Q: This conference is about "global access to health". To you what are the main challenges and the most important issues when it comes to this topic?
Regarding access to health: universal and equitable access to health is a big challenge in Pakistan where I am working. There has been a realization of this challenge at all levels.
At this time, the government is committed to expand the coverage of the public healthcare with the support of the international donor agencies, such USAID, DFID and many others. Efforts are put in place in order to increase access and coverage to basic health services and various models are proposed to achieve this goal.
But simply scaling up is not enough. The quality and quantity have both to be looked at. Indeed, the quality of care, the availability of equipment, and the standards of care and training of care providers are essential. Just expanding the same low quality health care is not going to solve the problem at all, and it is not available 24 hours. As a result, the population heavily relies on private facilities and services; a common scenario in the poor and under-privileged segments of the population in rural areas and slums, where in Pakistan almost 70 to 80% of the population lives. This is where public-private partnerships become pertinent.
Q: There is indeed a lot of talk about public-private partnerships (PPP's). What opportunities and challenges do you see for these kinds of collaborations?
The question is how to match the very different agendas of the public and the private sectors. Regulatory mechanisms for the private sector and accountability are the major challenges in this context. We can indeed not to ignore that for most of the private sector it is about profit. However, when we talk about accountability, we can ask if there should, for example, be a ceiling for the profit? Also, can the private sector become a true partner to the general health facilities? Can private companies help improve the standard of the government sector? And of course, it should be a two-way street: in return, what can they get from the government sector? It needs to be kept in mind that the private sector has a limited scope of service provision. For country-level overall services provision, the governments remain the main key player. It is capacity and quality of services that need to be improved and this is, I believe, where strategic PPP's can indeed help. In turn, private universities and academia, such as my institution, the Aga Khan University, can be used as resource centres, improving the services.
Q: What do you expect from a conference like this one?
First of all, I would like to commend the organizers for their initiative. On the positive but critical side of things, I would have hoped that a conference focusing on global access to health would bring even more perspectives from the developing world. This could possibly be done through roundtables. Secondly, the alternate solutions and proposals that were presented in some of the talks --for example with regards to public-private partnership and alternate healthcare financing-- the developing world perspectives were not well reflected.
Image source: Aga Khan University
