Disguising Trade in Development Partnerships

Public-private partnership (PPP) once christened to improve on quality and economic efficiency of public services in developed countries, is now widely promoted as a development tool that could ensure basic social services in LDCs. This paper analyses the doctrine of PPP and the application of various models to LDCs health delivery systems. It examines different types of PPP arrangements including in international trade, other economic arrangements, development PPPs and domestic health initiatives. Examples are drawn from LDC countries especially Sierra Leone, to illustrate the practice of respective health PPPs and regulatory challenges inherent in complex PPP mix. A crucial issue is the appropriateness of marketing ‘Public-Private for profit partnerships’ as a development mechanism for health delivery in poor countries. The paper recommends a more pro-active role for LDC governments in the design, implementation and surveillance of health PPPs as essential in achieving health development goals.