The Public Health Value of Public-Private Partnership (PPP) in Africa: A personal perspective Prof. Francois-Xavier Mbopi-Keou, Member, UNAIDS Scientific and Technical Advisory Committee Council Member, International Society for Infectious Diseases University of Yaounde I & Cameroon Ministry of Health UNESCO-Merck Africa Research Summit , Geneva, 19-20 October 2015
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The Public Health Value of Public-Private
Partnership (PPP) in Africa:
A personal perspective
Prof. Francois-Xavier Mbopi-Keou,
Member, UNAIDS Scientific and Technical Advisory CommitteeCouncil Member, International Society for Infectious Diseases
University of Yaounde I & Cameroon Ministry of Health
UNESCO-Merck Africa Research Summit , Geneva, 19-20 October 2015
Outline (1)
1. Background
2. The Understanding of Public Health value of Public-
Private Partnership
3. HIV-related Public-Private Partnership and Health
System Strengthening in Africa:
• Contributing to a better understanding and the
Management of STDs interactions : The case of GSK in
the clinical and Biological studies of HIV and HSV
interactions in Africa
• Contributing in strengthening Research & Public Health
labs : The role of PEPFAR, ASLM, WHO, FIND, CDC,
The IDA in this historic change in Cameroon
Outline (2)
• Contributing to equitable access to essential Medical
products and Technologies : The case of Merck Millipore
in the development and Validation of the Muse® Auto
CD4/CD4% Assay in Cameroon
• Contributing to effective access to Health care delivery :
The case of the Mobile Health Units in Cameroon
sponsored by the Cotco Pipeline Chad/Cameroon Project
4. Lessons learned
5. Acknowledgements
1. Background
• Infectious diseases, do compound an already heavy public
health burden and threaten the health and survival of
millions in Africa
• PPP between governments and companies (in cooperation
with additional partners such as donors, technical agencies
and nongovernmental organizations) gain new importance
in extending health services
• This presentation will focus on selected cases of
HIV/AIDS related PPP and health sector strengthening in
Africa
2. The Understanding of Public Health value of Public-
Private Partnerships (PPP)
• PPP refers to :
a) global health initiatives of impressive magnitude (Buse &
Harmer, Soc Science and Med, 2007)
b) Partnership of private companies and development
agencies (Beckman et al, ILO, Geneva, 2005)
c) Business relation of the private sector with public
organizations (United Nations, A frame work for
collaboration, 2008)
d) The privatization of public services and the public-private
mix of health care provision (Evans D, Bull World Heath
Organization, 2006; Seikh et al, Trans R Soc Trop Med
& Hyg, 2005)
3. HIV-related Public-Private Partnership and
Health System Strengthening in Africa
Mbopi-Keou et al. J Infect Dis 1999
Mbopi-Keou & De Mowbray, Lancet Infect Dis 2003
Mbopi-Keou et al. Lancet Infect Dis, 2002
Belec & Mbopi-keou, Lancet, 2012
Contributing to a better understanding and the
Management of STDs interactions : The case
of GSK in the clinical and Biological studies
of HIV and HSV interactions in Africa
* Genital herpes and HIV: deadly synergy
- clinical reactivation of HSV-2 with HIV
- increased shedding of HIV in patients
with symptomatic and asymptomatic genital herpes
* Genital herpes increases the per-contact transmission
of HIV-1
[Gray et al, Lancet 2001]
Journal of Infectious Diseases 2000; 182:1090-6
HSV-2 antibody prevalence and HSV-2 shedding by
HIV-1 status
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
HIV negative (N=221) HIV positive (N=79)
Serum IgG to HSV-2
Genital HSV2 in HSV-2 sero+ve
20%
43%
P<0.0001
(35)
(174)
(73)
(31)
Neutralizing antibodies to HSV
Mbopi-Keou F.X., L.
Belec, Dalessio, J., Gresenguet, G., Mayaud, P.,
Weiss, H.A., Brown, D.W.G., Ashley-Morrow
RL. Neutralizing antibodies to Herpes simplex
virus type-2 (HSV-2) in cervicovaginal
secretions of African women.
Clin Diagn Lab Immunol 2003, 3: 388-393.
•Biological interactions between HSV and HIV
Mbopi-Keou and colleagues, Clinical Microbiology and
Infection 2003, 3: 388-393.
The public Health value of the GSK
HIV/Herpes project
* Assess the burden of clinical disease due to
HSV-2 in different settings
* Evaluate the potential of anti-herpetic therapy to
reduce HIV transmission:
- Effect of suppressive therapy on HIV shedding
among dually infected
- Effect of therapeutic treatment for GUD on HIV
* Develop and test preventive interventions
(youth interventions, safe & effective vaccine)
.
Contributing in strengthening Research &
Public Health labs : The role of PEPFAR,
ASLM, UNAIDS, WHO, FIND, CDC &The
IDA in this historic change in Cameroon
• A National Public Health Lab is under construction
• 600 laboratories within the central, regional and district
levels that are enrolled in and actively implementing basic
quality assurance systems
• 595 laboratories enrolled and actively participating in the
national Proficiency Testing program for HIV testing.
• 9 labs have gone through external audit by SLIPTA
certified auditors for accreditation
• Cameroon has 7 trained ASLM certified SLIPTA Auditors
who provide support to other countries across the continent
Contributing to equitable access to essential
Medical products and Technologies : The case
of Merck Millipore in the development and
Validation of the Muse® Auto CD4/CD4%
Assay in Cameroon
Background
The 2010 WHO revised guidelines for scaling up ART in resource limited countries emphasized the need of immunological assessment based on CD4 enumerationand HIV viral load