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PRIVATE SECTOR – EWEC

PRIVATE SECTOR

The private sector has a vital role in reaching the targets of the Global Strategy and supporting the implementation measures outlined in this Operational Framework by contributing to each of the nine ingredients for action. The Global Strategy itself calls for the business community to:

  • support government policies aimed at universal health coverage, better nutrition, healthier foods and cleaner energy
  • identify and address with partners the external consequences of business actions that might harm the health of women, children and adolescents
  • protect and promote the health and well-being of employees and their families
  • support efforts to improve access to good-quality health services and life-saving commodities
  • explore new drugs, technologies and interventions to improve health in resource limited settings, address emerging global challenges, such as antimicrobial resistance, and bring the most promising innovations to market
  • use business expertise to create and scale up interventions that promote health, such as essential interventions and education on sanitation and hygiene and access to improved nutrition.

The private sector is comprised of many different types of organizations with widely varying characteristics, including:

  • small and medium sized enterprises (SMEs) operating at a local or national level, including individual vendors, service providers and social enterprises
  • regional enterprises
  • multinational enterprises operating on a global basis
  • privately owned and publicly traded (shareholder owned) companies.

The business activities and industry characteristics of companies also vary widely and include: employers that provide health services and/or health insurance to employees and their families; private health sector providers; pharmaceutical and medical technology companies that supply essential drugs, vaccines, diagnostics and technologies; financial services companies that invest in health service delivery and digital operators that use mHealth services to promote health delivery; and communications companies that can help drive positive health-seeking behaviour.

With the launch of the SDGs, there are higher expectations of the private sector to help address global problems and unmet societal needs. Over the past several decades a number of varying mechanisms have evolved that promote cross-sector collaboration with the private sector. These include:

Corporate Philanthropy: Providing donations of cash or ‘in-kind’ products and services. An example is donation of pharmaceuticals to prevent or address particular health needs, such as river blindness. In-kind donations need to comply with international standards and guidelines such as those developed by the Partnership for Quality Medical Donations. Philanthropic donations must not be linked with commercial business gain such as increased sales or profits.

Corporate Social Responsibility (CSR): Deploying business resources and core competencies to achieve positive societal impact. CSR initiatives help address unmet societal needs and often also aim to enhance the sustainability of companies by reducing business risks and/or achieving reputational benefits. CSR activities are generally not directly linked to commercial sales generation.

Creating Shared Value (CSV): Utilizing commercial business models to simultaneously achieve positive societal and business outcomes. An example is developing new commercial innovations that reduce child mortality, such as insecticide-treated bed nets or affordable technologies for low-resource settings. CSV initiatives, by definition, engage with the core business operations of a company and are intended to support growth in sales and profits. One factor distinguishing CSV from Corporate Philanthropy and CSR is that there is no inherent limitation to the scale that can be achieved since investments are mainstreamed into the core business of the company.

Aligning Policies, Standards and Practices: Aligning advocacy and policy initiatives from companies, both internally and externally, to be consistent with broader societal policies, standards and goals. This can include progressive workforce policies to encourage healthy behaviors among employees. The private sector can also utilize its influence to encourage national and international laws, guidelines and regulations that support achievement of goals reflected in the Global Strategy and the SDGs.

While the former two categories are most discussed in terms of private sector contribution to health, the latter two categories are more substantial in terms of impact and potential. The private sector is an integral part of all economies; in many countries, the private sector represents the majority of the health sector. Therefore, more substantive engagement is required in policy and programming, with explicit identification of interests, contribution and potential for real harms. Governments also need to build their capacity to steward private sector engagement, including through regulation.

Since the launch of Every Woman Every Child in 2010, over 80 private sector commitments have been made, with some common principles for best practices emerging:

  • private sector commitments need to be well aligned with the health and development goals prioritized by national governments, including specific priorities represented by SDG targets and initiatives
  • commitments need to be specific in terms of intended populations served and health impacts, and include projected indicators that will be utilized for measurement and accountability
  • the majority of commitments will involve some form of cross-sector collaboration (such as public-private partnerships), for which it is important to establish common objectives among the partners. Collaboration requires trust, and care must be taken to choose partners, including companies, where motivations are well aligned
  • these objectives and related action plans should be articulated in a formal document such as a Memorandum of Understanding, such that there is full transparency on each partner’s interests, intent, role and contribution
  • leaders of collaborative partnerships need to possess personal characteristics that are conducive to working across sectors while being respectful of the need for local, country ownership
  • where conflicts or harms to health occur, clear arbitration mechanisms are required which adhere to the laws and democratic processes of countries and respect national sovereignty
  • while the majority of EWEC commitments to date are in the category of Corporate Philanthropy and CSR, a growing number of companies are embracing shared value models that combine social and commercial impact. Increasingly, partnerships with companies leverage the expertise and core assets of business, rather than being limited to financial donations.

CASE
STUDY

Eliminating disease spread due to injection device reuse in childhood immunization programmes

The Expanded Programme on Immunization (EPI) is among the greatest accomplishments in the history of global public health. However, by the late 1980s the agencies that administered the EPI became aware that disease was being spread from child to child in the EPI due to reuse of injection devices designed for single use and from improper sterilization of reusable devices. WHO and UNICEF reached out to industry to help address this problem by developing technical solutions that would not disrupt continued progress in expansion of the EPI.

Becton, Dickinson and Company (BD), working in collaboration with Program on Appropriate Technology in Health (PATH), was the first company to respond, through development of the first “auto-disable” immunization device, which locks and is rendered nonfunctional after a single use. This innovation was introduced into WHO field trials in 1988 and became commercially available in 1991.

It took eight years for these devices to achieve full scale deployment. Over this time, the key barriers to achieving full scale were addressed. These included policy changes (joint policy statement issued in 1998 requiring use of auto-disable devices for publicly funded immunization campaigns), funding (provided by GAVI and associated with the broader scale-up of global immunization), accessible technology (first generation designs were revamped to substantially reduce cost to a level comparable to standard injection devices) and mass deployment via disease elimination initiatives for maternal and neonatal tetanus (MNT) and measles.

In supporting the goal of eliminating disease spread during mass immunization programmes, BD implemented all four modes of private sector action:

  • Corporate Philanthropy – Provided substantial cash and in-kind donations to the MNT and Measles Initiatives, totaling over US$10 million
  • Corporate Social Responsibility – Trained health workers on proper injection technique when using auto-disable technology, in support of the Measles Initiative
  • Creating Shared Value – Established a sustainable business model for the development, production and supply of auto-disable syringes, ultimately supplying 6.5 billion of these devices over the MDG period
  • Aligning Policy – Successfully advocated for changing national immunization policy in India, from use of reusable glass syringes to auto-disable syringes, “leapfrogging” standard disposable syringes.

As a result of this effective multisectoral effort supported by international agencies, funding partners, policymakers and industry, BD helped to eliminate an entire category of disease spread among children.

Source: Cohen G, BD
INTRODUCTION
ROLE OF PARTNERS