Global Health Systems Are Cracking: Can Public-Private Partnerships Offer A Solution?

Ambitions around public health are central to the United Nations Sustainable Development Goals (SDGs). Targets for 2030 include providing universal health coverage (UHC) and eliminating the epidemics of HIV/AIDS, tuberculosis, malaria and neglected tropical diseases (NTDs). Such an agenda would be a monumental feat even under the best of circumstances, and experts now worry the novel coronavirus pandemic will put the achievement of these health goals — and the rest of the SDGs — in jeopardy.

“COVID-19 is driving us even farther off-course from achieving the vision and promise of the 2030 Agenda for Sustainable Development,” U.N. Secretary-General António Guterres said at the World Health Summit, an annual global health conference. 

Beyond the direct risks presented by the coronavirus, measures to control its spread are disrupting global and local health systems — putting millions at risk and hindering progress on health-related SDGs. Still, even in the midst of the pandemic, we’ve seen public and private partners achieve significant gains to advance public health. Africa was declared free of wild polio in August, after a lengthy vaccination and surveillance program led by governments, multilateral health bodies, and private-sector supporters. And last month, the leaders of 194 countries signed on to a global strategy to eliminate cervical cancer as a public health threat.

“We’re at a critical moment,” notes Trey Watkins, executive vice president of global health and corporate responsibility at GCI Health, and former health advisor in the U.N. Secretary-General’s office. “On one hand, we see incredible progress. But on the other, COVID-19 has reiterated that we have to evolve our ways of working and collaborating if we are to truly address some of the world’s biggest challenges.” 

A similar message rang clear from experts at the World Health Summit in October: The piecemeal, largely siloed efforts so far employed to advance public health are no longer enough. A truly collaborative, global effort is needed not only to combat the pandemic, but also to ensure it does not erase decades of progress around health and well-being. 

“Collaboration and innovation are the key ingredients to support countries’ efforts to recover from the COVID-19 pandemic and accelerate progress toward the SDGs,” Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), said at the Summit. 

This cannot be the sole responsibility of the public sector or multilateral bodies such as the WHO. Participation from the private sector — particularly companies in the healthcare industry — is critical, Guterres added. “We need global solidarity every step of the way,” he said. “We must join together as governments, the private sector, civil society and all partners.”

Public-private partnerships can strengthen multilateral efforts, even when government support is found wanting 

Expert calls have not fallen entirely on deaf ears, as a record number of collaborative funding and programming initiatives launched in recent months to coordinate a global pandemic response. 

The Access to COVID-19 Tools (ACT) Accelerator, for example, brings global partners together in a first-of-its-kind effort to accelerate development, production, and equitable access to COVID-19 tests, treatments, and vaccines. 

For the first time, the WHO opened up funding channels to private individuals, corporations and institutions anywhere in the world through the COVID-19 Solidarity Response Fund, created in partnership with the U.N. Foundation and the Swiss Philanthropy Foundation. The fund had raised or committed more than $238 million — and disbursed over $220 million — as of November. 

“Financial accessibility is one of the biggest barriers to health, both in the U.S. and abroad, particularly for marginalized groups,” said Loyce Pace, executive director of the Global Health Council and member of U.S. President-elect Joe Biden's COVID-19 Advisory Board.  “Financial access and inclusion has to evolve from traditional corporate responsibility or philanthropy to a better way particularly in the age of COVID-19.”

To fulfill their responsibility to meet the moment, healthcare companies in particular must combine their capital with relationship-building that allows for the sharing of innovation and resources, both locally and at scale. 

For example, the Medtronic Foundation is leveraging its own network of nonprofit and government partners to maximize impact and scale during this historic time. 

"We’ve looked at how we can support the public-sector response through nonprofit partners that have existing relationships with governments,” Jessica Daly, director of global health for the Medtronic Foundation, told TriplePundit. “But we also looked at scale: How could we really contribute to efforts that were happening at scale?” 

In addition to pledging capital to the WHO Solidarity Response Fund and the CDC Foundation, the Medtronic Foundation partnered with the WHO and CDC directly to place and activate funds in areas at greatest need. “It's been important for us to plug into existing platforms and then to also support coordinated public-sector actions so that we could be complementary and leverage the strength of our resources,” Daly said.

A six-year veteran of the Medtronic Foundation, Daly previously led partnerships for the CDC in areas such as HIV/AIDS prevention and the Ebola crisis in West Africa, so she understands what’s possible when the public and private sectors break down silos and come together. “I've seen from both perspectives — the perspective of the private sector and the perspective of the public sector — how much they need each other and the power of a strong collaboration, which is sometimes difficult to achieve and easier said than done,” Daly told us. 

“In the case of an emergency or a pandemic, you need to be able to move with speed and agility,” she continued. “Sometimes the public sector is constrained in their ability to act quickly and to be nimble and flexible with their resources. At the same time, those simple, flexible, private-sector resources can't reach the scale and sustainability that the public sector can. When these are able to come together, it really shows the power of collaboration.” 

From response to recovery: Closing gaps in the healthcare system

Calls to “build back better” from the COVID-19 pandemic have spurred national efforts to expand the social safety net and begin to decarbonize economies in the fight against climate change. Similar rallying cries are beginning to spread across the healthcare sector, as stakeholders call for recovery plans that root out and address existing shortfalls within healthcare systems. 

In markets including the U.S., for example, the pandemic has laid bare existing disparities which leave broad segments of the population — namely rural communities, people of color and those with lower incomes — underserved. Overall, people of color continue to be more likely to contract COVID-19 and experience adverse health outcomes, and the American Medical Association — the largest group of doctors in the U.S. — recently recognized racism as a “public health threat.” 

“COVID, in and of itself, is revealing the fractured way which people of color and underserved populations are experiencing healthcare,” Daly said. “Even with a lot of really well-intended efforts, we still haven't been able to make the progress we want to make in reducing disparities. This is where I think the public sector is such a critical collaborator with nonprofit organizations and the private sector …. because we need to make more progress than we've made.”

Similarly, on a global scale, some fear that so-called “vaccine nationalism” — countries refusing to participate in vaccine collaborations or taking steps to hoard vaccines for their own people — could hinder global efforts. “Let me be clear: Vaccine nationalism will prolong the pandemic, not shorten it,” Ghebreyesus said at the World Health Summit. “The only way to recover faster, be it lives or livelihoods, is to recover together.” 

Pace of the Global Health Council agreed. “Who gets treated? Who will have access to treatments and later to a vaccine? This is a very important conversation, and there’s a real opportunity for companies to step out and lead in that way,” Pace said. 

At the World Health Assembly, an annual meeting of global health ministers held in November, Dr. Bruce Aylward, senior advisor to Ghebreyesus, noted key points of progress stemming from the global Access to COVID-19 Tools Accelerator — including the development of rapid tests and life-saving treatments. But he noted that access differs widely across nations and within communities, warning the discrepancies could worsen without “urgent action” to close the ACT-Accelerator’s $4.5 billion financing gap.

The ways in which companies, nonprofits and communities come together on a fix could prove to be a testing ground for future collaborations around public health, and stakeholders already have examples to follow. 

“The world is changing, and communities are demanding more of us than ever,” Watkins reiterated. “In the face of nationalism and inequity, we must unite in solidarity and purpose to nurture meaningful engagements and identify sustainable solutions.”


This article series is sponsored by GCI Health and produced by the TriplePundit editorial team. 

Image credit: arrowsmith2/Adobe Stock