Why we should be redefining the private sector's role in global health

The ubiquitous term 'private sector' is used often in global health, yet rarely interrogated with precision.

In practice, the private sector is an omnivorous category. It includes pharma firms, diagnostic suppliers, logistics providers, insurers, AI startups and social enterprises. All these actors have vastly different incentives and proximity to public systems.

That’s precisely why more deliberate and more honest reflection is needed on what private sector engagement in health means.

The label is often used as shorthand: the private sector as funder, implementer or innovator. Funding remains an important contribution, especially in contexts with constrained public budgets. Blended finance mechanisms, such as the Medical Credit Fund in sub-Saharan Africa or the Global Financing Facility's engagement with private capital, have helped unlock investment for infrastructure and delivery. But financing alone doesn’t build resilient systems, and it shouldn’t be the only lens for engagement.

To move from transactional inputs to systemic outcomes, engagement must be rooted in clarity of function, alignment with public priorities and shared accountability.

Much of the innovation that enters global health markets is designed for high-income settings, then adapted, sometimes awkwardly, for others. Yet, advanced tools may still be unusable where they’re needed most.

Adaptive design is about building with context in mind — designing products, platforms or systems that reflect the realities of where they’ll be used. It means accounting for infrastructure gaps, environmental constraints and human behaviours from the start, rather than retrofitting solutions after the fact. At its core, adaptive design is less about perfection in theory and more about functionality in practice.

Rather than assuming a product that works in one setting will translate seamlessly to another, adaptive design starts with the question: What’s needed here and what might get in the way?

Zipline, a drone logistics company, adapted its delivery model to support blood and vaccine distribution to remote areas in Rwanda and Ghana, bypassing road infrastructure and reducing delivery times from hours to minutes. This wasn’t innovation for its own sake, it was designed with frontline needs in mind, including terrain challenges, urgent delivery timelines and cold chain limitations.

Adaptive design isn’t about scaling what works elsewhere. It’s about asking, what works here and why? It begins not with technology, but with listening.

In many settings, the issue is not the absence of tools, it's the lack of interoperability between them. Health systems often juggle multiple digital platforms, parallel procurement systems and fragmented data streams.

Here, the private sector’s strength in systems integration, logistics and platform engineering can support governments to build infrastructure that is coherent, functional and publicly anchored.

In global health, operations rarely depend on flashy innovation, but on internal consistency and clarity around how information and resources move. When internal operations are aligned across budgeting, procurement, data flows and reporting cycles, they create the foundations for external interoperability.

In practice, this means that an organization’s ability to support health ministries or partners with integrated solutions depends heavily on whether its own internal systems are integrated. If teams don’t coordinate internally on timelines, data definitions or procurement protocols, the result is often duplication, internally and externally, as those inefficiencies are passed downstream to implementing partners or government counterparts.

Dimagi’s CommCare platform has been used in over 80 countries to unify digital workflows for frontline health workers. In India and Sierra Leone, it helped integrate vertical programmes, from malaria to maternal health, into one tool, improving coordination and reducing duplication across systems.

The real opportunity isn’t more technology, it’s the operational discipline to make systems work with one another and to embed that coherence inside organizations and across the health systems they serve.

Capacity building in 2025 and beyond means more than training individuals. It requires strengthening institutions, embedding systems that evolve with context and building digital and analytical fluency at every level of the health system. It also involves redefining what success looks like: not just knowledge gained, but whether that knowledge is retained, shared and acted on in practice.

Capacity must account for complexity, helping mid-level managers make decisions in uncertainty, interpret data and manage teams. Increasingly, adaptive leadership, systems thinking and digital literacy will be as critical as clinical or logistical expertise.

Health system resilience depends not only on frontline workers or national decision-makers, but on the often-overlooked operational 'middle layer.' These are district logisticians, procurement officers, warehouse managers, data analysts and others who translate strategy into execution.

Roche Diagnostics, through its Global Access Program, has supported laboratory training across sub-Saharan Africa, equipping technicians with the skills to operate, maintain and troubleshoot diagnostic platforms. This investment has helped strengthen public laboratory networks over time.

Sustainable capacity is more than just exit strategies. At its core, it is the product of knowledge transfer, local ownership and operational continuity.

Health systems operate under persistent and layered uncertainty, from disease outbreaks and climate shocks to geopolitical instability and supply chain breakdowns. While governments are often expected to absorb and manage this volatility, few public health institutions are equipped with the enterprise risk frameworks, tools or response structures needed to anticipate and plan for it in real time.

In contrast, many private sector actors, particularly those in finance, logistics and manufacturing, have long operated under the assumption that risk is constant, not exceptional. They invest accordingly in enterprise risk management systems: modelling future scenarios, building redundancy into operations, stress-testing supply chains and designing early-warning triggers for intervention. These capabilities are not just applicable in global health; they’re essential.

Enterprise risk in health systems spans a wide spectrum. It includes strategic risks, such as misaligned funding cycles or shifting political priorities; operational risks, like cold chain failure, staffing disruptions, or data loss; financial risks due to currency fluctuations or procurement delays; and reputational risks that arise when initiatives fail or public trust is compromised. Yet, these risks rarely surface systematically or are addressed through shared frameworks.

During the West African Ebola outbreak, Johnson & Johnson partnered with governments and research institutions to accelerate vaccine development and to plan ahead for production, storage and distribution. By modelling demand curves and setting clear readiness thresholds, it was able to move from ad hoc response to structured deployment, turning uncertainty into informed action.

As health systems become more interconnected and more exposed to external shocks, risk management cannot remain a reactive exercise. A forward-looking approach involves building resilience into the architecture of delivery: diversifying suppliers, decentralizing logistics hubs, strengthening data visibility and improving contingency planning at every level.

This kind of planning requires that risk be embedded as a core design principle, not treated as a footnote or a temporary deviation from routine.

This matters now because global health systems face mounting pressure. How the private sector is engaged will shape whether systems remain reactive or become resilient.

Note: This piece does not reflect the views of any institution and is written in a personal capacity.