Global Fund needs to partner more with the private sector

Workers build the Grand Renaissance Dam near the Sudanese-Ethiopian border. Infrastructure and energy provision remain key challenges for Africa. AFP PHOTO 

By EDWARD OMETE

In Summary

• Changing social, cultural and environmental dynamics mean approaches should not be the same as they were a decade ago.

The Global Fund initiative against malaria, TB and HIV has started the latest round of campaigns. Current data shows that malaria seems to be declining locally.

Several theories have been given for this. From the government’s side, the explanation is that a concerted effort in tackling the problem has borne fruit. From the scientific point of view, it could be due to introduction of “test before you treat for malaria” recommendations.

The data people say it could be due to flaws in the past or underreporting. These divergent viewpoints show the importance of having a broad approach.

The fund’s move to subcontract quasi private entities as fund recipients is a bold step. However, this must also come with prudent management of the funds and more importantly incorporate the missing innovative solutions of private sector players.

For a long time health interventions have tended to be delivered through traditional channels akin to a recipe handed down from one generation to another. Changing social, cultural and environmental dynamics mean approaches should not be the same as they were a decade ago.

Few fund administrators have dared to get out of the confines of these templates and start a new. That said a few positive notes are being seen from the current programme. For one, the participation of the private sector health workers in the fund’s activities is welcome.

I was impressed that my county recognised the role private health providers play in the fight against malaria, TB, HIV and other conditions covered by the fund.

The fund has to finally realise that there is no distinction between patients attended to in the private sector and those seen in public hospitals: they are all Kenyans.

Taking a condition like HIV/Aids, it is obvious that public facilities are stretched thin. Patients at HIV clinics often have to wait in long queues, in public. For a condition that sometimes attracts stigma, those yet to disclose their status are unlikely to be comfortable in such setups.

On the other hand private facilities and doctors are working below capacity in tackling HIV. Would support to the latter help deliver better care and in better environments?

One such model could be pairing public facilities with private doctors to work on patient cohorts or for private doctors to join their colleagues during busy hospital days.

Secondly a “team approach” to interventions is important. All cadres must work together, from policy makers to implementers. An often ignored group in this fight is the “critic”. At times having an external “negative” viewpoint in such a long term and costly initiative is important. Just one missed observation could translate to millions of shillings misspent.

In the HIV component, more resources need to be channelled towards support groups. For most HIV patients seeking health services in a public facility, contact with a medical worker is at best only 10 minutes every three months due to the long queues.

Support groups in contrast meet every week or bi-monthly. They offer more because emotional and psychological fortitude are important components of long term medical care compliance.

Hopefully, the current fund managers will also incorporate innovative delivery models and use of technology in their proposed plans.