Source: Institute of Development Studies
The All Party Parliamentary Group (APPG) for Trade Out of Poverty, the APPG for Debt, Aid and Trade and IDS co-hosted a meeting in parliament examining how governments, businesses, practitioners and academics can collaborate more effectively to ensure that health markets in developing countries work better for the world’s poorest communities.
Strengthening health markets
Chaired by Lord Crisp, it was the first in a series of meetings being organised by the three organisations entitled Driving private sector for public good which will look at how UK development policy needs to evolve to ensure the beneficial long-term impact of business and development initiatives on the well-being of the poorest communities.
Current thinking on health systems and markets out of date
In his opening comments to the meeting, IDS Research Fellow Gerry Bloom highlighted that compared to 30 years ago when the major guiding frameworks for international health policy were agreed, people in poorer countries have much better access to drugs, health workers and information about health services. Access has improved as a result of the rapid developed of mixed health systems, which incorporate both public and private providers (either formal or informal). However, understanding of these systems and markets has not kept pace with the changes that have taken place and new strategies and approaches are now urgently required if performance is to be improved.
Referring to his work as part of the Future Health Systems consortium with partners in the US, China, India, Bangladesh, Afghanistan, Nigeria and Uganda, Dr Bloom argued that more needs to be done to share learning and best practice across countries and between governments, businesses, practitioners and academics. He underlined the potential of informal markets in developing countries to broaden access to health care and services. However he was also clear that improved regulation of these markets was needed to ensure the quality, safety and appropriate use of drugs and to address issues such as the over-prescription and use of antibiotics which was leading to growing resistance to these drugs.
Health innovations in Bangladesh and the challenge of scale and sustainability
Drawing on examples from Bangladesh and a scoping study of health innovations that he undertook in conjunction with IDS, Rubaiyath Sarwar, Managing Director of Innovision, also highlighted a number of opportunities in relation to expanding informal health markets and private sector providers. He referred to a number of innovative approaches that were being implemented in Bangladesh including floating hospitals and the Mobile Alliance for Maternal Action which provides health information to new and expectant mothers via their mobile phones.
However Rubaiyath Sarwar also raised two important challenges in relation to these innovative approaches. How can they be made sustainable, particularly in terms of ongoing financing, and how can they be taken to scale? Addressing these questions is critical to progress and improvements.
Private sector investment in health in poorer countries
Another challenge that was highlighted by Dr Allan Pamba, Vice President, Pharmaceuticals, East Africa and Government Affairs, Africa, GlaxoSmithKline (GSK), was in relation to the risk attached to, and potential lack of incentives, for private companies and businesses to invest in health systems in poorer countries. He used the example of Africa, which has only 1% of the global health budget and 3% of the global health workforce.
However Dr Pamba highlighted that companies like GSK have taken a broader perspective that not only demonstrates value to shareholders but also has significant social impact in developing countries. In order to achieve this, he explained how GSK has had to adapt their business models to work in some of the least developed countries and partner with NGOs and governments to reach the poorest communities, which he admitted still presented a real challenge.
Ensuring health services and markets are targeted at the hardest to reach
Ensuring access to health care and services for the hardest to reach was also an issue that Patricia Atkinson, Vice President and Health Systems Director at Marie Stopes International highlighted in her contribution to the discussion. She spoke about how Marie Stopes was working with partners to increase the utilisation of health services and exploring how health insurance schemes in countries such as Ghana and Kenya could be targeted at the poorest 20% of the population.