About eleven years ago, I was challenged about the Public Health Foundation of India (PHFI) being set up as a public private partnership (PPP) through contributions from the government, charitable foundations and private philanthropy. While it was common then for policymakers to advocate PPPs in industry and infrastructure, it was considered unusual in the social sector. Apart from the lack of clarity about how PPPs were crafted and governed, there was scepticism about their contribution to the larger public good. Some saw it as an abdication by the state of its role in delivering public services, be it water and power or health and education. Many doubted the state’s ability to steer the private partner on the committed path. Indeed, cynics defined PPP as a ‘Partnership for Private Profit’.
I felt that PPP was an inappropriate term to describe an initiative that brought together different types of organisations for the common good of society. To me, it appeared that PPP should stand for Partnership for a Public Purpose. Especially so in the social sector. I started describing PHFI that way, not as a defensive response but from a genuine conviction that this was the right way to look at it. When I started using that definition in various national and global health meetings, the wording appealed to many when I explained my reasoning.
Much of the ambiguity about the taxonomy, architecture, operational guidelines, governance and accountability of PPPs can be removed if we first clearly define the public purpose that calls for a PPP and then proceed to define the overall deliverables, roles and responsibilities of the partners, consultative and collaborative channels, monitoring mechanisms and measures of accountability.
Further, such a definition helps us move beyond the conventional construct of a PPP as a marriage of convenience between a public sector entity and a private sector entity which are philosophically misaligned and often mutually suspicious. It also takes into account the heterogenous nature of the non-governmental actors loosely bunched together as the private sector. They encompass both for-profit and non-profit private sector entities, apart from the academia, media and community based organisations (CBOs). Social sector challenges frequently call for multi- sectoral actions involving a variety of partnerships. These can connect a public sector entity to a for-profit or a non-profit entity, forge a link between two or more for-profits, between several non-profits or between a for-profit (like an industry) and a non-profit entity (like a grass roots CBO). These partnerships can be formed on the basis of what they can best deliver together, whether in sanitation, health education, health service provision or non-formal education.
By expanding the universe of PPPs in the social sector to engage a diversity of actors in differing combinations, we can create fit-for-purpose partnerships suitable to each social objective and each specific task linked to it. There is no reason why two for-profits cannot work together to develop innovative technologies for improving access to primary health care and partner with a non-profit for training frontline health workers and an academic institution for impact evaluation. All, of course, for a clearly defined public purpose that the partners agree on and not motivated by a pecuniary pursuit. The partners will agree on defined deliverables, operational design and delineated measures of mutual accountability. Where it involves participation in a public service or government-led programme, even without public funding, oversight by a public sector agency should be provided to partnerships between private entities. This is not to tie them down with red tape but to ensure a needed level of social accountability.
Societal welfare requires active engagement of multiple actors, often working together. The conventional public-private partnership model is too limited a pathway and too outmoded a concept for advancing the agenda of social development. Redefining PPP as a partnership for a public purpose makes it possible to draw upon the energy of several innovative models of socially-committed partnerships. It also enshrines public good as the guiding principle and essential deliverable of such partnerships, moving us from an era of scepticism about social sector PPPs to an era of enterprise in seeking new opportunities for team work in social development.
K Srinath Reddy, President, Public Health Foundation of India
Views are personal