Health-Focused Public–Private Partnerships in the Urban Context Proceedings of a Workshop (2020) / Chapter Skim
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7 Political Leadership and Governance of PublicPrivate Partnerships for Urban Health
7 Political Leadership and Governance of PublicPrivate Partnerships for Urban Health
Pages 73-88
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From page 73... ...
. • The World Health Organization's Healthy Cities Network can mitigate the c omplexities of policy development (which involves substantial legwork, data, and education and diverse stakeholder interest)
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Jo Ivey Boufford moderated the workshop's final discussion after Baptista Leite and Marchandise-Franquet presented. CORPORATE GOVERNANCE AND PARTNERSHIPS: THE CITIES CHANGING DIABETES INITIATIVE Niels Lund (Novo Nordisk)
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From page 75... ...
recognized by the UN. Lund then turned to the Cities Changing Diabetes initiative and noted that, as Napier explained earlier, diabetes is rising at an alarming rate around the world (see Figure 7-1)
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As of July 2019, 22 cities and more than 150 civil society and academic institutions are partners in the Cities Changing iabetes initia D tive, and more cities are expected to join over the coming years. Lund noted the importance of all partners realizing some value in any partnership, and that holds true for Cities Changing Diabetes.
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In the future, Cities Changing Diabetes will take a long-term approach to bending the diabetes curve and improving population health by 2045. Between today and 2025, the initiative aims to implement health actions and policy changes in cities that will create new social norms, behaviors, and health-promoting environments over subsequent decades.
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Typically, the list of stake olders includes city health authorities, national finance h m inisters, information technology companies, insurance organizations, patient associations, sport associations, school officials or the education minister, and employee associations. She noted that one differ ence between Better Hearts Better Cities and Cities Changing Diabetes seemed to be that Better Hearts Better ities relies mostly on local C resources, but the Novartis Foundation provides seed funding for the "risky" or most innovative parts of Cities Changing Diabetes -- parts for which governments do not necessarily have the budget.
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From page 79... ...
Lund replied that although working with elected officials is difficult, sustaining programs that are not anchored in local political processes and local decision making is also difficult. That said, Lund noted that the collaborations his program helps form do engage local civil society because those are the organizations that produce change on the ground.
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. A major question prompted by the data is how to generate even better FIGURE 7-2 Health outcomes versus health spending per head.
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Baptista p Leite said, "It goes to show that if you do not measure, you just believe whatever the awards tell you." A second project he discussed was Smart Health Cascais, which aims to monitor key health and social indicators among city residents. The genesis of this project, Baptista Leite explained, was his interest in under
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From page 82... ...
He said that achieving universal health care will be impossible without the participation of nongovernmental and community-based organizations and of the private sector. Baptista Leite commented, "If we do not work with civil society, we will leave people behind, and we will not have true universal coverage." FIGURE 7-3 The proportion of people who have a family physician (teal)
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This is where the WHO Healthy Cities Network enters. It empowers city mayors to use their convening abilities to get people to the table; their positions and communication skills, as well as the best research available, to influence public opinion; and their clout to develop win–win strategies and partnerships.
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In closing, Marchandise-Franquet said that creating healthy cities requires a global vision, not a mere sprinkling of a little of this and a little of that onto existing problems. The Healthy Cities movement represents an ecosystem that addresses the complexity of cities and the issues that adversely affect their residents.
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While transactional relationships still occur, today's PPPs are likely to based on shared, purpose-driven values and goals. Companies, foundations, and civil society organizations join municipalities to solve societal challenges.
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He said, "Not only did it become the most fashionable skate park in the country, it is a source of revenue for that whole area, and it has actually generated a whole set of social initiatives and movements around it." Responding to a question about the extent to which ideology hinders developing effective programs at the local level, Baptista Leite said ideology impedes local progress less; people are more concerned about how a program affects their own lives and about what it means for their children and their neighborhood than they are about ideology. Baptista Leite noted, "If we were to reinforce the role of local governance, then there would be a potential to move away from the ideological stance and go toward what it impacts in the real world, on real people's lives." Aerts agreed that local work with a range of stakeholders and with civil society often rises above ideology.
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From page 87... ...
Boufford stated that it seems clear that incentives will need to be developed to address the relative lack of market forces supporting sustainable PPPs that create long-term shared value for all partners. Some examples have been explored in this workshop, but more are needed to align the expertise, financial resources, and political forces important for improving urban health and reducing urban health inequities -- both of which are critical factors in achieving global health.
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