COVID-19 has touched every part of the world, with the possible exception of Antarctica.
Since March, we have witnessed global shortages in health care personnel and commodities—from personal protection equipment to test kits and ventilators—and breakdowns in supply chains. Sadly those shortages have resulted in breakdowns in the provision of preventive care and critical primary health care services.
For example, there are reports from around the world that women are not going to clinics to seek antenatal care or give birth, that immunization drives have been paused, and that there are critical access issues for women seeking family planning (FP). A pulse survey by the Global Financing Facility (GFF) found that half of GFF partner countries were reporting disruptions in these services. The implications of this backward slide are severe and concerning to the international development community. So how do we bolster these critical services even as we combat COVID-19? Ensure we’re bringing along the private sector.
A Global Call for Partnerships
Recent WHO interim guidance on engaging the private sector in the response to COVID-19 calls on governments to adopt a multi-sectoral approach and coordinate actions with private sector and civil society actors. Despite this, many low- and middle-income countries are still focused on public sector responses. Response plans include the designation of public sector hospitals and labs where the public can access diagnosis and treatment, as in Mozambique and Madagascar. While many countries have made strides in engaging private sector actors in health sector strategies and programming, an emergency response requires immediate action and, for some governments, it is quicker to galvanize a systematic response through public sector infrastructure. However, excluding the private sector will lead to greater impacts to the health system in the immediate response to COVID-19, and devastate the progress countries have achieved in their pursuit of providing universal health coverage.
How? First, as the numbers of infected cases grow, the health system in every country will need to rely on all of its resources. Not just to test and treat to prevent surges in COVID-19 cases, but also to prevent interruptions—and maintain access—to primary care services. Second, private providers who rely on a steady stream of clients for revenue will face economic repercussions from reduced client visits, either due to restrictions on care seeking or because patients are afraid to seek services. The loss of income may force many smaller facilities to close their doors. Many of these smaller independent providers are critical to communities around the globe, and they operate on small margins that can’t weather disruptions such as we’re seeing today. They’re needed now, and they’ll be needed when the COVID crisis is over.
Private Sector Partners for the Long-Term
Given its long-term role—and potential short-term role buttressing COVID efforts—we need to look at the private health sector as a key partner. Country governments can and should contract with private providers to deliver COVID-19 services when they are overwhelmed, or to serve as delivery points to ensure essential services are still being provided on behalf of the public sector. Doing so will minimize disruptions to crucial services and also throw a financial lifeline to smaller facilities.
This collaboration will require that the private sector be fully involved in the COVID response, that messages are shared, that the private sector providers receive training and PPE equipment, and that they are linked to government commodities in the case of supply shortages. At the same time, leveraging these partners can reduce the strain on public health services while speeding the response. Public health implementers must advocate for governments to include private sector manufacturers, businesses, and associations in strategies and roundtable discussion on health impacts and economic impacts, as they are doing in Senegal through the National Epidemic Management committee (CNGE in French). Bringing the private sector more fully into the fold can be a win-win for health systems and, right now, I think we can all agree we really could use a few more wins.