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Articles

Public–private partnerships (ppps) in global health: the good, the bad and the ugly

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Abstract

Global Health Partnerships (ghps) have become ubiquitous within global health governance (ghg). Even before the onset of the global financial crisis public–private partnerships (ppps) were an omnipresent policy tool in global health and in the current austerity climate ppps have been heralded as an effective way to address a growing resource gap in ghg. Despite their omnipresence, ghps have not received adequate attention from critical scholars; few efforts have been made conceptually and theoretically to grasp how ppps are transforming the logic of ghg. We argue that ghps have contributed to the emergence of a complex global health governance architecture in which private solutions (market mechanism) are generally privileged over public approaches. Drawing on Gramscian conceptualisations of public/private, we suggest that the reshaping of the private and public realm inherent to ppps represents a further deepening of the neoliberal management of individuals and populations, allowing private interest to become more embedded within the public sphere and to influence global and national health policy making. This undermines the attempt to improve global health results as the inequitable distribution of social determinants of health, especially poverty and social exclusion, remain the main barriers to achieving health for all.

Acknowledgment

Ronald Labonté is supported through the Canada Research Chair program of the Government of Canada.

Notes

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2. Buse and Walt, “Global Public–Private Partnerships: Part 1.”

3. Except for Rushton and Williams, Partnerships and Foundations.

4. Best and Gheciu, The Return of the Public in Global Governance.

5. Peck and Tickell, “Neoliberalizing Space.”

6. Buse and Walt, “Global Public–Private Partnerships: Part I.”

7. Brugha, “Global Health Initiatives.”

8. Buse and Walt, “Global Public–Private Partnerships: Part I.”

9. Dukes, “The Contribution of the Private Sector,” 74.

10. Brugha, “Global Health Initiatives.”

11. World Bank , World Development Report 1993.

12. Brundtland, “who.”

13. Buse and Walt, “Global Public–Private Partnerships: Part I,” 555.

14. Kickbusch and Quick, “Partnerships for Health,” 70.

15. Buse and Harmer, “Seven Habits,” 259.

16. Buse and Walt, “Global Public–Private Partnerships: Part I.”

17. Szlezak et al., “The Global Health System.”

18. McCoy et al., “The Bill & Melinda Gates Foundation’s Grant-making Programme.”

19. Brugha, “Global Health Initiatives.”

20. Caines and Lush, Impact of Public–Private Partnerships.

21. Druce and Harmer, The Determinants of Effectiveness.

22. Kickbusch and Quick, “Partnerships for Health.”

23. Khawaja et al., “Evaluating the Health Impact of Public–Private Partnership.”

24. Binagwaho et al., “Achieving high Coverage.”

25. McKinsey and Company, “Building Effective Public Private Partnerships.”

26. Malmborg et al., “Can Public–Private Collaboration Promote Tuberculosis Case Detection?”

27. “Paris Declaration on Aid Effectiveness.”

28. Buse and Harmer, “Seven Habits.”

29. Shakow, “Global Fund – hiv/aids Programs.”

30. Brugha, “Global Health Initiatives.”

31. “Paris Declaration on Aid Effectiveness.”

32. McKinsey and Company, “Building Effective Public Private Partnerships.”

33. Casper, “Updated Discussion Paper.”

34. Carlson, Assessing the Impact of Global Health Partnerships.

35. Conway et al., “Building Better Partnerships.”

36. Caines et al., Assessing the Impact, 5.

37. Carlson, Assessing the Impact of Global Health Partnerships.

38. Stuckler et al., “Global Health Philanthropy.”

39. Nishtar, “Public–Private Partnerships for Health.”

40. Lins et al., “New Frontiers.”

41. Muula, “Will Africa Achieve the Millenium Development Goals?”

42. World Health Organization, Closing the Health Equity Gap.

43. Ibid.

44. Conway et al., “Building Better Partnerships.”

45. Martins et al.,“Did the First Global Fund Grant (2003–2006) Contribute?”

46. who Maximizing Positive Synergies Collaborative Group, “An Assessment of Interactions.”

47. Hafner and Shiffman, “The Emergence of Global Attention,” 48.

48. Shorten et al., “The International Health Partnership Plus.”

49. Ibid.

50. Hsu et al., “Countdown to 2015.”

51. Conway et al., “Building Better Partnerships.”

52. Ooms and Hammonds, “Global Governance of Health.”

53. York, “Economic Crisis hits Health Aid.”

54. The Global Fund, ccm Newsletter.

55. Conway et al., “Building Better Partnerships.”

56. Overseas Development Institute, Global Health.

57. Kickbusch and Quick, “Partnerships for Health.”

58. Carlson, Assessing the Impact of Global Health Partnerships.

59. Ibid.

60. Conway et al., “Building Better Partnerships.”

61. Buse and Walt, “Global Public–Private Partnerships: Part II.”

62. Shah, “Corporate Philanthropy and Conflicts of Interest.”

63. Holcombe, Writing off Ideas.

64. Buse and Walt, “Global Public–Private Partnerships: Part II.”

65. Brownell and Warner, “The Perils of Ignoring History.”

66. Freedhoff and Hébert, “Partnerships.”

67. Buse and Walt, “Global Public–Private Partnerships: Part II.”

68. Muula, “Will Africa Achieve the Millennium Development Goals?”

69. For example, Hall and Biersteker, The Emergence of Private Authority.

70. For example, Abrahamson and Williams, “Security beyond the State.”

71. Best and Gheciu, The Return of the Public in Global Governance.

72. Peck and Tickell, “Neoliberalizing Space.”

73. McCoy et al., “Global Health Funding.”

74. Ng and Ruger, “Global Health Governance.”

75. Rushton and Williams, Partnerships and Foundations.

76. Committee for Development Policy, Implementing the Millennium Development Goals.

77. Labonté et al., Globalization and Health.

78. Nishtar, “Public–Private Partnerships,” 1.

79. Action for Global Health, Financial Transaction Taxes.

80. Benatar et al., “Values in Global Health Governance.”

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