Affordable healthcare for all Indians is an audacious goal. What better time in history to accomplish this target than today? The National Health policy 2017 released recently promises healthcare in an ‘assured manner’ to all Indians and addresses current and emerging challenges arising from the fast changing socio-economic, demographic and political scenario in the country. Nearly two years ago, the Indian government joined hands with the global community at the UN General Assembly session to adopt Sustainable Development Goals (SDGs). The SDG agenda urges all countries to “ensure healthy lives and promote well-being for all at all ages”, a tall order for a country like India, which has historically lacked a robust public health system.
Though India has scored several successes such as eradication of polio and reduction in the rates of infant and maternal mortality, there’s a long road ahead. Improved health indicators in some areas and good economic progress don’t necessarily reflect the threat of vaccine-preventable diseases (VPDs) such as measles, meningitis, tuberculosis, pneumococcal disease, and diarrhea, to public health in India. One fourth of deaths from VPDs occur in India. PPPs are a critical tool in the battle against community health challenges like VPDs. The past decade has seen a rise in partnerships as a strategy to tackle global public health issues of AIDS, tuberculosis, and malaria. Several of our national health programs receive support from the private health sector: polio eradication, EPI (extended program of immunisation), family welfare, TB-DOTS, HIV/AIDS, and malaria.
The rapidly growing burden of public health challenges makes the need for PPPs absolutely imperative. Emerging disease patterns and constantly evolving technologies and treatments call for the pooling of resources and improvement of healthcare if we want better health outcomes. PPPs are one way that state governments can address the inefficiency and inequity in the health system, and deliver critical, life-saving interventions to the neediest, most underserved communities. Refreshingly, our national health policy also advocates the “establishment of inclusive partnerships,”—referring to the proactive engagement of the government, with the private sector for critical gap filling in certain areas: strategic purchasing, capacity building, skill development programs, awareness generation, developing sustainable networks for community, and so on.
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Providing impetus to national immunisation program by leveraging PPPs will enable achievement of health targets in a cost-effective manner. Sustained and progressive collaboration in the form of PPPs will potentially drive market growth of vaccines and drugs in India. Most thriving research and development (R&D) ecosystems stem from strong collaborations and partnerships. A multi-partite research and marketing consortium in priority areas of health like tuberculosis and malaria would propel the development of innovative preventive and curative tools. There are several outstanding examples of successful partnerships in the arena of drug and vaccine development, such as Global Health Innovative Technology (GHIT) Fund in Japan. Established in 2013 as a PPP between the Japanese government and a group of leading Japanese pharmaceutical companies.
In India, successful partnerships have also resulted in leading drug discovery and vaccine development projects. Rotavac, a “Made in India” rotavirus vaccine, serves as an example of the effectiveness of the PPP approach. Another example of global vaccine collaboration is that of the Malaria Vaccine Initiative, that partnered with a private pharmaceutical company (GSK) to develop a vaccine through Phase III clinical trials. Medicines for Malaria is another PPP that has succeeded in building the largest malaria drug pipeline in history, comprising almost 60 projects through innovative R&D partnerships and conducting of clinical trials in malaria-endemic countries.
Yet another example of a PPP that has influenced public policy agendas and garnered major financial commitments is the Drugs for Neglected Diseases initiative (DNDi). This PPP functions as an open source model with participation from multiple public and private research organisations, NGOs, academic institutions and pharmaceutical companies for the development of new treatments for neglected tropical diseases. By 2018, DNDi expects to deliver treatments for a range of diseases from leishmaniasis, sleeping sickness, and Chagas disease, to malaria and pediatric HIV.
Harnessing even a fraction of the private industry’s vast resources—manpower, laboratories, and databases—would help the public sector evolve quicker, smarter and affordable solutions to health dilemmas. Innovation is the need of the hour and pooling of resources to solve complex health problems is the way forward.