Enhancing public-private partnerships – it won't be an “easy walk in the park”

Here’s a wild question. How can governments collaborate more effectively with industry in the midst of a pandemic? Although there is ‘room for dialogue’, it won’t be an “easy walk in the park”, warns Caroline Mbindyo, CEO of Amref Health Enterprise Kenya.

"The government doesn't always trust the private sector. The private sector mostly feels that governments are bureaucratic. Citizens often feel that the private sector is very capitalist.

“How do we continue to collaborate effectively so that [different] sectors can listen to each other? How can the private sector address the needs of the citizens, not just those who are able to pay, but all those who need the services being provided? There is room for dialogue, but I don't see that it's going to be an easy walk in the park.”

Public-private partnerships are key because governments can't solve health challenges on their own. Complex health challenges cannot be solved without a whole-of-society approach, said Mbindyo on Wednesday, at a webinar hosted by Health Systems Global, a Swiss-based network of health researchers that promotes effective public-private engagement to strengthen health systems.

And although governments can be slow to respond to the private sector’s dynamic pace, the industry needs to be actively engaged with authorities, emphasized Mohamed El Sahili, chief vision officer of the privately-owned Medlands Health Services hospital.

“The private sector can't just wait for the public sector to come and engage with you…You [the private sector] are accountable the moment you get into this business, and should not wait for authorities to regulate you.

“Governments are maybe slow, but that is not a reason for us not to engage with them.”

How a private hospital synergized with public authorities during Covid-19 in Zambia. Early on in the pandemic, Covid-19 efforts were mostly led by public authorities in Africa, leaving private healthcare facilities in limbo, said El Sahili. However, Medland Health Services — a private hospital in Zambia’s capital Lusaka — decided to opt for a more proactive approach to help authorities save as many lives as possible, said El Sahili. Here’s how the hospital synergized with authorities:

1. Training of healthcare workers. Even before the hospital’s Covid-19 diagnostics facility was officially approved by Zambian authorities, healthcare workers at Medland Health Services were already trained to detect active Covid-19 infections, using lab-based polymerase chain reaction (PCR) testing. The hospital also developed a training program to address a severe shortage of nurses and lab technicians in the region.

2. Screening & referral. Once Medland Health Services received formal approval to diagnose Covid-19 infections, it offered screening to the local community and developed a referral system to quickly relay Covid-positive patients to public facilities.

“Ever since the first cases of Covid-19 were spotted in the region, we activated our response committee and our campaign,” said El Sahili.

“The federal hospital is now working hand-in-hand with private facilities and with the public sector to support more testing. Screening is also being offered to the general community.”

Effective regulatory frameworks can also enable the private sector to innovate. It is also crucial to allow the private sector to flourish, added Anirudh Rastogi, founder of Delhi-based Ikigai Law, a law firm that advises space missions ventures, cryptocurrency firms, and healthcare initiatives. Some pointers to improve regulation in digital healthcare:

• The government’s job is to lay down broad regulatory principles for technologies, but the "micro-details" need to be left to the private sector, as technology advances much faster than regulations, said Rastogi. Telemedicine guidelines, for instance, should be ‘technology-agnostic’ to prevent them from ‘playing catch up’ with new technologies.

• In other words, the private sector needs to be given some ‘level of discretion’ instead of having to follow guidelines that are too prescriptive or rigid — in the same way that doctors are free to judge each context based on their professional experience, even though they have general guidelines to follow.

“Any regulatory system must enable innovation,” said Rastogi. “Regulatory mechanisms are bound to fail if they are very rigid.”

Pushing legislative change — a shared responsibility. Although governments are responsible for updating regulations, the private sector needs to push reform as well, while also acknowledging that government processes take time, concluded panelists on Wednesday.

“The best that governments can do is to update the regulations [to] facilitate the daily operations” of the private sector, said El Sahili. However, the private sector “has to abide by the existing regulations and push for an update of those regulations” when they are needed.