The rising burden of non-communicable diseases and the chronic pressure being placed on healthcare systems are two forces that can barely be contained in today’s modern world. Around 70% (40 million) of global deaths in 2015 were due to non-communicable diseases.
As the needs and expectations grow for better health care services, most countries are blighted by under-investment in healthcare infrastructure and are facing serious resource constraints. Funding, access to innovation and technology, and efficient health care management are all in short supply in developing countries.
Universal Health Coverage for all (UHC), one of the targets under Sustainable Development Goal 3 (Ensure healthy lives and promote well-being for all at all ages), includes financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines. Essential health services include reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases and service capacity and access, among the general and the most disadvantaged population.
In order to cope with the double burden of more diseases and resource shortfalls, healthcare systems badly need to be redesigned, making use of innovations in technology, IT and business and financing models.
In most developing nations primary healthcare is a public service that is largely funded by the government – and supported through private donations. Governments spend most of their healthcare budgets on operational expenses, especially salaries, and are not able to raise the required investment capital.
There are ample opportunities to develop new models of health delivery and make primary healthcare an enticing investment target for investors. Private capital and expertise are increasingly seen as a way to engender efficiency and innovation and governments are looking to the model to solve larger problems in areas such as care delivery and wellness.
The International Financial Corporation (IFC), offers investment, advisory, and asset management services to encourage private sector development in developing countries through the World Bank and long-term, risk-sharing arrangements between government and private entities. No two partnerships are the same, but the reward Philips has seen from partnerships in South America and Asia illustrate how new Public Private Partnership (PPP) models are building bridges toward UHC and bringing much-needed equipment, expertise and healthcare services to those who need it most.
Enhancing imaging capabilities in India
HealthMap Diagnostics Private Limited, a joint venture between Manipal Health Enterprises Private Limited and Philips India Limited, is running two successful PPP projects in diagnostic imaging. The first was signed in 2015 with the government of Haryana for providing radiology services (CT and MR) for eight centres – four district hospitals and four medical college hospitals and there are now four more centres in the pipeline in Panipat, Kaithal, Jind and Kurukshetra. The Rohtak centre in Haryana is one of the busiest centres under this PPP, doing more than 100 scans per day. HealthMap picked up its second PPP project in Jharkhand for all 24 districts. It is now operational in six locations. The technology spans from basic radiology like ECG, X-ray, and ultrasound to high-end CT and MR.
Bringing imaging access to remote Brazil
IFC funding supported Bahia state government’s PPP initiative to provide imaging and diagnostic services and facilities across the state. As a province in Northeastern Brazil, Bahia has insufficient or limited technology and coverage to supply the local healthcare demand. The healthcare infrastructure is not uniformly-developed and in addition to a chronic shortage of health care professionals, confidence in the healthcare system in Brazil is low. As part of a consortium consisting of Philips do Brasil, Alliar (one of the largest diagnostic-medicine networks in Brazil with over 30 health facilities that offer patients image-based diagnostic exams in cities throughout Brazil) and FIDI (the largest diagnostic-medicine operator that provides services to SUS, the Brazilian public healthcare system), Bahia has had more than $40 million in private investment in operating equipment and infrastructure, leading to improved access to high complexity tests for underserved areas in both the capital and the countryside. Currently, more than 28,000 exams are being performed each month through this PPP to serve patients with the best quality of care.
The lessons we have taken away from such partnerships are good lessons for private entities embarking on a PPP arrangement – in any partnership there are going to be teething problems as processes get established between two overtly complex organizations. Bringing cutting edge technology to remote corners of the world is reliant also on talent supply, and in that area there are significant challenges.
These obstacles are offset by the rewards – increased access to quality health services goes a long way to addressing UHC and through helping to expand these services and improve quality, we are complementing the traditional public-sector approach.
The challenges we face in healthcare are so vast today, PPPs are seen as an effective way to capitalize on the relative strengths of both sectors to address problems that neither could tackle adequately on its own, in particular for diseases that affect developing countries. The participation of all stakeholders is required to safeguard one of the world’s most precious resources: the health of its people.