Brazil to consider PPPs to develop PHC health centres

PHC & PPP: an old story?

In a field where there is not one single definition of PPPs, all would agree that they constitute complex public law contracting arrangements between public and private sector to meet clearly expressed and agreed public needs, generally characterized by a long duration, an allocation of risks and rewards between partners as well as performance based payments.

Public-Private Partnerships were put at the forefront of procurement law in the 1990’s and are still all the rage when it comes to healthcare transformation. In fact, they appear more than ever on the radar of health decision makers for better or worse, in particular in LMICs.

This is in part due to international organizations or funders suggesting this option for the construction of new infrastructure to fill the gap, or the refurbishment of existing assets, or the reallocation of health offerings.

A good example is offered by Brazil, where thanks to our friends at PPP bulletin we know that the municipality of Aracaju which is considering a PPP to help build, finance, deploy and operate up to 25 health centres in order to bolster its health offering related to PHC.

The Inter-American Development Bank and the Brazilian Development Bank are supporting this initiative together with the World Bank, illustrating the support of international funding organizations for the growth and use of complex contracts.

Similar complex contracting arrangements were observed in other parts of the world. Illustrative of this trend were the contracts awarded to consulting group EPOS Health India more than 10 years ago to strengthen public health and PHC facilities in some of the Indian States such as Uttar Pradesh, with funding from German Development Bank KFW.

It is also not dissimilar with the successful Local Improvement Finance Trust (LIFT) in the UK which since 20O1 enabled the NHS to build and operate 350 community-based healthcare facilities dispensing PHC, and sign up to 49 joint ventures between public and private health sectors!

As usual, your Decide Hub will make sure it brings you more news and update about this Brazilian project.