Panelists

• Moderator: Professor Sydney Rosen, Center for International Health, Boston University/University of the Witwatersrand
• Dr. Adel Chaouch, Director of Corporate Social Responsibility, Marathon Oil
• Mr. Alan Fine, Public Affairs Manager, AngloGold
• Dr. Ernest Darkoh, Chairman, BroadReach Healthcare
• Dr. Donald DeKorte, Director of HIV/AIDS Access Program, MSD
• Mr. Richard Kabeto Matlhare, Director, National AIDS Coordinating Agency, Republic of Botswana
• Mr. Jay Naidoo, Chair, Global Alliance for Improved Nutrition

Summary

Prof. Rosen: She is skeptical about partnerships and the value they create, because it’s hard to prove that a partnership is producing something greater than the sum of its parts. We must specify the goals, rights and responsibilities of each partner and evaluate the initiative to know whether a partnership is truly substantive.

Dr. Chaouch: He talked about their partnership on the Bioko Island off the coasty of Equatorial Guinea. The island has some of the highest rates of malaria in Africa and Marathon wanted to provide assistant. The project's goals were to eradicate malaria on this island over a period of 5 years - components of the program include spraying, monitoring, and communication with community leaders. Partners include Marathon Oil, Equatorial Guinea Ministry of Health, health NGOs, Harvard and Yale health experts. How does it work? Marathon provides the funding, Ministry of Health provides the decree, and NGOs provide the expertise. Results to date: malaria prevalence decreased by 40%, Mosquito population diminished by 95%.

Mr. Fine: AngloGold developed a program in close proximity to a company-owned gold mine in Ghana. They discovered that each employee was sick with malaria one day per month, on average. AngloGold sprayed all facilities, conducted research and surveillance, and implemented communication outreach programs for employees and family members. Results: a decrease in malaria prevalence by 73%. This is the type of program that should be extended, but there are questions about where the funding will come from.

Dr. Darkoh: the Siyakhana program works with governments to scale up and improve HIV treatment and works with the private sector to provide employee healthcare services. The public sector in SA is overwhelmed in its attempts to treat 85% of the population.

Siyakhana partners and mechanisms:

Mail order pharmacy
Network of private doctors
Treatment facility
Local churches – used to access people, a central place to pick up medications
Revolving fund – capable of providing for 300,000 people

Please see the CCA HIV/AIDS Dec 07 Newsletter for more information on the Siyakhana project

Dr. DeKorte: MSD has developed a partnership called Ibani-SE between the Nigerian government, local communities, and oil companies for HIV/AIDS and improved healthcare. the idea behind the PPP was to help the island of 30,000 (local) and 220,000 immigrants and oil workers break free from dependency.

Mr. Kabeto Matlhare: With a national HIV prevalence of 32%, Botswana is faced with the possibility of HIV reversing the country’s development gains over the past decade. A partnership was formed between the Gates Foundation, Merck and Botswana Government. It is engaged in a variety of activities, including condom distribution, grants to small community projects, ARV clinics, and a teacher building capacity program. What are the returns? When they started in 2004, there were two ARV sites, now there are 32—just one of many successes.

Mr. Naidoo: GAIN is an alliance and donor that partners with the private and public sectors and civil society on micronutrient malnutrition programs. GAIN is working to fortify flour in SA, and fortify soy sauce in China. The alliance has established an infant and young child program in Nigeria,which feeds children in schools with a fortified shake. They hope to expand the program to reach 27 million children in Nigeria. GAIN also has a yogurt project in Bangladesh— a partnership with Grameen Bank to distribute the yogurt through Grameen ladies has created a health and entrepreneurial endeavor.

Prof. Rosen: Should we think of PPP as Donor-Public-Private-Partnership…is the role of the donor is under-emphasized?

What are the limits to scalability?

Who initiates a partnership?

Dr. Chaouch: Referring to the scalability issue, on an island you are able to use metrics for tracking success

Mr. Fine: Referring to the donor and scaling question, How do you turn the island setting into something more national?

Dr. Darkoh: Donor funding can be structured in a manner that creates dependency and it can also be structured in a manner to work oneself out of a job.

Dr. DeKorte: Often the requirements of donors makes it difficult to get money in isolated, high-risk areas, you also need financial experts to build the estimates. It is important to look to communities as sources of investment—albeit small, this adds to sustainability.

Mr. Kabeto Matlhare: Referring to who should initiate the PPP, everyone is capable of initializing a partnership, but PPP should fit into national priorities.

Mr. Naidoo: The tension between national and private sector priorities is important. You must have a government framework for what you are going to achieve. Big PPP projects have to be driven by government.

Comment from Care International, Egypt: In Egypt, the government is very distrusting of the private sector, but the NGO community sees the private sector as a great resource and ally; NGOs can be the initial catalyst for such partnerships, the facilitator or connecting point.

Dr. Darkoh: The idea of the private sector being concerned with making money is a distraction—what is more important to focus on is ownership, of funding a country’s core activities through enterprise, not donations. In SA, PPPs are much easier to undertake on the provincial level.