Public-Private Partnerships -Selected Experiences in the Western Pacific & Cambodia- National Forum on Public-Private Partnership in Health 7 November, 2012 Dr. Pieter JM van Maaren Representative, World Health Organization in Cambodia

PPP by categories, range of partnership & funding Source: Global Strategy for Women’s and Children’s Health, p.20

Objectives of Public-Private Partnerships Developing a product e.g. International AIDS Vaccine Initiative. Distributing a donated or subsidized product e.g. initiatives to distribute leprosy medicines (WHO-Novartis) Strengthening health services e.g. Eli-Lilly WHO partnership to address multi-drug resistant TB

Other PPP examples Public sector programmes with private sector participation: Roll Back Malaria, Safe Injection Global Network, and Stop TB Partnership Global Alliance for Vaccines and Immunization Legally independent “public interest” entities: Global Fund to Fight HIV/AIDS, TB and Malaria

PPP Health Experiences in the Western Pacific Public-private mix in Tuberculosis Control – Philippines Malaria- Public Private Mix (PPM) for Malaria Diagnosis and Treatment in Lao PDR Health services contracting in Papua New Guinea under the Partnership Model (Churches & Faith-Based Organizations) Cambodia: Policy direction, Regulation and licensing of public and private health care professionals, facilities & pharmaceutical outlets

Public-Private Mix DOTS (PPMD) in Philippines: >10% additional TB cases detected & treated By 2009: > 200 PPMD units established and operational Over 7000 private physicians trained Through PPM approach 11% additional TB cases identified in areas implementing PPM

1.Increasing access to diagnostics and treatment for the population, through private sector 2. Increasing quality of service in private sector, especially regarding adherence to treatment guidelines 3. Enhancing comprehensiveness of malaria case reporting & data, by including private sector PPM objectives for Malaria Diagnosis and Treatment in Lao PDR

Malaria Diagnosis in public & private sectors

9 PNG Health Partnership Model

1.NDoH is a steward of the unified system. 2.Health Partners: NGOs, churches, international NGOs, industry groups and the private sector 3.Government policy sets principles for partnership arrangements 4.Guidelines for contracting the provision of services (outputs) – both for for-profit and non-profit organizations 5.Consistency with the national health plan & no duplication 6.Capacity and accountability, focus on quality 7.Contribution to universal access, equity and sustainability 8.Priority on the needs of vulnerable groups 10 PNG Health Partnership principles

PPP in the Health Strategic Plan Promote effective public and private partnerships in service provision based on policy, regulation, legislations, and technical standards” through: Use of contracting and Special Operating Agency (SOA) Development and implementation of an accreditation system Strengthening joint planning between public and private sectors and coordinated HIS and surveillance reporting Reinforcing implementation of health laws and regulations

Regulation of Health Professional Education in Cambodia: Example of mutual advantage National Exam: dialogue through national committee, clear standards for graduates, capacity building opportunities through preparation of written and clinical exam

Lessons Learned for Public/Private Partnerships Importance of working to mutual advantage Need opportunities for strategic dialogue to create joint understanding, such as this PPP Health Forum Overlap between public and private creates conflicts of interest and silences dialogue Few formal representative bodies of private sector which makes dialogue difficult Policy imperative for management of PPP to ensure Universal Coverage, Universal Access and Quality Services

Future for PPP in Cambodia: Cambodia Mid-Term Review HSP  Achieve Universal Coverage and Primary Health Care service through a pluralistic health system  Strengthen regulatory frameworks for private & public providers (e.g. registering and accreditation of clinics, laboratories, hospitals and practitioners)  Strengthen regulatory frameworks for private income within the public sector (e.g. user fees & financial incentives)  Reduce out-of-pocket and catastrophic health expenditure through social health protection mechanisms

Cambodia Mid-Term Review HSP (continued) Capacity development for contracting in SOAs, Public Administrative Enterprises and the evolution of new Social Health Insurance institutions Strengthen joint planning between public and private sectors and coordinated surveillance and HIS Develop and reinforce implementation of public health laws and regulations Develop policy for private / public research agenda

Regular meetings with presentations to increase understanding about private sector engagement: Malaria, TB, Health Professional Councils Health Forum for further understanding: learning from international experience Dialogue and information sharing also at Pro TWGH level; next stage reporting Disseminate Government policy and existing regulation Needs to expand membership to the for profit private sector 16 Cambodia sub-TWGH for PPP/ IHP+: progress and plans

PPP Health Forum: Seeking Public/Private Mutual Advantage Investment in mutual dialogue for achieving Universal Coverage for the Cambodian Health Service Share implementation experience and plans; nationally and regionally Disseminate government policy, strategy and regulation Learn from private sector: creating demand; environment needed for quality service provision Mutual capacity building gains: training, information, communication structures

THANK YOU