Public–Private Partnership

Public–private partnerships (PPPs) in healthcare involve formal collaborations between the public sector (including national and local governments, international donor agencies, and bilateral government donors) and the nonpublic sector (which includes commercial entities, nonprofits, and traditional healers). These partnerships aim to jointly regulate, finance, or implement the delivery of health services, products, equipment, research, communications, or education. A PPP in health is any formal collaboration between the public sector at any level (national and local governments, international donor agencies, bilateral government donors) and the nonpublic sector (commercial, nonprofit, and traditional healers, midwives, or herbalists) in order to jointly regulate, finance, or implement the delivery of health services, products, equipment, research, communications, or education. The most complex form of PPP is a formal agreement between public and private sector partners, with clearly defined roles and responsibilities. These partnerships address weaknesses in the health system, specifying investments from each partner and conditions for risk-sharing and benefit-sharing. PPPs are widely accepted as a strategy to achieve global health goals, recognizing the private sector’s potential to enhance health outcomes. However, consensus on PPP definitions and essential elements remains elusive. To improve communication, this paper proposes a new definition for PPPs, distinguishes them from other public–private engagements, and outlines three models: market-based, socially based, and balanced. An algorithm helps determine when to pursue a PPP for health system improvement. Remember, PPPs should be used judiciously, considering simpler alternatives to avoid unnecessary costs. Essential elements include value for money, quality service contractibility, risk transfer to the private sector, competition, legal frameworks, technical expertise, and transparent disclosure. Each PPP model balances commercial and social objectives, emphasizing both financial and societal returns.