Health expenditures are rising – but government funding has stalled, and personal spending is filling the gap. A June 2019 World Bank report, for example, found people in developing countries, including the Caribbean, spend half a trillion dollars (over $800 per person) annually on out-of-pocket payments.
Universal health coverage (UHC) is about ensuring all individuals and communities have access to the healthcare they need. UHC does not mean healthcare is free, but that personal out-of-pocket payments do not deter people from using health services, and that people are protected from “catastrophic health expenditure” (i.e. spending more than 30% of their household income on health).
The private sector has enabled better health for communities and individuals. It provides services ranging from hospitals, clinics and laboratories to drugs, vaccines and diagnostics to ancillary services like ambulances and insurance. It contributes to advances in technology, governance, research and development, workforce development and capacity building. In many developing countries, the private sector plays an enormous role in the provision of health services, such as in India, where 70% of services are provided by the private sector.
The private sector, alongside all UHC stakeholders, has a key role to play – but all too often, the sector’s involvement is fragmented. This needs to change.
What is the World Economic Forum’s Sustainable Development Impact summit?
It’s an annual meeting featuring top examples of public-private cooperation and Fourth Industrial Revolution technologies being used to develop the sustainable development agenda.
It runs alongside the United Nations General Assembly, which this year features a one-day climate summit. This is timely given rising public fears – and citizen action – over weather conditions, pollution, ocean health and dwindling wildlife. It also reflects the understanding of the growing business case for action.
The UN’s Strategic Development Goals and the Paris Agreement provide the architecture for resolving many of these challenges. But to achieve this, we need to change the patterns of production, operation and consumption.
The World Economic Forum’s work is key, with the summit offering the opportunity to debate, discuss and engage on these issues at a global policy level.
The new UHC2030 Private Sector Constituency statement outlines seven ways the private sector can contribute to achieving UHC by 2030:
1. Offer quality products and services that consider the needs of all people, including poor and marginalized populations, and make these affordable, accessible and sustainable.
The private sector is a major provider of products and services in most countries. For example, Allied World Healthcare (AWH), a social enterprise empowering rural and remote communities in South-East Asia, provides custom digital platforms to local peer workers so they can collect comprehensive individual health data and create a health profile for the community. This led to provision of free vitamin A supplements to 1,211 infants (6-11 months of age) and 7,714 children ages 12-59 months.
GSK, one of the world’s leading vaccines companies makes vaccines available in a sustainable and affordable manner using a tiered pricing policy in which prices are linked to the country’s ability to pay. In partnership with Gavi, the Vaccine Alliance, GSK ensures Gavi-eligible countries get the lowest prices and has committed to provide Gavi with more than 850 million vaccine doses at reduced prices to help protect 300 million children in developing countries by 2024.
The self-care industry is focusing on creating high-quality products to ensure primary healthcare is available to all. The Global Self-Care Federation members develop digital healthcare innovations to drive insights and accelerate healthcare without costly and time-intensive consultations. The goal is to make healthcare more affordable, more accessible and, therefore, more sustainable.
2. Incorporate UHC principles, including leaving no individual behind, in core business models and objectives.
To develop resilient and sustainable health systems, it’s critical to think long-term. Novo Nordisk, a leading global healthcare company, established the Changing Diabetes® programme in 2009 to provide care and lifesaving medicine for children with Type 1 diabetes in low-and-middle income countries. Currently, 14 countries are enrolled in the programme and it has reached more than 25,000 children and young people with the disease. This success also demonstrates the importance of public-private partnership between various actors in UHC, with the involvement of the International Society for Pediatric and Adolescent Diabetes (ISPAD), the World Diabetes Foundation, Roche alongside Novo Nordisk.
As another example, Fullerton Health delivers affordable and accessible care across the Asia-Pacific region with Project Big Heart, which provides free consultations and medication to elderly and underprivileged Singaporeans, targeting identification and treatment for chronic diseases such as hypertension, diabetes and high cholesterol.
3. Develop, test and scale innovative business models aligned with UHC goals.
Innovation can happen on many levels, especially in approaches that drive greater and more equitable access, quality and sustainability of health products and service offerings. Philips and Amref Enterprises, in partnership with Makueni County Government in Kenya, are testing an innovative model for primary healthcare delivery in three clinics. Serving over 20,000 people, this intervention has vastly improved the quality of services, utilization, enrollment in national health insurance, and will scale up across Makueni to 200 facilities, serving 1 million residents across Kenya.
Accessibility and availability of essential medicines are often absent in many countries, especially in sub-Saharan Africa with dilapidated transport and logistics systems. Absence and inconsistent access to essential product and services which are vital to provide quality care led to the development of Informed Push Model (IPM-3PL).
MSD for Mothers, in partnership with the Government of Senegal, National Supply Pharmacy (PNA), IntraHealth International, and the Bill & Melinda Gates Foundation, piloted and scaled IMP-3PL in Senegal with the aim of leveraging the capacity of local private organizations to reduce stock. In less than three years, IPM-3PL reached all public health facilities in Senegal and significantly reduced contraceptive stock-outs. Given this success, the model extended to include essential commodities for maternal health, HIV/AIDS, tuberculosis, malaria and other conditions.
4. Create, adapt, apply and scale innovations.
Private sector innovation is an engine for new products, techniques and insights, with the ability to improve healthcare, strengthen health systems and increase efficiencies. Sumitomo Chemical invented the first long-lasting insecticidal mosquito nets (LLINs), which are highly effective at preventing malaria. Vector control, primarily LLINs, were responsible for an 81% decline in malaria cases by 2015. Sumitomo Chemical continues to innovate new vector-control tools to fight insecticide resistance.
In Aragonda Village, located in the Chittoor District of the Andra Pradesh in India, Apollo Hospitals Enterprise provides accessible, affordable, sustainable and quality healthcare to over 70,000 people through Apollo’s Total Health Program (THP). It integrates all components of the healthcare ecosystem including delivery, skilled workforce, health communication and technology, quality assurance mechanisms and a strong monitoring structure. THP fosters innovative partnerships for activities including provision of safe drinking water, nutrition and sanitation facilities.
5. Help strengthen the health workforce, responding to local context, priorities and needs.
GE Healthcare’s Primary and Referral Care initiative is an innovative and sustainable health delivery approach to strengthen primary care, an essential step towards attaining UHC in Africa. This involves training and capacity-building of local healthcare workers to improve access to quality and affordable essential health services and better health outcomes – and has already trained over 1,500 workers.
With communication difficulties across the globe, especially in sub-Saharan Africa, Takeda, in collaboration with Elewa Cancer Foundation, educates primary care professionals in Kenya to provide knowledge for comprehensive cancer control and care. This approach translates into more timely diagnosis, referral and effective management of cancer patients.
6. Contribute to efforts to raise financing available for UHC.
Contributing to innovative finance models and tools can articulate the business care for investing in health, specifically UHC. The Pfizer Foundation, in partnership with M-TIBA, launched a Health Financing App Partnership in Kenya to help Africans without health insurance save money on health expenses. Using M-TIBA’s platform, users save and send money that can only be spent on services at qualified, licensed and approved healthcare providers. The app also provides monetary incentives for saving a certain amount of money each month. App users have already paid approximately $6.7 million in medical expenses.
Also, in partnership with M-TIBA, Sanofi run a mobile healthcare platform connecting patients, payers and providers through a mobile health wallet, Ngao ya Afya “Shield for Health”. This platform generates unprecedented amount of data, which enables transparency on cost and outcome of care. It also provides real-time feedback to patients, providers and payers to improve the value of care.
Financing Sustainable Development
The world’s economies are already absorbing the costs of climate change and a “business as usual” approach that is obsolete. Both scientific evidence and the dislocation of people are highlighting the urgent need to create a sustainable, inclusive and climate-resilient future.
This will require no less than a transformation of our current economic model into one that generates long-term value by balancing natural, social, human and financial conditions. Cooperation between different stakeholders will be vital to developing the innovative strategies, partnerships and markets that will drive this transformation and allow us to raise the trillions of dollars in investments that are needed.
To tackle these challenges, Financing Sustainable Development is one of the four focus areas at the World Economic Forum's 2019 Sustainable Development Impact summit. A range of sessions will spotlight the innovative financial models, pioneering solutions and scalable best practices that can mobilize capital for the the world's sustainable development goals. It will focus on the conditions that both public and private institutions should create to enable large-scale financing of sustainable development. It will also explore the role that governments, corporations, investors, philanthropists and consumers could play to deliver new ways of financing sustainable development.
7. Engage in, build, and champion policy dialogue and partnerships with government and other stakeholders.
To achieve UHC, it’s important to identify shared objectives and collaborate on shared outcomes. The partnership between the World Economic Forum, Novartis and Harvard Medical School Center for Primary Care is an example of a public-private partnership to strengthen and transform primary care in Vietnam. The partnership ensures a coordinated approach to fragmented health investments and initiatives, and could help the country meet its goal of UHC by 2030.
To ensure no one is left behind, Mission & Co, a platform for technology-driven solutions and partnership to achieve the Sustainable Development Goals (SDGs), developed Health in Your Hands, an initiative focusing on last-mile solutions. True to its name, the initiative places the health in the hands of patients and healthcare providers to deliver affordable services to low-resource communities.
What's ahead
UHC remains an aspiration for many countries, and it cannot be achieved unless we recognize how the private sector has contributed to and continues to accelerate and amplify efforts towards improving health for all. When world leaders gather at the United Nations in New York on 23 September to reaffirm their commitment to UHC by 2030, they must acknowledge the crucial role of partnerships for shared outcomes – and must engage the private sector.
The World Economic Forum, the international organization for public private cooperation, hosts the Private-Sector Constituency of UHC2030. The UHC2030 Private-Sector Constituency is the convening platform for private sector entities wishing to exchange and collaborate on universal health coverage. The Constituency accepts new private sector members every three months. For-profit private entities that are directly working on strengthening health systems can apply.
