By KATE HAWKINS, FHS member
This year’s Prince Mahidol Award Conference in Bangkok, January 28-30 2009, was on mainstreaming health into public policies. STEPS Centre affiliate, Future Health Systems, was represented at the conference by Gerald Bloom who contributed to a panel on the private sector and policy responses to improve its performance in terms of efficiency, equity, quality and affordability.The starting point for the panel on the private sector was a recognition that many countries have experienced a very rapid growth in health related markets over the past couple of decades and that poor people often rely on a wide variety of drug sellers and providers of health care, many of whom have very little formal training.
Regulation and other policy frameworks
Viroj Tangcharoensatien presented an analysis of successful arrangements for regulating private providers and argued that governments need to give greater priority to measures for influencing private providers.
Richard Smith used examples from pharmaceuticals and health service delivery to illustrate the increasing interconnection between national and global health actors. He argued that effective policy responses need to take into account both trade and health-related considerations.
Institutional arrangements and including communities
Gerald Bloom pointed out that the spread of markets had been much more rapid than the development of institutional arrangements to influence their performance. He argued that governments need to work closely with providers of health-related goods and services and with a variety of organisations representing communities, specific patient groups, and different private and public sector health stakeholders to test new ways to organise these rapidly growing markets.
Dai Hozumi presented findings of a survey which found high levels of distrust between governments and private sector actors in low and middle income countries and argued that these attitudes impede effective engagement to improve health system performance.
The panellists agreed that governments and other health stakeholders face major challenges in exercising effective stewardship over these complex, pluralistic markets. On the one hand, they need to build new kinds of partnership to improve the performance of these markets. On the other hand, they need to recognise the powerful interest groups involved and the special efforts that will be needed to ensure that the poor and relatively powerless have access to effective and affordable health care. This period of economic crisis, when it has become clear that action is needed to ensure that markets respond to social needs, represents a major window of opportunity for action in health, as well as financial markets.