Public and Private Provision of Health Care in Sub-Saharan Africa

In order to reach Africa's great potential, improving health must be a top priority. Health care systems face daunting challenges and most Africans depend on public health services that are hobbled by inadequate budgets, under-investment in physical infrastructure, and insufficient numbers of trained health care providers. Most African countries also lack developed and well-functioning private markets for health care, thus adding to the burdens borne by already hard-pressed public systems. These institutional weaknesses make it difficult for countries to respond effectively to endemic diseases such as HIV/AIDS, tuberculosis, and malaria, as well as to the non-communicable diseases that increasingly affect patients in Africa and throughout the developing world.

On November 2, 2006, the Global Health Initiative and the Africa Program hosted a discussion of the public and private provision of health care in Africa, made possible with the support of Pfizer, Inc. Victor Barbiero of the George Washington School of Public Health and Health Services, Dan Kaseje of the Tropical Institute of Community Health and Development in Africa, and Patrick Osewe of the World Bank presented their papers on Africa health trends, improving health efficiencies, and expanding public-private sector partnerships respectively. Each presentation was followed by open dialogue among the participants about these and other key issues. The group discussed the challenges facing public and private service delivery; current thinking behind public-private partnerships for health; ways to improve current systems to meet the needs of Africans; and identified ways to deepen collaboration between the public and private sectors. This meeting was not designed as a one-time event, but rather the beginning of activities and an informed dialogue aimed at highlighting opportunities for expanding access to high quality health care throughout Africa.

This day-long discussion was followed by a dialogue facilitated by Robert Mallett, senior vice president of Corporate Affairs at Pfizer Inc., and Howard Wolpe, director of the Wilson Center's Africa Program, on the next steps for action and change. The Global Health Initiative will post a short policy brief in the near future. The papers written for the event and a video archive of the presentations are posted to the right.

Discussion Outline

Session 1: Future Public Health Trends and Issues in Africa

• Victor K. Barbiero, Visiting Professor, Department of Global Health, School of Public Health and Health Services, The George Washington University; and Senior Adviser to the Global Health Initiative, Woodrow Wilson Center
  David Oot, (Discussant) Director, Health, Save the Children, U.S.

Session 2: Opportunities and Challenges in the Efficient Provision of Health Care in Africa

• Daniel Kaseje, Director, Tropical Institute of Community Health and Development in Africa
  Jonathon Simon, (Discussant) Chair, Department of International Health; Director, Center for International Health; and Associate Professor Boston University School of Public Health

Session 3: Roles of the Public and Private Sectors in Africa's Health

• Patrick Osewe, Senior HIV/AIDS Specialist, World Bank
  Nancy R. Pielemeier, (Discussant) Vice President, International Health Division, Abt Associates