Fostering healthcare Investments through PPPs George Uduku November 2017
Healthcare Industry : Infrastructure 1/2 There is a wide gap in healthcare infrastructure and a major shortage of healthcare workers across the continent Human Resources (Density of Physicians per 1000 population by Region) Hospitals Beds (Number of beds per 1 000 population by Region) NA Libya Tunisia Algeria Morocco Mauritania 40-45% Libya Tunisia Algeria Morocco Mauritania 45-50% WA Sao Tome and Principe Nigeria Equatorial Guinea Cape Verde Gabon Comoros Cote d'ivoire DRC Gambia Guinea Congo, Rep Ghana Mali Cameroon Guinea-Bissau Benin Senegal Burkina Faso Togo CAR Chad Liberia 0.0 0.5 1.0 1.5 2.0 90-95% Sierra Leone Burkina Faso Cote d'ivoire 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 Key BRICS Average (1.8) Source: Index Mundi World Bank Team analysis Already Served /Gap Africa 7 BRICS Average (3.2) Gabon Sao Tome and Principe Comoros Equatorial Guinea Cape Verde Congo, Republic of the Cameroon Gambia CAR Guinea-Bissau Ghana Liberia DRC Mali Togo Nigeria Benin Chad Niger Senegal Guinea 55-60%
Healthcare Industry : Infrastructure 2/2 There is a wide gap in healthcare infrastructure and a major shortage of healthcare workers across the continent Human Resources (Density of Physicians per 1000 population by Region) Hospitals Beds (Number of beds per 1 000 population by Region) Egypt Egypt NEA Sudan Djibouti 50-55% Djibouti Sudan 60-65% Eritrea Eritrea Mauritius Mauritius South Africa South Africa Namibia Namibia Botswana Swaziland Swaziland Zambia SA Angola Madagascar Zambia 80-85% Botswana Zimbabwe Malawi 45-50% Zimbabwe Lesotho Lesotho Angola Mozambique Mozambique Malawi Madagascar Seychelles Ethiopia Kenya Seychelles EA Uganda Rwanda Ethiopia 80-85% Burundi Rwanda Kenya 25-30% Burundi Tanzania Tanzania Uganda 0 1 2 3 Key 0 2 4 6 8 BRICS Average (1.8) Already Served /Gap BRICS Average (3.2) Source: Index Mundi World Bank Team analysis Africa 7
Africa faces an annual infrastructure financing gap of $40B - $50B
Healthcare Industry: Healthcare Expenditure There is limited money flowing into the healthcare pipe. Av. per capita expenditure healthcare in Africa is 5+ times lower than the developed world average Africa av.
Other advantages of PPPs Performance based standards yield high quality and patient satisfaction Access to innovation and advanced technology, yet affordable Efficient healthcare management Increased accessibility to poor patients For private investors, ready pool of patients from day 1
Challenges High upfront costs Weak policy and legal frameworks Limited capacity and expertise of governments at different levels in designing and managing PPP contracts Weak incentive system for partners Ambiguity of roles/ responsibilities of each partner Often misaligned motives of partners
Opportunities for improvement Incentives for private sector investment in healthcare Ease of doing business Policy driven strategy and continuity by government Grievance redressal system and timely payments
PPPs in Philips: Examples of PPP projects 1/2 India HealthMap Diagnostics Private Limited SPV between Philips India and clinical operator Established in 2015 Philips has minority stake in SPV 2 successful PPP projects in diagnostic imaging- Haryana, Jharkhand Covering total of 32 diagnostic centers Brazil PPP initiative driven by Bahia state government Consortium between Philips Brazil, Alliar and FIDI More than $40M in private investment in operating equipment and infrastructure More than 28000 exams each month
PPPs in Philips: Examples of PPP projects 2/2 Kenya