Public private partnerships in health: a global call to action

This paper, produced by Health Research Policy and Systems, outlines key challenges in public-private arrangements in health care and makes a Global Call to Action to address these challenges. The author establishes several ethical challenges in public-private partnerships. These include: a lack of global norms and principals, threatened impartiality of health care due to poorly designed partnerships, the risk of abandoning social safety nets for vulnerable groups, and conflict of interest due to ‘for-profit’ demands of the private sector. Other ethical issues consist of redirecting national health policies, fragmentation of the health system, contribution to common goals and objectives, and lack of contributions to improvements in quality and efficiency.

Operational and process-related challenges in public-private partnerships include: legislative frameworks, policies and operational strategies; participatory approaches to decision making; governance structures; power relationships; criteria for selection; sustainability, and accountability. In order to overcome these challenges, the author highlights the need to develop a set of global norms and ethical principles. Such initiatives must be rooted in a ‘benefit to the society’ rather than a ‘mutual benefit to partners’ and should centre on equity in health. Partnerships should also be seen as a process, rather than an outcome, and incorporate third party reviews to ensure transparency.[adapted from author]