Abstract
BackgroundThe Global Public Private Partnerships for Health (GPPPH) constitute an increasingly central part of the global health architecture and carry both financial and normative power. Gender is an important determinant of health status, influencing differences in exposure to health determinants, health behaviours, and the response of the health system.We identified 18 GPPPH - defined as global institutions with a formal governance mechanism which includes both public and private for-profit sector actors – and conducted a gender analysis of each.ResultsGender was poorly mainstreamed through the institutional functioning of the partnerships. Half of these partnerships had no mention of gender in their overall institutional strategy and only three partnerships had a specific gender strategy. Fifteen governing bodies had more men than women – up to a ratio of 5:1. Very few partnerships reported sex-disaggregated data in their annual reports or coverage/impact results. The majority of partnerships focused their work on maternal and child health and infectious and communicable diseases – none addressed non-communicable diseases (NCDs) directly, despite the strong role that gender plays in determining risk for the major NCD burdens.ConclusionsWe propose two areas of action in response to these findings. First, GPPPH need to become serious in how they “do” gender; it needs to be mainstreamed through the regular activities, deliverables and systems of accountability. Second, the entire global health community needs to pay greater attention to tackling the major burden of NCDs, including addressing the gendered nature of risk. Given the inherent conflicts of interest in tackling the determinants of many NCDs, it is debatable whether the emergent GPPPH model will be an appropriate one for addressing NCDs.
Highlights
The Global Public Private Partnerships for Health (GPPPH) constitute an increasingly central part of the global health architecture and carry both financial and normative power
We focus on global public-private partnerships for health (GPPPH) since they are an important component of the global health architecture, are seen as having significantly increased the resources available for global health [1,2,3,4], and are promoted by some as offering critical opportunities to improve “efficiency, equity, value
Given the importance of the GPPPH model within global health activities, and the central role that gender plays as a determinant of health, the question we address in our paper is how and to what extent the GPPPH focus on issues of gender within their priorities, policies and programmes
Summary
The Global Public Private Partnerships for Health (GPPPH) constitute an increasingly central part of the global health architecture and carry both financial and normative power. The partnership model has been criticised as implying privatisation by stealth [9], of disrupting the focus and governance of country level health systems [10,11,12], of unduly influencing international norm-setting [13, 14] and of promoting an overly narrow technical focus on solutions for health problems [15, 16] Notwithstanding such criticism, public-private-interaction is likely to grow across all sectors, including health, as countries and international organisations mobilise to achieve the sustainable development goals (SDG) by 2030. The Addis Ababa Agenda on Financing For Development identifies a critical role of private finance for development, including through the mechanism of public-private partnerships [18]
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