Opinion: Achieving UHC in Africa requires focus and collaboration from the private sector

Patients and relatives at the intensive care area of the El Fasher Hospital, North Darfur, Sudan. Photo by: Albert González Farran / UNAMID / CC BY-NC-ND

The Sustainable Development Goals set forth an ambitious target to provide access to quality, affordable health care for all by 2030 — a target that has evolved into a global movement. Yet, each year, 11 million Africans citizens are pushed into extreme poverty because of out-of-pocket health expenses that trap poor households in cycles of catastrophic expenditure, impoverishment, and illness, particularly in countries lacking social protection and health insurance.

When it comes to universal health coverage, the private sector's biggest potential impact lies in increasing business investment and developing scalable market-based approaches.

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2030 is a just over a decade away and now is the time for global leaders to evolve their commitments from agreements and plans into measurable actions that will help us achieve universal health coverage.

Improving access to care in underserved communities in Africa will require stronger partnerships that leverage the unique skills and resources of governments, civil society, and the private sector alike. As donor funding declines and health care costs rise, domestic resource mobilization is a must. In addition, the private sector could be encouraged to invest more in health service delivery and fill a significant part of the UHC financing gap through sustainable business models.

Where the private sector stands to make a difference

When it comes to UHC, the private sector’s biggest potential impact lies in increasing business investment and developing scalable market-based approaches. Companies are willing to invest in innovations, but need to be sure that they can achieve reasonable returns.

The challenge is finding shared-value propositions that unlock private investment while ensuring that the health services they fund are efficient, effective, and affordable. The public sector has a critical role to play in establishing policy and regulatory frameworks that allow for meaningful private sector engagement and accountability, while civil society organizations can ensure that private sector investments benefit communities and deliver quality in health outcomes.

There are five areas where the private sector can add unique value to help achieve UHC:

1. Understanding patients: While civil society and governments understand citizens, the private sector has the unique ability to understand patients as customers, pursue customer satisfaction, and accelerate the consumer-centric healthcare transformation that impacts the organization of care.

2. Implementing innovations at scale: The private sector has the global footprint, networks and solutions to deploy innovations at scale and do so quickly.

3. Designing the right business models: Private sector players such as banks, private equity firms, and health technology companies bring diverse perspectives on innovative business models and risk sharing.

4. Building government capacity: The private sector can complement and strengthen the governments’ capacity through the merging of capabilities in public-private collaborations. In order to be successful, both parties have to share common values and potential risks.

5. Innovating to meet local needs: In low-resource settings, innovations can be driven by private sector startups and small- and medium-sized enterprises to create solutions that meet the needs of the community.

Where transformation needs to focus

Innovative solutions should be intuitive and allow the caregiver, regardless of their location, to focus on caring for the patient — not the technology. A challenge as large as UHC requires focused efforts in strengthening primary and community care, as well as developing digital products and optimizing care delivery as solutions that could radically transform health care.

What does this look like in practice? One example is Kenya’s SDG Partnership Platform — a multistakeholder initiative chaired by the United Nations, the Kenyan Ministry of Health, and counties — which aims to unlock $1 billion of investments in primary care to support Kenya’s national ambition of achieving UHC by 2022. The platform allows for public and private sectors, as well as civil society, to engage in shared-value partnerships that leverage the skills and capabilities of each organization.

Under this umbrella, Philips and Amref Health Africa are working closely with the Makueni county government on the improvement and management of public primary care facilities. The innovative partnership aims to improve the quality of care, expand services to include treatment of NCDs, and reorganize the referral chain using a sustainable business model that leverages Kenya’s National Hospital Insurance Fund. Following successful trials in select facilities, this model will be scaled and implemented throughout Makueni county and potentially beyond.     

Value-based care: The way forward

For locally relevant innovations to take off, we need new business models that bring together donors and impact investors, governments, NGOs, and the private sector. Public-private partnerships, managed equipment services, social franchising, results-based financing, and other hybrid business models can help increase the potential to deliver on the SDGs and implement programs that drive real outcomes for patients.

Moving the needle on UHC will require that public and private players share innovative ideas and form durable partnerships. Platforms such as UHC2030’s Private Sector Constituency, convened by the World Economic Forum, ensure that the private sector is represented in the collective movement for UHC, and critically, provide opportunities for the private sector to support UHC delivery.

Forum’s such as this year’s Africa Health Agenda International Conference in Kigali, Rwanda, and the upcoming U.N. high-level meeting on UHC, will galvanize health leaders, innovators, and the private sector to redouble our collective efforts to realize universal health coverage by 2030 — with the aim of increasing quality of life for each and every person and building human capital for the prosperity of all.

Update Jan. 10, 2019: This article has been updated to reflect that the Africa Health Agenda International Conference will take place this year in Kigali, Rwanda.

Devex, with financial support from our partner MSD for Mothers, is exploring how the private sector is driving innovations in global health. Visit the Focus on: Future of Health Partnerships page for more.

About the authors

  • Carla kriwet

    Carla Kriwet

    Carla Kriwet is executive vice president and CEO of the Connected Care businesses at Philips, as well as a member of the Royal Philips Executive Committee. A passionate advocate for patients and caregivers, Carla cares deeply about how digital innovation can radically change care delivery inside and outside the hospital, improving clinical and operational outcomes. With more than 20 years of experience in medical devices and other technology companies, Carla has a successful record of achieving ambitious targets and leading organizations through transformations. A former aid worker in Burundi, Carla is dedicated to furthering the way connected health technologies are expanding global access to primary care. She chairs Philips Community Life Centers program which bring appropriate, leading-edge technology to remote healthcare centers.
  • Githinji gitahi

    Githinji Gitahi

    A passionate advocate for a pro-poor universal health coverage, Githinji Gitahi joined Amref Health Africa as the group chief executive officer in June 2015. Amref Health Africa, founded in 1957, is the largest African-led international organization on the continent and reaches more than 9 million people each year through 150 health-focused projects across 35 countries. Gitahi is also co-chair of the UHC2030 Steering Committee, a global World Bank and World Health Organization initiative for universal health coverage.