PS015 - Public-Private Partnerships: The Human Factor

Under the themes of 'responsive health systems', 'health policy and health system financing' and 'the role of the private sector', this session discussed collaborations between the public and private sector with a special focus on the human factor.

In his introduction, the chair Jean Freymond, Director, Geneva Dialogues, Switzerland, noted that there has been an explosion of partnerships in the last ten years, a phenomenon which is a reaction to the previous health-governance model. These partnerships are now in a 'trial era'. Mr. Freymond is convinced of the need for public-private partnerships to be institutionalized in order to work effectively, and that the human factor in health systems should not be overlooked.

Patrizia Carlevaro, Head of International Aid Unit, Eli Lily and Company, Switzerland, stated that Tuberculosis (TB) kills close to two million people every year. There is therefore an urgent need for sound knowledge among health care professionals as well as patients, not only to provide proper treatments, but also to raise awareness and to engage patients and their families worldwide. In addition to these needs, Patrizia Carlevaro mentioned that we should also work on staff retention.

When public interests are international or global - as is the case with TB - Sally Sandsfield, Executive Secretary, Health Metrics Network, World Health Organization, Switzerland, stressed that "governments are no longer the sole guidance of the public good or interest." They require transnational or supranational intervention. In the absence of a global government or a strong U.N, the new role for the private sector cannot be limited to profit-oriented business. Although the private sector is becoming more important globally in efforts to finance public services, market forces themselves are not the sole solution either. Thus public-private partnerships offer a relevant combination of both.

An example of a successful public-private partnership on Multidrug-resistant tuberculosis (MDR-TB) was given by Patrizia Carlevaro. Eli Lily's partnership is a multi-dimensional, comprehensive cooperation between the pharmaceutical industry, governments, NGOs, international organizations, professional health care associations, academic institutions and the business community to deal with all aspects of the MDR-TB issue, ranging from drug supply to community support.

Although the UN Millennium Development Goals (MDGs) gave us a clear vision of what needs to be achieved for the public and private partnerships, Pascal Villeneuve, Associate Director, UNICEF, Switzerland, also addressed some significant issues to consider. These include the 'governance of partnership', 'performance' and 'human chemistry'.  

Companies or organizations entering into public-private partnerships would not increase the profit on the drugs that they developed. However, neither would they be exposed to financial risk because their partners would collaborate, for example, by paying for the most expensive part of the process: staging large, clinical trials.  

Patrizia Carlevaro refers to this as a 'not-for-profit' but also 'not-for-loss' approach which offers big, indirect pharmaceutical benefits: a good public image, an introduction to developing-countries' markets and to researchers who might help them in other ways. But of course the objectives should translate at the national level and integrate with government policy, Pascal Villeneuve added. He highlighted that effective collaborations need partners and people with some shared goals and values. Successful alliances have to be trust-based, or a matter of 'human chemistry' in relationships.

Following the presentations, there were questions from the floor mainly concerning how to link local community based clinics to the public-private partnerships and how those local clinics can keep and improve the performance of their staff. Sally Sandsfield responded that although high staff turnover is a depressing reality that we have to acknowledge, we are beginning to see effective alliances integrating local clinics and improving their quality, such as 'Health Metrics Network', 'Global Health Workforce Alliances' and recently a G8 health initiative.

Another concern from the floor was how, for example, a small pharmaceutical company can get in touch with potential partnership organizations. Jean Freymond regretted that one of the major problems with international organizations, in this respect, is that it is often not apparent who to contact within them. 

The chair Jean Freymond concluded the session emphasizing that "public-private partnerships should not be an addition, but should be considered as mainstream in tackling global health issues."