Opportunities and Models for Increasing Impact by Collaborating with the Private Sector in Health

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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