to us to engage with governments to establish regulatory frameworks, guidelines and monitoring mechanisms to ensure that public-private collaborations align with the broader goal of improving healthcare access.

By leveraging resources, expertise and innovation, private entities contribute to expanding infrastructure, improving service delivery and enhancing the broader pharmaceutical and diagnostic value chain, promoting technological advancements and supporting capacity building at local and national levels.

Addressing the complex healthcare delivery challenges in Africa is a responsibility – or a duty – that cannot be shouldered by governments alone. With continued collaboration and ongoing strategic partnerships, the private and public sectors can work together to bridge healthcare gaps, improve health outcomes, and create a sustainable healthcare ecosystem in Africa.

References:

Value of Clinical Labs

Kaboru, B. B. (2012). Uncovering the potential of private providers’ involvement in health to strengthen comprehensive health systems: A discussion paper. Perspectives in Public Health, 132(5), 245-52. Retrieved from