Over the last couple of decades there has been a substantial increase in the amount of Overseas Development Assistance (ODA) being channelled to the private sector to support the delivery of global development goals.
There has also been an escalation in investment in private health facilities via Development Finance Institutions (DFIs) such as the UK’s British International Investment (formerly the CDC group) fuelled by the construction of a narrative positioning the private sector as the only solution to key global health financing and delivery challenges. Additionally, key global health actors, such as the World Health Organisation and the Global Fund to Fights AIDS, Tuberculosis and Malaria (Global Fund), are increasingly focused on engaging private actors and broadening the scope of that engagement across the board.
Civil society organisations have identified several risks and challenges associated with this agenda, including: the lack of safeguards on the use of public resources and the diversion of public resources; insufficient focus on results and outcomes for the most marginalised; insufficient focus on people-centred approaches, human rights and the right to health; a skewed focus on more lucrative types of health services; increased health inequalities; lack of evidence base; poor transparency; and limited accountability.
There is a growing body of evidence to suggest that the increased engagement of the private sector in global health without clear guiding principles focused on increasing access of and quality services for the poorest and most marginalised and is leading to actions that do more harm than good, including undermining public health systems and negatively impacting the most marginalised and vulnerable populations.
WHAT STOPAIDS IS FIGHTING FOR
With our members and as part of international coalitions, STOPAIDS is seeking to define clear principles which drive the private sector’s role in health to reduce inequality and deliver global health goals. We are proud to be part of the International Consortium Against Healthcare Commercialisation. A particular focus area for STOPAIDS advocacy is the engagement that the FCDO’s DFI ‘British International Investment’ and the Global Fund have with private actors.
As outlined in our soon to be published principles document, we believe that Private Sector Engagement in Global Health must:
- Not undermine public healthcare provision
- Be driven by patient centred needs and social accountability for health rather than commercial interests
- Have a demonstrated public health impact, be evidence based and adhere to the principle of equitable access to services
- Have strong transparency and accountability mechanisms in place in line with the principles of aid effectiveness.
- Support and promote human rights, workers’ rights, the rights of women and girls and all marginalised groups.
- Not be used to promote private sector investment in health in countries where there is not effective regulation of the private health sector.
Interested in learning more about this work and joining Working Group? Please contact James Cole (james@stopaids.org.uk).