Recorded presentation

Pia Schneider, PhD, Abt Associates, 4800 Montgomery Lane Suite 600, Bethesda, MD 20814 and Zillyham Rojas, PhD, MPS, BS, Central American Institute for Health, Apartado 2234, Managua, Nicaragua, 5052700252 ext.102, zil@icas.net.

Issues: Many initiatives to scale up priority services such as HIV/AIDS prevention and treatment services, depend significantly upon increased use of private sector providers. One of the principles underlying The Global Fund to fight AIDS, TB and Malaria is a “Focus on the creation, development and expansion of government/private/NGO partnerships”. Description: The study presented here assesses how Global Fund-supported activities have affected (a) the number, distribution and organization of providers (public, private for-profit, private non-profit, informal sector)? (b) the quality of care, range of services, and volume of services offered by private sector providers and (c) the development of public/private partnerships. The study is based upon document review, facility surveys (including private providers), and in-depth interviews with key informants, in a total of six different countries. Lessons Learned: Diverse strategies are being used to engage the private sector including contracting the private sector for behavior change and communication activities, and in the provision of DOTS/TB care, and HIV/AIDS care. Frequently these initiatives occur in a context where government lacks trust in the private sector. Sometimes new NGOs have emerged in response to the arrival of Global Fund monies in country. In some countries issues of transparency, corruption and conflict of interest in the award of contracts have also been of concern. Recommendations: While the private sector is an essential partner in scaling up priority services, it is also extremely heterogeneous. Governments need to develop more trusting relationships and greater capacity to manage public/private partnerships.

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