Global governments faced with the practical and strategic challenges of the United Nations' 2030 strategic goal are asking – how it can achieved and who can help them?
The global picture of public private partnerships (PPPs) in healthcare is tipping on its head. Following more than 15 years of expansion and innovation in high-income health systems, enabling in some markets the largest renewal of healthcare infrastructure in their history, PPP appears to be a declining force. At the same time, health systems in Asia, Africa, Latin America and the Middle East are gearing up for their own unprecedented expansions in access to care. Universal health coverage (UHC) is an idea whose time has come, and governments around the world are looking to how private sector partners can contribute investment and skill to help them achieve it.
For governments and citizens, PPP offers one way of containing the seemingly ‘bottomless pit’ of UHC’s potential costs, by capping commitments into the long term and leveraging ultra-lean models of care provision. For the private sector, UHC-focused PPPs offer the opportunity for large-scale projects in healthcare markets experiencing levels of growth not seen in the West for a generation. The ultimate goal of both is a ‘triple win’ of countries getting:
Yet the challenge of making this relatively complex contracting mechanism work in the most complex of sectors is considerable. Countries will need to learn the lessons of the past where PPPs sometimes failed to achieve the desired results, including:
Low- and middle-income countries will not only be content with learning from the past, however. They are also showing that they have something to teach mature health systems about the possibilities and potential of PPP for health system development. While much of the initial focus of UHC PPPs will be traditional hospital estate and equipment deals, we will also see innovation, with new forms and applications of PPP springing up from emerging economies, including:
The success or failure of PPP in helping to achieve UHC will stand or fall on the ability to combine the lessons of the past with the creativity of the future. This report concludes with six insights from KPMG’s most experienced global leaders on what this means, practically, for countries on the ‘health for all’ path: