The advance of private healthcare: The future of healthcare in Africa lies increasingly in a Mixed market approach, as governments look to ease pressure on budgets by entering public-private partnership.

Author:Thomas, David
Position:HEALTHCARE - Conference news

In a crowded United Nations conference room at the height of General Assembly week, ministers from across Africa united in support of an unlikely cause--a bid to boost private healthcare. Rubbing shoulders with the private sector, representatives from Namibia, Botswana, and Togo explained how their countries are enabling the once-controversial arrival of big business in hospitals and clinics.

After years of being left to their own devices as governments toiled on donor-funded public systems, profit-making providers are once again in vogue as governments look for ways to boost mixed outcomes and ease the pressure on ballooning budgets. Healthcare experts say that government scepticism towards private sector involvement is abating as ministers face new disease threats and an uncertain financial outlook.

"In an era where things have opened a bit and there's much more acceptance of the private sector, we can begin to see what the opportunities are," says Pape Gave, chief executive of IntraHealth International, a US-based non-profit that trains health workers on the continent.

"There's severe underinvestment in the training of health workers, and we don't have enough schools. There's an incredible opportunity for people to invest. The epidemiological profile is changing and in Africa we are seeing more non-communicable diseases (NCDs). We need more engagement of the private sector and pharmaceutical companies to deal with these complex issues."

Despite a perception that governments dominate Africa's health systems, the private sector has long been embedded on the continent. A 2008 survey by the International Finance Corporation estimated that around 60% of health care financing in Africa came from private sources, while citizens spent around 50% of the continent's total health expenditure on costly out-of-pocket payments. This inefficient system meant that governments and businesses rarely worked together on well-planned initiatives to promote and deliver sustainable solutions.

Double disease burden

While donor-funded initiatives have slashed deaths from communicable diseases such as malaria and HIV/AIDS, the rise of sophisticated non-communicable 'rich world' conditions such as cardiovascular disease, cancer and diabetes, are forcing a rethink about how the government can utilise private sector expertise to tackle what has become a double disease burden. The World Health Organisation estimates that NCDs will rise by 27% over the next 10 years...

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