TB Public Private Partnerships Opportunity or Risk

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TB Public Private PartnershipsOpportunity or
Risk?
Cheri Vincent Senior Public Health
Advisor USAID June 3, 2008
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USAIDs commitment to PPP

• Strong advocate for Public Private Partnerships
  at all development levels and fields
• developed the Global Development Alliance (GDA)
  in 2001
• - unique partnership to build public private
  alliances
• - gt680 alliances with 1,700 partners at the
  global level
• - leveraged gt 9 billion from public and private
  resources.
• Many more partnerships supported at country/local
  levels.
• USAID Administrator Fore challenged the Agency to
  triple investment in all types of PPPs by the
  end of 2009.

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USAIDs Commitment to TB PPM

• 2001 USAID was one of the first supporters of
  TB PPM activities through WHO
• Global level TB PPM support 4.5 million/yr
  through WHO, TB CAP, Global Drug Alliance, USP,
  RPM, CSHGP TB grants, and PATH TO
• 18 country level TB PPM activities supported
  through various partners.

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Global TB PPM Activities Supported

• Stop TB Partnership PPM Sub working group
• TA to pilot and scale-up TB PPM at the global,
  regional, country level
• Guidance tool development to strategically
  scale-up PPM
• TA to address country level constraints to
  scale-up of PPM
• New drug development and expanded manufacturing
  of 2nd line drugs
• Mobilization of resources for PPM scale-up, e.g.
  GF applications.

Source WHO
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Country TB PPM Activities Supported

• Bangladesh TB/HIV referral linkages with NGOs
  and Blue Star service providers
• Cambodia pharmacy staff traditional healer
  training referral systems
• Ethiopia training and referral systems for
  clinics (private, NGO, work place) and private
  pharmacies and development of medical college TB
  curriculum
• Ghana private sector lab facilities national
  coordination of TB PPM
• Indonesia ISTC adoption and implementation, and
  Hospital DOTS Linkages (HDL) expansion
• Kenya Integration of quality services in private
  facilities (including TB)
• Philippines PPMD expansion, systems
  strengthening, and TB financing mechanisms
• Other countries with PPM activities Djibouti,
  DR, DR Congo, India, Malawi, Mexico, Pakistan,
  Senegal, South Africa, Tanzania, Zambia.

Source USAID FACTS Database
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Success relies on

• Public sector leadership in organization of the
  partnership
• Partnership exploits the comparative advantage
  and unique skill set of its members
• Joint program development of all key
  stakeholders
• Clearly defined responsibilities, risks, and
  resources required of each partner
• Inclusiveness and transparency and
• Appropriate incentives for each partner.

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Lessons Learned for Successful partnerships

• A comprehensive strategic plan to lead the
  partnership is essential
• Designation of a leader responsible for ensuring
  quality and equity of services
• Each partner must provide competent and
  sufficient human resources
• Partners need to be flexible and adapt to current
  and variable situations and environment
• Clear and transparent lines of communication and
• ME system to document baseline information as
  well as progress for advocacy and motivation.

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Challenge Partners may say the same thing but
mean different things.
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Challenge Partners and Beneficiaries have
Biased Perceptions of Quality
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Challenge Ensuring the Quality
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Ultimate Challenge

• Scale-up and Sustain Quality TB PPM

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Opportunities must outweigh the risks
Bottom Line

• Private health care sector has and continues to
  expand rapidly in developing countries.
• People continue to go to secondary care and
  private facilities first, making them an
  essential partner to improve case detection and
  diagnostic delays.

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Together in partnership we are more than the sum
of our parts!
THANK YOU!