We have travelled deep into Africa and found chocolate, washing powder, soap, SIM cards, condoms, pencils, beer and soft drinks available to people that live in hard-to-reach places. There is a prevailing theory that if the private sector can do it, why can’t the public health system get medicines to these same people? There are many reasons why it is not yet happening effectively, one of which being that the health supply chain is much more complicated than delivering consumer goods, but maybe it doesn’t have to be. There are existing private sector supply chains that public health providers can, and should, learn from. Which is why private sector engagement in the public health supply chain is so important: we need to figure out what can be done to ensure that every person can get a vaccine as simply as they can get a bar of chocolate.

Governments do not need to start from scratch to work out how to get medicines to patients. The private sector has immense existing knowledge and tried and tested approaches that can be leveraged in the public health space. if public supply chains followed similar routes, channels, pick up points, pricing and packaging guidance, could patients in hard to reach areas experience better availability of medicines? This case for change is growing. In fact, many donors and governments already firmly support the business case for applying private sector approaches to the public health supply chain.

Now, it is about how we do it. How do we draw in the private sector? How do we partner well with governments? How do we set it up?

PILOT LANDSCAPE

Considering the overall buy-in to engage the private sector in developing more effective public health supply chains, thousands of pilot projects have been set up in different contexts across Africa, and they are producing remarkable results. However, their long-term success will come down to how they can be scaled.

The next 10 years of developing these systems is likely going to be about properly structuring the supply chain and getting contracts and organisations appropriately set up with long-term financing and agreements so they can be rolled out on a national level.

ONE OF MANY SOLUTIONS

When the Africa Resource Centre (ARC) approaches private sector engagement, we do not aim to have private sector providing commercial services to government; we work to facilitate truly collaborative engagement that focuses on knowledge sharing, expert inputs, best practices and toolkits. What we have found is that, free resources or volunteers are difficult to incorporate long-term in a sustainable or impactful way. The best model has been to bring in people who have worked in the private sector to work with ARC’s Ministry of Health stakeholders to function as translators between the private and public sectors.

Private sector engagement is one of many components that make up ARC’s theory of change. To realise equitable availability of medicines there must be coordination of public and private sector partners and better supply chain strategies. Governments also need new and updated policies, and private sector thinking needs to be included.

MEASURING SUCCESS

One challenge with the case for private sector engagement is the difficulty in measuring its success. We have a deep conviction that it works, but it is currently hard to measure. This is something that advocates of private sector engagement need to continually interrogate: are there better ways to be sure this is working, or better ways to measure it?

To gain long-term buy-in there will ultimately need to be hard evidence of what did and did not work. The amount of time involved in establishing and effectively implementing a supply chain transformation that leverages private sector expertise requires patience from donors and governments, and there may be hard lessons that have to be learnt along the way. However, it is important to keep working towards success because medicines should be equally available to all.

About the authors

Bronwyn Timm is the strategy and partnerships lead at ARC. She learnt and implemented design thinking, agile organisations and disruptive growth methodologies and best practices in her work at McKinsey and AB InBev. She now applies those skills to improve medicines’ availability in Africa.

Trip Allport is managing director of ARC. For over a decade, he has helped shape and manage partnerships supporting market-oriented solutions to the world’s most challenging development issues between the private and development sectors.