Bringing the Private Sector to Public Health: How Business Innovation Can Improve Health Care Access
What does scalable innovation in global health look like?
It could be a piece of software that provides faster access to blood supplies in Cameroon, an m-health platform that links virtual health coaches to people facing chronic illness in Nigeria, or an app that lets people use points to buy and exchange health products in Senegal, helping them save for out-of-pocket expenses. Or it might be a primary care service that reaches underserved people in India via telemedicine, or a microscope app that can diagnose breast and cervical cancers in remote areas in sub-Saharan Africa, where some 400,000 women die each year because they cannot access screening services.
These initiatives are among the five that took home a first-ever USAID Inclusive Health Access Prize at an event hosted by USAID and Management Sciences for Health at the UN General Assembly this fall. The award recognizes effective and inspiring solutions that have improved access to health care in low- and middle-income countries. These solutions are locally derived and financed, yet they have potential for broader application. Four of the winners are for-profit companies making significant and sustainable contributions to public health.
The Key Role of Private Sector Health Care Approaches
Engaging the private sector is an increasingly critical theme in global health, and it is because we are realizing that there is no guaranteed way to achieve universal health coverage—broad access to affordable, quality, essential health care—without it. Globally, particularly in rural areas, people often access health care from private providers. Plus, for-profit entities, including entrepreneurs and micro-enterprises, create nine out of 10 jobs in the developing world.
Innovation, as we saw from the Inclusive Health Access Prize winners, often occurs outside of the public sector—but it is still motivated by a desire to achieve health care for all. These solutions boost the reach of the public sector further than we could have imagined. Their success is also due to support from their governments, whether through connections to public services or regulatory oversight. They illustrate a key reality: Rather than ignoring alternative approaches, governments and development professionals must co-opt them, even when they are fledgling innovations.
For decades, global health aid has focused on driving public health efforts. To bring private-sector initiatives into our work, we need to create an enabling environment where new ideas and technology can flourish and endure. That means focusing on the health systems strengthening that we already know how to do well. It also means addressing interrelated factors like human resources, financing and strong governance with appropriate, enforceable policies and regulations, to create a culture of partnership where everyone—from communities to national governments—looks for ways to support one another to achieve ambitious development goals.
How Partnerships Drive Health Care Innovation
We also need to develop diverse, creative partnerships. There are a number of partnership-driven initiatives that have already gone from promise to impact. Partnering with social messaging platforms like Facebook and Viber, UNICEF’s Office of Innovation created U-Report, a mobile app and data gathering platform, which reaches 7.8 million young people in 60 countries, to deliver peer-to-peer education on issues including HIV/AIDS, cholera and Ebola prevention, mental health and bullying, and to relay their health experiences to public leaders.
Creative partnerships can also lead to innovative financing approaches. For instance, the Cameroon Cataract Bond, a pay-for-performance loan launched last year, supports the Magrabi ICO Cameroon Eye Institute to provide free or low-cost cataract surgeries to up to 18,000 low-income people over five years. In its first year, the project screened more than 50,000 people and completed more than 2,300 surgeries. The Overseas Private Investment Corporation (OPIC) and the Netri Foundation financed the bond, and a coalition of outcome funders will pay back investors with interest.
Innovations can come from any actor working locally who identifies a need and an appropriate response. Last year, at Management Sciences for Health, we launched a for-profit company, MedSource, in Kenya. MedSource is a group purchasing organization that helps public and private health facilities and pharmacies purchase quality medicines at optimal pricing, passing along both safety and savings to consumers. MedSource also provides access to business management training and loan resources, strengthening Kenya’s pharmaceutical sector.
Wherever they may lie on the health continuum, we need to ensure that we share the same goals for outcomes with our private-sector partners and monitor our results carefully. Our collective end goal must continue to be high-performing health systems where people have access to accountable, affordable, accessible and reliable health care.
Photo courtesy of Samy Rakotoniaina / MSH.
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