GSO Commentary — The Current State and Prospects for Public/Private Partnerships

Summary of a Roundtable Discussion on HIV/AIDS and Social Responsibility.
Geneva, Switzerland

The Geneva Social Observatory convened the first of a series of dialogues to look at how the private sector and the world of work can be better integrated into comprehensive national and global campaigns against HIV/AIDS.  Participants were invited from a wide variety groups with an interest in the campaign against HIV/AIDS – from intergovernmental organizations, donor governments, NGOs, trade unions, private sector associations, and individual companies. The preliminary exchange of views in this first event identified the following areas for further consideration in the roundtable series:

•    How to overcome the barriers to involvement of the private sector in funding from the Global Fund (and other sources)
•    Dealing with the tensions and mistrust between public and private sectors,
•    Dealing with the tensions and mistrust between business and NGOs
•    The challenge of networking with SMEs and the informal sector
•    The changing dynamics of drug pricing
•    The changing dynamics of public/private cooperation in developing a health infrastructure and capacity-building in general
•    Applications of best practice in country-specific circumstances
•    Engaging the diverse perspectives from international organizations, donors, the private sector, NGOs, trade unions, and host governments for which the Geneva setting is well situated.

This first discussion featured interventions from the intergovernmental organizations, large multinational companies, organizations representing small and medium enterprises, and non-governmental organizations.  The IGOs emphasized their interest in a rights-based approach and their normative expertise, with a focus on developing a co-investment strategy with the private sector.  It was noted that multilateral institutions like the WHO and the ILO and even the Global Fund tend to have good relationships with governments, but that entities from the private sector are often excluded from such relationships.

Representatives of SMEs pointed out that the campaign against HIV/AIDS is often perceived to be beyond their means, while other participants suggested that there are programmes for SMEs that are cost-effective.   Large MNEs are experimenting with a decentralized approach to awareness building and partnerships with strong NGO networks as well as their supply chains. The participants agreed that training programmes are always important, but they should also facilitate a broadened transfer of knowledge and other resources to others.

Thus, another role for multinational companies is to apply their core competencies to the campaign against HIV/AIDS.  MNEs, especially those in the health field, can and should leverage their knowledge about health care delivery.  There is also a need for better information about public/private cooperation in delivering health care and a need for greater experimentation in this area.

The discussion reaffirmed the need for public and private efforts to focus on building up the health infrastructure.   However, pharmaceutical firms and others involved in various aspects of health or health care delivery can only contribute to infrastructure development to the extent that there are markets for their products or services.  Other kinds of innovative tools are also being looked at through public policy in the regulatory arena or taxation or other kinds of policy initiatives that are seemingly unconnected to the HIV/AIDS campaign and yet have the potential to break open the logjam.  Something drastic has to happen to release the capacity bottlenecks in the system.  Other factors besides drug prices are currently more important, although there continue to be differential pricing issues and issues relating to research and development and the intellectual property rights of private pharmaceutical companies.

Finally, there was a general consensus that the potential for partnerships with the private sector should be encouraged in a wide variety of combinations.  Although the dilemma of how to improve direct public/private cooperation continues to be a serious issue, especially in Africa, there is also an accelerating array of other kinds of partnering opportunities that could contribute to a better involvement of the private sector in the campaign against HIV/AIDS.