Engaging the Private Sector and Developing Partnerships to Advance Health and the Sustainable Development Goals Proceedings of a Workshop Series (2017) / Chapter Skim
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5 The Enabling Environment for Effective Partnerships in Global Health and the Sustainable Development Goals
5 The Enabling Environment for Effective Partnerships in Global Health and the Sustainable Development Goals
Pages 59-76
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From page 59... ...
. T hroughout the workshop series, participants acknowledge the importance of creating an enabling environment for multisectoral engagement in health and the Sustainable Development Goals 59
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This chapter summarizes presentations and discussions during the workshop series on regulation and accountability for creating an enabling environment for effective action on the SDGs, which includes strengthening national regulatory authorities, designing laws and regulation to improve the accountability of public–private partnerships (PPPs) , and the increasing role of civil society.
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From page 61... ...
However, Valdez noted that there are national regulatory authorities that have a total of only 10 to 50 employees. Beyond personnel, Juergen Voegele from the World Bank noted the variability in the legal frameworks governing national regulatory authority, ranging from those with limited regulation or poorly designed laws to countries where there is overregulation but limited implementation.
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From page 62... ...
As Valdez had acknowledged the need to do, this approach is moving to a systematic, structured, and multisectoral approach. THE ROLE OF REGULATORY SYSTEMS IN ENABLING INDUSTRY INVESTMENTS AND MARKET GROWTH Rajeev Venkayya, Takeda Pharmaceutical Company Limited Given the success of public–private collaborations to address arket m failures that has occurred in several areas of global health, Rajeev V enkayya from Takeda Pharmaceutical Company Limited suggested the global health community should look to these successful examples to extract lessons about the interactions between the private and public sectors and regulations.
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On the third element, he noted regional harmonization efforts, which Dan Hartman from the Bill & Melinda Gates Foundation
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HOW REGULATORY SYSTEMS PROTECT AND SUSTAIN CONTRIBUTIONS Dan Hartman, Bill & Melinda Gates Foundation Recognizing the importance of strong and predictable regulatory systems for attracting private-sector investments in global health, multi sectoral partnerships have been developed that target optimizing the regulatory systems through which products must go to be developed, registered, procured, and distributed in low-income countries. Dan artman H from the Gates Foundation described these initiatives, stating that a key consideration in the design of these initiatives has been identifying sustainable solutions that will have the greatest impact in the shortest time with the least amount of human and financial resources.
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Hartman emphasized that creating impact within the 15 year timeframe of the 2030 Agenda is not feasible in such a system, especially when it comes to patient access for new products being developed now to address medical issues specific to LICs. Within the context of this existing regulatory environment, the Gates Foundation sought to develop with its partners an approach to creating an optimized system through which a quality dossier could get to local registration (first registration to registration in LIC)
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From page 66... ...
. NOTES: AMRH = African Medicines Regulatory Harmonization; NRA = national regulatory authority; SRA = stringent regulatory authority; WHO = World Health Organization.
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, Hartman noted that the goal is to improve the fragmented regulatory system for product registration in Africa by changing from a country-focused approach to a regional approach, using established regional economic communities that are optimized and collaborative. The AMRH partnership was launched in the East African Community (EAC)
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From page 68... ...
. Based on the experience from the harmonization process in East Africa, Hartman shared several elements that he feels were necessary for the success of the AMRH partnership that can likely be applied in forging successful partnerships for regional regulatory approaches in these other regions as well as global health partnerships more broadly.
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From page 69... ...
ridging B interests to create effective PPPs, Magnusson suggested, depends on robust law, governance, and regulatory design, which create opportunities and strengthen accountability for PPPs as they accelerate national sustainable development initiatives. Focusing on the role of law and regulatory design in managing PPPs, Magnusson proposed three scenarios for PPPs in the space of advancing the SDGs: (1)
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Added to this, he noted, is the notion that an empowered civil society is essential for effective partnerships. PPPs, Magnusson argued, often reflect volunteerism rather than regulation in that businesses engaging in partnerships negotiate based on their interests and priorities, whereas under regulation, they submit to controls placed upon them.
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Businesses harmful to health may include those that market harmful products, damage the environment, ignore the health and welfare of their suppliers and employees, or fail to prevent workplace accidents. He emphasized that confronting harmful products and practices using law and regulation are vital and may be far more beneficial to public health than soft diplomacy, whereas businesses may be attracted to partnerships for reputational improvement, legitimation, and potential access to policy makers, which thereby presents them with an opportunity to shift policy to the business's advantage.
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From page 72... ...
Even when health goals are pursued through voluntary partnerships, there may still be room for governments to intervene in underperforming partnerships in order to strengthen performance, such as through setting objectively verifiable targets, ensuring the partnership faces systematic and independent monitoring, and providing economic incentives for businesses to improve performance. Magnusson noted that improving private-sector performance also depends heavily on independent assessments and reviews of partnerships regarding their progress toward stated goals, as well as on continuous public reporting of results made accessible to civil society.
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From page 73... ...
In response to Magnusson's presentation, Jo Ivey Boufford of The New York Academy of Medicine acknowledged a dichotomy that had been present throughout the workshop series discussions: regulations and legal frameworks are often seen as obstacles to forming effective partnerships, but at the same time, as Magnusson presented, concerns exist over the lack of legal frameworks and the rule of law governing PPPs. She requested examples of either the strengthening of or relaxing of regulations to form productive partnerships.
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This framework would allow civil society to monitor, evaluate, and hold governments accountable for the progress on the development agenda. Smith explained that accountability at the regional level is necessary in order to monitor best practices and share them between countries.
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Convening a platform with civil society organizations and the private sector was an effective mechanism for addressing the challenge of universal health coverage, as the private sector is increasingly involved in development initiatives and is a principle funder of these projects. Smith shared a project on which Save the Children collaborated with Bond, an umbrella organization for nongovernmental organizations (NGOs)
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From page 76... ...
, as a good example of an organized coalition ( that aims to build the capacity of civil society engagement in the sustainable development agenda. Together 2030 coordinates indicator consultation responses and produces webinars that educate individuals about the SDGs and raise awareness about how they might engage with the 2030 Agenda.
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