Published on Investing in Health

Fostering health care in emerging economies takes partnership

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vaccines being prepared Partnerships between public, private, and not-for-profit sectors can help countries achieve their health goals, including ensuring stable supply chains and local production of vaccines and other health products. Copyright: IFC/Anindito Mukherjee

It is time for the global community to get back on track with its health care goals. The COVID-19 pandemic diverted many positive steps that the world was taking towards universal health coverage. It revealed weaknesses in global health systems: Supply chains faltered and access to new vaccines and needed advanced medical equipment was limited. Now more than ever, fundamental changes are needed to build more resilient health systems that include innovations and offer affordable quality care to everyone, especially for the most vulnerable and during times of crisis.

Meeting the challenge requires better partnerships between public, private, and not-for-profit sectors so we are ready to face today’s complex health care environment.

Private sector collaborations

While most health care services are provided by the public sector, the role of the private sector is growing in many countries. In sub-Saharan Africa, for example, for-profit hospitals and other businesses deliver 35% of outpatient care, according to the World Health Organization (WHO). An additional 17% is delivered by healers, nurses, and drug sellers, who may offer the only health care option in rural and disadvantaged areas. Private health care does not only help relieve overcrowded or limited public systems, it can provide the medical innovations that improve patient care.

For the private sector to best contribute to national health goals, governments need to integrate it into public health strategies while ensuring equitable access to health care services.  What we have seen is that governments that are taking steps to implement universal health coverage goals can do more in partnership with private health providers. For example in Egypt, the government, IFC and the World Bank are closely collaborating to support the country’s new health insurance system. One goal is to identify where and how the private sector can be deployed to best provide services that expand access to quality care. We see this as a potential model for collaboration elsewhere.

Broad social benefits through partnerships

The pandemic showed us that many health systems are only as good as their local health care services capacity, capabilities, and supply chains. Creating resilient and self-reliant health systems requires ensuring stable supply chains, which in some cases means local production of drugs, vaccines and other health care products. For example, we learned in the scramble for COVID-19 vaccines that efforts must be made to expand Africa’s life sciences sector. The need is urgent. Africa is the market for about a quarter of the world’s vaccines, but it produces only 1% of the vaccines used there. Moreover, with only 375 drug makers and more than a billion people, the continent imports over 75% of the drugs its people need.

A partnership between IFC, the Institut Pasteur de Dakar (IPD), and other development finance institutions is aimed at boosting vaccine capabilities in the region, helping Africa meet its goal of 60% vaccines regionally made by yea r 2040. In South Africa, IFC helped form a consortium of 9 investment groups and development agencies to team up with vaccine maker Biovac to expand COVID-19 vaccine and multi-vaccine capacity.

Efforts like these don’t just advance long-term health security. They also advance the economy more generally, attract skilled talent to the region, boost tertiary education to ensure students are employable in these industries, and support more reliable supply chains that in turn contribute to more advanced manufacturing that underpins economic development.

The future of partnerships

Besides the private sector, governments should look to collaborate more closely on health care with not-for-profits and global health agencies. The goal of partnerships is to provide better quality, affordable health care to all citizens. The newly established Pandemic Fund, for example, is leveraging public and private resources to help countries better prepare for future health emergencies. Similarly, the Coalition for Epidemic Preparedness Innovations has brought together partners to fund ongoing research into rapid vaccine development. The goal is to respond to new diseases within 100 days.

The best partnerships require strong institutions, sound governance, and senior management with significant experience in multiple sectors. That’s where the World Bank and IFC can provide guidance on best practices from both the private and public sides and help governments manage the complexities of successfully expanding national health strategies by developing more public-private partnerships.

No single partnership model will work for health care in every region or market. Approaches must be country specific. However, the fundamental principle remains. Health systems work best when they draw on the strengths of different partners. Given the tremendous need for health services and medical supplies, partnerships can play a critical role in making health systems resilient and affordable. 


Farid Fezoua

Global Director Health and Education, International Finance Corporation/World Bank Group

Juan Pablo Uribe

Global Director, Health, Nutrition & Population and the Global Financing Facility, World Bank

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