This piece was originally published on the Health Systems Governance Collaborative site.
By Anna Cocozza, WHO, Barbara O’Hanlon, Independent Consultant, Aurélie Paviza, WHO, and Meru Sheel, Jhpiego, along with Kristopher Ansin, Accenture, Grace Chee, John Snow Inc., David Clarke, WHO, Shalini Desai, WHO, Rebecca Fields, John Snow Inc., Somesh Kumar, Jhpiego, Christopher Morgan, Independent Consultant, Naomi Nathan, WHO, Gaurav Sharma, Jhpiego, Samir Sodha, WHO and Aya Thabet, WHO
The COVID-19 pandemic has stretched many health systems and reinforced the need to restore fundamental commitments to strong primary health care systems and adopt a ‘whole-of-government’ and ‘whole-of-society’ response to the pandemic across both public and private sectors. In health, such partnerships have included engaging the private sector to respond to various aspects of the pandemic such as testing, contact tracing, health information systems, isolation, treatment, in maintaining essential health services and more recently, for the roll-out of COVID-19 vaccination.
Rapidly vaccinating health workers and other priority groups against COVID-19 and expanding access to other population groups will require innovative and creative solutions. Similar to the response to the pandemic, developing and delivering a large-scale COVID-19 vaccination roll-out calls for strengthened engagement of all stakeholders – public and private alike – by governments to support national efforts.
Additional capacity and complementary competencies available in the private sector present an important opportunity for governments that are faced with constrained resources and overstretched health systems. The private health sector may also have historical links to groups that do not access government services. Effectively harnessing and aligning these private resources can provide a significant boost to ensure an efficient and accelerated COVID-19 vaccine roll-out that respects the principles of equity, quality, access and financial protection.
Technical agencies’ key global plans and implementation guidelines already support this ‘whole-of-society’ approach to immunization:
- The Immunization Agenda 2030 advocates for broadening partnerships and multi-sectoral collaborations to work together towards common immunization goals and objectives.
- The 2017 WHO Guidance Note on Engagement of private/non- governmental health providers in immunization service delivery highlights areas for potential collaboration and action to enhance equity, quality and scope of vaccination coverage through engagement of the private health sector.
- WHO’s COVID-19 vaccine introduction toolkit guides countries on the introduction and roll-out of COVID-19 vaccines and supports government engagement with multiple stakeholders including the private sector.
So, what can governments do next? How can they engage the private health sector to expedite the roll-out of the COVID-19 vaccine?
Recent history provides meaningful lessons on private sector contribution to immunization and new vaccine introduction. Evidence reviews demonstrate that the private sector can contribute to the scale and speed required for the roll-outof COVID-19 vaccination programmes (watch this space for upcoming policy briefs). These examples show that the private health sector has been involved in all aspects of a national deployment and vaccination plans, ranging from planning, coordination, regulation and financing; todevelopment, manufacturing and procurement; vaccine cold chain and logistics; communication and demand generation; service delivery; human resources management, training and supervision; and monitoring and evaluation (click here for Figure 1).
Already, the private sector is actively participating in the introduction of COVID-19 vaccines in some countries. Emerging country examples show private sector involvement in planning, coordination, regulation and financing (Philippines), development, manufacturing and procurement (India), vaccine cold chain and logistics (Nigeria), communication and demand generation (Uganda), and service delivery (Ghana, India). Given that health workers are an important vaccination target group, ensuring inclusion of non-government health staff is essential for completeness of protection.
Engaging the private sector may come with challenges. On the private sector side, private providers are not always included in government lists of health facilities and staff; may not be licensed to supply vaccines; experience challenges in reporting into national information systems; or may not have access to vaccines and safety monitoring systems among other issues. On the public sector side, the responsibility for routine immunization services is mostly a government function, meaning that many governments, particularly in LMICs, can often lack the knowledge, the experience, and ‘know-how’ to engage the private health sector in vaccine services.
We are calling on countries to start actively looking for opportunities to engage with the private sector for the COVID-19 vaccines roll-out. Private sector engagement can inject resources and expertise, promote operational efficiencies through technology and innovation, and relieve pressure on government immunization programme staff and resources as well as expand access to services. Acknowledging and anticipating the challenges in partnering with the private sector is a first step.Governments can examine and reassess vaccination plans to include the private health sector; and identify specific opportunities to engage with the private sector.
To support government action to collaborate with the private sector, the World Health Organization is partnering with the USAID’s MOMENTUM Private Healthcare Delivery and MOMENTUM Routine Immunization Transformation and Equity project to document the evidence on and opportunities for effective private sector engagement in COVID-19 vaccine rollout. We will share country examples of successful (or not) partnerships and provide implementation guidance across the three phases of the COVID-19 vaccines readiness and roll-out (click here for Figure 2).
We want to hear from everyone involved in this journey to engage the private sector as part of the COVID19 vaccine roll-out – governments, immunization managers, private health providers, etc. We are calling for countries to share their experiences in collaborating with the private health sector in the COVID-19 vaccines roll-out, their role and lessons learned in successful partnerships – both the good and the bad. We encourage everyone to reach out to [email protected] to share their experiences. We will share the information on the Governance Collaborative site and TechNet21, and through a series of webinars to showcase lessons learned and experiences. WHO is also working with global health partners to establish a new platform to convene global, regional and local actors to join forces and align programmes of work in order to help country governments deal with the private components of their health systems to respond to COVID-19. We hope those initiatives will help governments and their private partners accelerate safe and equitable access to the COVID-19 vaccine and turn the tide of the pandemic faster!