CÉSAR NIETO: Collaboration the key to a better healthcare system in SA
The power of public-private partnerships has been demonstrated to work here and in the rest of the developing world
As various participants in SA’s health arena give input to the proposed National Health Insurance (NHI) system and the form it should take, they are agreed on one thing: its goal to achieve quality universal healthcare for all South Africans.
The recent Covid-19 vaccine rollout gave a foretaste of what is possible for SA’s healthcare system through the power of cross-sectoral collaboration — and is a great case study for health systems strengthening in other countries too.
The rollout saw the public and private sectors, trade unions and community organisations pooling their resources and expertise to get the vaccines to South Africans as fast as possible, and the campaign showed that the country has the resources and expertise to provide a better, more equitable healthcare service.
The question is how we take those lessons and embed them in a healthcare system that serves all of a country’s citizens, and does so in a sustainable way while adhering to best practice standards.
The clear answer is through the power of partnership — which has been demonstrated to work here and in the rest of the developing world. Promoting public-private partnerships (PPPs) can accelerate access and distribution of innovative medications. By working together, government, originator companies and funders can ensure that patients benefit from the latest advancements in healthcare.
Rwanda, for instance, has made much progress in managing non-communicable diseases (NCDs) through community-based health insurance schemes. Brazil has successfully implemented a comprehensive primary healthcare approach. These countries have prioritised prevention, early detection and treatment of NCDs, which can be adapted to the SA context.
Locally implemented initiatives under the global Making More Health programme include training community health workers to provide primary care services, supporting local entrepreneurs in developing innovative healthcare solutions, and partnering with NGOs to improve access to healthcare in rural areas. These initiatives have helped address complex healthcare issues by empowering local communities and leveraging local resources.
Making More Health is a social initiative from pharmaceutical company Boehringer Ingelheim in collaboration with global community organisation Ashoka, which combines business and social values to unleash innovation and achieve economic and social progress in healthcare. The objective of this long-term initiative is to source social innovation around the world, to explore unconventional partnerships and business models, and to encourage Boehringer Ingelheim employees.
We must also turn our attention to NCDs, which are a major health threat. The World Health Organisation estimates that globally they are responsible for 74% of deaths. Research into SA’s NCD situation can play a crucial role in health systems strengthening by identifying the most prevalent diseases, understanding their risk factors, and informing evidence-based policies and interventions. This would help target resources more effectively and improve health outcomes.
That requires robust health data hosted on a digital infrastructure, which would promote data-sharing among healthcare providers and encourage the use of standardised data collection methods. This would help create a more accurate picture of the population’s health needs and enable better decision-making across the entire health ecosystem.
We also need to make sure we retain our world-class doctors and address our critical nursing shortage — it’s estimated we need about 26,000 additional nurses to fill the gap. Without sufficient personnel to deliver healthcare all the best intentions in the world will not deliver universal health coverage.
We must invest in improving the working conditions and incentives for healthcare professionals in the public sector, strengthen primary healthcare services and promote collaboration between public and private providers. That would help to ensure that the expertise and experience of these professionals is effectively employed to benefit the broader population.
Moreover, increased collaboration with innovator companies in the private sector, many of which are already involved in initiatives to strengthen the health system, would ensure patients receive the right treatment while expanding the reach across the entire population. This would help tackle inefficiencies, streamline processes, and enable better resource allocation.
The fundamentals of health system strengthening in SA include adequate financing, a well-trained and motivated healthcare workforce, efficient supply chain management, and strong governance and leadership. Addressing these gaps — through partnership and collaboration — would help build a more resilient and responsive healthcare system and ensure that SA citizens have access to better healthcare.
• Nieto is GM and head of human pharma at Boehringer Ingelheim Southern Africa