opportunities and models for increasing impact by collaborating with the private sector in health
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Opportunities and Models for Increasing Impact by Collaborating with the Private Sector in Health
Camille Saadé, Halima Mwenesi and Christian Winger
January 26, 2011
Camille Saade
Halima Mwenesi
Christian Winger
Objectives
• Familiarize audience with FHI 360 private sector skills, resources, capabilities and experience
• Role of private sector in increasing scale and sustainability of health programs
• How can we incorporate public-private partnerships (PPP) into existing and future projects
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Importance of Private Sector in Health
Bill Gates, November 2011Cannes G20 Summit
‘…the role the private sector plays in fighting poverty and improving livelihoods is more critical and profound than ever.’
‘The private sector is the
primary driver of economic
growth’
Rajiv Shah, December 2011New Delhi, India
Bringing the Private Sector in …
“ …we can create a hospitable enabling environment and develop creative incentives to encourage the private sector to engage more deeply on development challenges.” Bill Gates, November 2011
Innovation With Impact: Financing 21st Century DevelopmentA report to G20 leaders, Cannes Summit
An Enabling Environment - Examples
• Policy– Clear yet flexible to embrace private sector-i.e.
flavored ORS, or zinc in any form (tablet or syrup)• Regulations
– Fast-track registration of conforming new product– Enforce labeling/ claims to reflect policy– Classification as OTC drug (beyond pharmacies,
outreach distribution, public promotion)• Taxes and Tariffs
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PPP: Enabling Policies are Critical
• Taxes and Tariffs on essential health products– Major barrier to availability and affordability
• Private sector imports less or not at all• Increase price mark-ups significantly
– Double whammy for the bottom of the pyramid
• Non-tariff barriers (or measures)– Customs procedures
What is the Private Sector in Health?
• Commercial – health providers– producers– R&D– product and service providers– Distributors and marketers
• Non-commercial – NGO, CBO, civil society in general– professional associations– universities
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Forms of Private Sector Involvement in Public Health
1) Philanthropy: donations (cash, products)2) CSR (Corporate Social Responsibility): P&G’s
PuR water treatment, Exxon-Mobil vouchers for ITNs
3) Core Business: Unilever’s PureIt water filter, Vestergaard-Frandsen’s Permanet, Dr. Reddy’s Zinc, Nutriset’s Nutributter, etc.
Which one is sustainable for our target population?
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What Public Health Benefits can be Delivered by the Private Sector?
• Supply of appropriate products and services
• Affordability• At-scale coverage• Marketing cost-
efficiency • Sustainability
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Rich
Poor
A
B
C
D
E
Existing Situation: Inefficient Coverage
Commercial Sector
PublicSector
NGO
Rich
Poor
A
B
C
D
E
Expanding Coverage Through PPP
PublicSector
Commercial Sector
NGO
Supply
“Shall I produce for the public sector or the
private market?
Diversify sources and engaging multiple partners • Technology transfer for local production : ITNs in Ghana,
Tanzania, Nigeria• Create competition - 31 local zinc producers in India, 8 in
Indonesia • In Tanzania, initial public sector supply through UNICEF .
Upgraded local GMP capabilities for government and private market supply
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Access
“But there is no market out there!”
• POU water filter manufacturers targeted only upper-income urban consumers
• FHI 360 linked self-help groups, NGOs, micro-finance institutions and the private sector to create a market for urban and rural poor. (Hindustan Unilever)
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Affordability
“How can I sell to the poor and
still make a profit?”• In India FHI 360 provided different POU products
(chlorine, filters) at different price points to meet demand. Expensive filters preferred by customers were accessible though micro-finance
• Across Africa, NetMark provided ITN vouchers via public sector targeting pregnant women. Vouchers collected via private sector kept leakage to a minimum
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Demand: Health Providers - Formal
• Pharmaceutical marketing: symposium, detailing by medical reps, journal ads, other SBCC materials and use of the cascade approach for formal providers
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Pediatricians
General Practitioners
Drug Sellers
Nurses/Midwives
Opinion Leaders
General Public
Demand: Health Providers - Informal
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• Enlisting NGOs in pharmaceutical detailing to cover 65,000 Rural Medical Providers (RMPs) in Uttar Pradesh and Gujarat
• GIS database - tracking of coverage, purchase and use shared with pharma and NGO partners
Demand: Caregivers
“Yes, but this is costly!”• If medical product direct marketing to caregivers after
providers• Message reflects and reinforces public policy
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Demand: Caregivers (cont)
• Use of appropriate mix: IPC, community activities, in-store promotion (POS), mass media.
• Created demand from caregivers across Indonesia using mass media and PSAs resulting in over 7 million treatment courses sold in 2011 (IMS-Health data)
• http://youtu.be/5xB58B2mpho
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Next Steps
Strategic vision for FHI 360• To be a leader in developing public-private
partnerships for health (and beyond)Our commitment for existing / future programs• What can we do together using PPPs to
increase health impact?
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