Private Sector Engagement Research Articles

The Private Sector Role as a Key Supporting Stakeholder towards Circular Economy in the Built Environment: A Scientometric and Content Analysis

The United Nations (UN) 2030 Agenda, borne from the most inclusive policy dialogue ever, emphasized partnerships built upon collaboration to achieve sustainable goals, as documented in SDG17. However, the building and construction sector has been experiencing sustainability issues, leading to several traditional government-led initiatives in the built environment. The private sector is critical to achieving the sustainable development goals (SDGs) and the 2030 Agenda by interacting with societies, governments, and other actors for a circular built environment. The circular economy (CE) is a paradigm that is becoming increasingly popular to drive the movement to sustainability, requiring the partnership of the private sector to be implemented successfully. However, the application of CE initiatives in the private sector engagement has received less attention. Recognizing the interaction of multiple parties’ influence on the uptake of a CE, this study thus seeks to examine the participation of the private sector in the CE in the built environment using a mixed review approach (scientometric and content analysis). The findings reveal that the private sector faces barriers in terms of financial and economic, institutional and technological, and political and regulatory factors. This research also identified areas for greater private sector involvement in CE initiatives in the built environment, such as resource reduction, sharing, and the adaptive reuse of existing buildings.

Private Sector Engagement for Infectious Disease Surveillance in Mixed Health Systems: Lessons from a Model Dengue Reporting Network in India

Disease estimates from surveillance in mixed health systems is affected by lack of data from the private sector. We aimed to characterize private sector engagement and reporting to a disease surveillance network, and determine the implications on dengue case detection. We developed and set up a public–private network (CODREN—Community Disease Detection and Response Network) with recruitment of eligible health resources ( n = 462) in a municipal ward of Pune city, India (population 209,331). Dengue cases reported through CODREN were compared with reports of the local dengue surveillance (LDS) over 1 year. Private clinics constituted the majority of eligible providers (60%, 276). Retention of participants was 81.7% with 13.9% reporting dengue cases. Phone call was the preferred reporting method (85.5%, 564 reports). CODREN captured a higher number of cases than LDS (78.9%, 251 vs 50.6%, 161), increasing case detection by 18% due to increased private reporting points. A twofold lower number of cases was reported by LDS from shared reporting points with CODREN, due to discrepancies in case definitions and diagnostic test preferences among private providers. We conclude that private sector engagement can improve dengue case detection with the selective inclusion of providers, sustained contact, feedback and simple reporting methods. Testing guidelines and case definitions adopted by the LDS need to address heterogeneity of private practice in mixed health systems, in order to improve dengue estimates in India.

A Value Chain Approach to Forest Landscape Restoration: Insights from Vietnam’s Production-Driven Forest Restoration

According to FAO figures, over 129 million hectares of forests have been lost globally since the 1990s, mainly in the tropical Global South, where agriculture acts as the main driver of forest conversion. International commitments, such as the Bonn Challenge, aim to reverse this trend through the application of forest landscape restoration (FLR) as an integrated and inclusive restoration approach. Beyond the discourse level, however, FLR implementation lags behind expectations due to insufficient funding and a disconnection with local implementation. We argue that, instead of relying on public resources for conservation-driven restoration, increased private sector engagement may point the way out of the funding impasse. However, this requires a shift towards production-driven FLR, which includes the livelihood needs of communities and smallholders as agents of landscape transition. For achieving the dual purpose of connecting landscapes with markets and promoting sustainable landscape restoration, we ascribe value chains and their economic, social and ecological configurations a key role in production-driven FLR. Drawing on Vietnam’s forest restoration pathway as an illustrative case, we examine how production-driven forest restoration, smallholder engagement and value chain upgrading can stimulate positive landscape transitions. We conclude that, depending on their configuration, value chains can have negative or positive social and ecological impacts at the landscape level. Furthermore, regulated, progressive and high-value commodity chains may perform better in the areas of integrated FLR objectives landscape integrity, ecological functionality and human well-being.

CHALLENGES IN INITIATION OF TREATMENT OF MULTI DRUG RESISTANT-TB PATIENTS: A HOSPITAL BASED CROSS SECTIONAL STUDY IN JHARKHAND.

BACKGROUND: Multi-drug resistant tuberculosis has become major public health problem and obstacle to effective control of tuberculosis. Over a period of time, there are several landmark achievements including policy and system preparedness for universal access to TB care including mandatory notication of TB cases, development of standard for TB care in India, comprehensive real time TB information management system-NIKSHAY, use of rapid molecular diagnostics, successful innovations in private sector engagement for TB care-Universal access to TB care. Objective was to nd out the challenges in initiation of treatment of Multi Drug Resistant-TB patients get admitted in ITKI Sanatorium Ranchi Jharkhand. METHODS: It was a hospital based cross sectional study carried out from August 2016 to Nov.2018 on Multi drug resistant tuberculosis patients admitted in MDR-TB centre Itki Sanatorium Ranchi after approved from institutional ethics committee. Total study subjects included in study was 64. RESULTS: Most of the study subjects 58 (90.6%) did not know about the MDR-TB. Most of the study subjects 40 (62.5%) had been given reports of CB-NAAT test on same day followed by study subjects 24 (37.5%) on alternate day. No one study subjects 64 (100%) had been given any type of incentive for travelling to pretreatment evaluation centre. In above table, most of the patients 51 (79.7%) had made payment for investigations at district hospital/ SDH level followed by 13 (20.3%) who were free of any expenditure for investigations. Most of the study subjects 60 (93.7%) were not visited by any health staff between nal diagnosis of MDR-TB and initiation of treatment for MDR-TB followed by subjects 4 (6.3%) who were being visited by health staff. Most of the study subjects 48 (75%) were unaware about the NIKSHAY POSHAN SCHEME for MDR-TB patients followed by subjects 16 (25%) who knew about the NIKSHAY POSHAN SCHEME for MDR-TB patients by means of various medium.

Universal health coverage and public-private arrangements within Sri Lanka's mixed health system: Perspectives from women seeking healthcare

Universal health coverage (UHC), a target of the United Nations' third Sustainable Development Goal on health, refers to people having access to essential healthcare services without suffering financial hardship. The World Bank and other leading global health actors champion mixed health systems—in which government and privately-financed market delivery coexist—as a sustainable model for UHC. Yet, little is known about what these public-private arrangements mean for women, a crucial partaker of UHC in low- and middle-income countries (LMICs). Using a critical feminist approach, this study explores how women negotiate access to public and private healthcare services within Sri Lanka's state-dominant mixed health system. Data were generated through focus group discussions and interviews with women residents of an urban division in Kandy, a city seeing rapid private healthcare expansion in central Sri Lanka. Notwithstanding policies of universality guiding public sector delivery, out-of-pocket payments burden socially and economically disadvantaged women. They use private services to fill gaps in the public system, and consult dual practitioners privately, to pave way for better (public) care. By contrast, wealthier women opt for private outpatient care, but capitalize on the dual practitioners to obtain priority access to oversubscribed services at public hospitals. Most women, regardless of social location, combine public with private, albeit to varying degrees, to save on household expenses. Relying on women's invisible care work, these public-private “hybrid” routes of access within Sri Lanka's poorly regulated mixed health system, reinforce social inequalities and individualize the responsibility for healthcare. The article throws light on the messiness of access within mixed systems and demands closer scrutiny of calls for private sector engagement in the quest for UHC in LMICs.

India's Public Education Subsidies

The purpose of this paper is to examine how higher education in India is currently supported, as well as the viability as well as feasibility of alternative financing plans. In India, the government pays for the majority of higher education. Furthermore, since higher education helps both individuals and communities, and since it draws society's wealthier members, a case might be made for moving the economic strain from the social to the private realm. Given financial constraints and concerns about justice, it is suggested that paying higher education largely via general tax revenue may not be the best long-term plan. As a consequence, many policy solutions are considered, including public support of higher education, student loans, graduate tax, student fees, and private sector engagement. A discriminating pricing system, it is said, would be the most efficient and equitable of the possibilities. While the government will continue to fund a large portion of higher education costs owing to socioeconomic and political realities, efforts should be made to build a funding model that integrates a range of techniques rather than relying on a single one. Fee and subsidy policies should also be differentiated across several levels as well as varieties of higher education, according to the authors.

Urban Population Growth and Per Capita Income's Effect on Nigerian Ruminant Livestock Production System

The study broadly explored the relationship between urban population growth and ruminant livestock production systems in Nigeria. It utilized aggregate time series data from World Development Indicators and FAOSTAT over a period of 53 years. Data collected were analysed with descriptive methods and Fully Modified Ordinary Least Squares (FMOLS) method. The three FMOLS models used were cointegrated. Growths in urban population, temperature change, per capita income in relationship with historical outputs of meat from cattle, sheep and goat were on the ascent right from 1961 to 2013. A major descent was observed in 1986 when the Structural Adjustment Programme was embarked upon in Nigeria. It was found that urban population, total population and per capita income significantly determined the long run output levels of meat from cattle production systems in Nigeria. Urban population significantly influenced the variability of meat production from sheep. The goat meat output were determined by urban population, total population and per capita income. Conclusively, the growing relationship between urbanization and livestock production could exacerbate land scarcity and fuel land intensification especially for livestock production in urban fringes. The need for guided, sustainable land intensification in livestock production is therefore recommended at peri-urban areas of Nigerian cities. Herdsmen and ranchers should be provided with farm credits to boost their productive capacities and meet the food security needs of the growing urban population in Nigeria. More engagement of organized private sector in livestock value chain should be promoted.

Assessment of the Role of Private Sector in the Achievement of Sustainable Development Goals (SDGs) In Nigeria

Given the deficiency of many countries in achieving the Millennium Development Goal (MDGs), the United Nations at its 2015 General Assembly, launched the Sustainable Development Goals (SDGs) as a new developmental strategy with a new terminal date for 2030. Countries including Nigeria, can effectively achieve most of the SDGs (reduce poverty by half, zero hunger and decent work and economic growth) if they emphasise the development of the nature, role and productivity of the private sector. This paper seeks to examine the general relevance of SDGs and assess the role of private sector in achieving SDGs in Nigeria. The methodology adopted is narrative textual; use was made of secondary sources of data to achieve this objective; It is found that, Nigeria is one among the 18 countries that are off track to halve multidimensional poverty by 2030. This is manifest in the high unemployment and dimensionally poor population (Poverty World Headquarters) among other factors, resulting to general low SDGs performance score. It also reveals that, the Nigerian SDGs implementare not strategic in the engagement of the private sector in the implementation of SDGs in Nigeria; low involvement of private sector in the national medium development plan, poor sensitization and awareness about SDGs among private sector operators leading to their non-inclusion of SDGs in the annual plans. It is recommended that, there should be increased strategic private sector engagement in SDGs implementation through awareness and conscious planning.

Assessing the Private Sector and Civil Society Engagement in Poliomyelitis Myelitis Vaccination among Internally Displaced People in Khartoum State, 2019

Background Poliomyelitis is an oro-fecal vaccine preventable disease affecting mainly children under five-years-old and is prevalent in poor sanitation and hygiene environment. The World Health Organization (WHO) stressed the need for coordination between the public and the non-governmental (particularly private) sectors to increase the coverage with immunization. This study aims to assess the private sector and civil society engagement in the implementation of poliomyelitis vaccination among internally displaced people and irregular settlement in Khartoum. Specifically, the study aimed to identify the major gaps in immunization program among internally displaced people (IDP), and to determine the enablers and barriers for the private sector and civil society active engagement in the immunization program. Methods This cross-sectional study used both quantitative and qualitative methods. Data was collected from the health facilities mangers and the expanded program of immunization (EPI) service providers at private and civil society’s facilities in the targeted areas using a semi-structured interview guideline and a self-administered questionnaire respectively. The obtained quantitative data was coded and then analyzed using the statistical package for social science (SPSS version 21) and presented using tables. For qualitative part, all data were transcribed verbatim and analyzed using a thematic analysis, paying particular attention to axes of difference, including gender, private center and non-governmental organization. Results The major gaps were the insufficient number of health facilities together with uneven distribution of the available ones, and unclear mandate of non-governmental organizations (NGOs) and private sector in EPI programme. Most of the managers complained from the lack of human resources for vaccination but stressed on the fact that training of the existing staff made the availability of the service easier. Twelve (12) out of 23 health facilities visited by the field team where in areas that do not have electricity or water supply which imposed more efforts to preserve the vaccines. Conclusion Private and civil societies were not well utilized by EPI program in Khartoum, Sudan. A clear mandate for engagement and periodic training for the service providers is highly needed.

Private sector engagement in humanitarian financing, logistics and technology and implementation of humanitarian aid projects in Kenya

Humanitarian crisis across the globe continue to increase in size, frequency, and complexity in the 21stCentury challenging the ability of Organizations in disaster relief to save lives of persons in distress. This has been a challenge in Countries prone to natural disaster as well as those prone to human conflict such as Syria, Southern Sudan, Central Africa Republic, Yemen, Somalia and Democratic Republic of Congo. In Kenya, humanitarian crises have occurred in the form of recurrent drought, floods, malnutrition and food security, disease outbreak, post election violence; resource based inter-communal conflicts as well as terror attacks. These crises often require immediate response in order to save lives, as a result there is increasing need to engage private sector in humanitarian logistics, financing and technology when implementing humanitarian aid projects. The objective of this study was to examine the influence of combined private sector engagement and the implementation of humanitarian aid projects. The paradigm guiding the study is pragmatism and the study employed a cross sectional-survey design. The sample was drawn from Organizations in disaster relief programmes using both probability and non-probability sampling technique. Both primary and secondary data was utilized in data collection. Primary data was collected using self administered questionnaires, Key Informant Interview, and Focus Group Discussions Guides. Questionnaires issued were 117 out of these, 85 which is 72.6% were returned for analysis. The data was analysed using both descriptive and inferential statistics. For descriptive analysis, mean, percentages and frequencies were used. For inferential analysis, correlations and regressions were used. For p<0.05, H0 was rejected and H1 accepted. For the strength of the relationships, r values were considered where: +0.10< r <+0.29; weak correlation +0.30< r <+0.49; moderate correlation +0.5 < r <+1.0; Strong correlation. The qualitative data was analyzed using content analysis. The study findings indicate that combined private sector engagement influence on implementation of humanitarian aid projects in Kenya. The study concludes that combined private sector engagement is critical in implementation of humanitarian aid projects and there is need to put more emphasis on collaboration. The study recommended that there is need for more academic research on humanitarian aid.

What’s behind the barriers? Uncovering structural conditions working against urban nature-based solutions

Nature-based solutions (NBS) are a promising and innovative approach to address multiple sustainability challenges faced by cities. Yet, NBS are not integrated into mainstream urban development practices. Based on a qualitative comparative case study of Germany, Hungary, the Netherlands, Spain, Sweden, and the United Kingdom, this study shows how barriers to mainstreaming urban NBS are shaped by the structural conditions in urban infrastructure regimes, which offers an improved, context-sensitive understanding of why such barriers persist. We identify underlying structural conditions shaping seven key barriers to urban NBS: limited collaborative governance, knowledge, data and awareness challenges, low private sector engagement, competition over urban space, insufficient policy development, implementation and enforcement, insufficient public resources, and challenging citizen engagement. This study also advances an understanding of urban infrastructure regimes as complex, heterogeneous systems, made up of different functional domains that define the space available for sustainability innovations. Importantly, our case comparison reveals that similar barriers to NBS mainstreaming in planning processes are caused by different structural conditions across countries. For example, perceived causes of limited citizen engagement are low environmental awareness in Spain, a lack of resources to support participation in Hungary, and NIMBY-ism in the Netherlands. Our findings stress the importance of moving beyond ‘silver bullet’-type approaches to addressing NBS mainstreaming barriers, towards systemic but context-sensitive responses, tailored to specific urban infrastructure regimes. This systematic understanding of barriers and their underlying structural conditions can help both scholars and practitioners identify promising pathways for the mainstreaming of NBS as an urban sustainability innovation.

Private Sector Engagement in the Self-Governance of Urban Sustainable Infrastructure: A Study on Alternative Fueling Infrastructure in the United States

Greenhouse gas emission reduction and decarbonization goals drive citizens’ interests in alternative fuel vehicles and have created fast-growing demands on alternative fuels. While governments are promoting the transition to alternative fuel vehicles, the lack of refueling and recharging infrastructure for the vehicles is a key barrier to the adoption. At the same time, the public sector cannot solely provide needed alternative fueling infrastructure due to limited financial resources. Consequently, governments in the U.S. have been working on facilitating the private sector’s investment in alternative fueling infrastructure. The most common approach was financial incentive programs and policies, but the U.S. also promotes self-organized collaborative governance of alternative fuels across sectors at the local level. This paper asks whether these two approaches stimulate the private sector’s engagement in providing alternative fueling infrastructure. This study uses the case of the Clean Cities program that targets the reduction in petroleum usage, adoption of alternative fuels and creation of self-governance at the local level. Local private businesses, local government agencies and non-profit organizations voluntarily participate in the local transition to alternative fuels. Therefore, this governance aims at facilitating more sustainable actions and business choices in the private sector. This paper tests the hypotheses of whether the local self-governance of Clean Cities increases privately-owned alternative fueling infrastructure using panel fixed-effects Poisson regression models. Based on the data of counties in 12 states from 2004 to 2015, the results of empirical analysis suggest that both self-governance and financial incentive programs are effective in increasing the engagement of private actors in providing alternative fueling infrastructure.

Molecular testing and analysis of disease spreading during the emergence of COVID-19 in Maca\xe9, the Brazilian National Capital of Oil

The Brazilian strategy to overcome the spread of COVID-19 has been particularly criticized due to the lack of a national coordinating effort and an appropriate testing program. Here, a successful approach to control the spread of COVID-19 transmission is described by the engagement of public (university and governance) and private sectors (hospitals and oil companies) in Macaé, state of Rio de Janeiro, Brazil, a city known as the National Oil Capital. In 2020 between the 17th and 38th epidemiological week, over two percent of the 206,728 citizens were subjected to symptom analysis and RT-qPCR testing by the Federal University of Rio de Janeiro, with positive individuals being notified up to 48 h after swab collection. Geocodification and spatial cluster analysis were used to limit COVID-19 spreading in Macaé. Within the first semester after the outbreak of COVID-19 in Brazil, Macaé recorded 1.8% of fatalities associated with COVID-19 up to the 38th epidemiological week, which was at least five times lower than the state capital (10.6%). Overall, considering the successful experience of this joint effort of private and public engagement in Macaé, our data suggest that the development of a similar strategy countrywise could have contributed to a better control of the COVID-19 spread in Brazil. Quarantine decree by the local administration, comprehensive molecular testing coupled to scientific analysis of COVID-19 spreading, prevented the catastrophic consequences of the pandemic as seen in other populous cities within the state of Rio de Janeiro and elsewhere in Brazil.

Why We Lack in Basic Sanitation? An Assessment of Challenges in Ajmer and Solution Strategies

Purpose of the study: The paper attempts to find the answer to the question – Why do we lack in basic sanitation? What are the reasons for it? Paper introspects the challenges encountered in sanitation services for Ajmer district in Rajasthan. It identifies the key bottlenecks of the sanitation system to the ground realities of implementation for a non-metropolitan city. The article also outlines the way forward which is suggested to make the sanitation system in the city more available to all. Methodology: The paper is drawn on policy document analysis, urban sanitation policy and other Indian government promotional materials on urban sanitation, Indian municipalities, and a number of public-private partnerships. The paper reviews the extant literature on urban sanitation and thereafter examines challenges met in Ajmer district of Rajasthan. Main findings: It emphasizes the major challenges of access to sanitation, lack of private sector engagement, lack of regulation and standardization, treatment of wastewater and septage, low infrastructure, weak institutional framework etc. The Paper also proposes suggestions for meeting these challenges so that a proper system of sanitation may emerge. Applications of this study: This study will be useful for all those agencies who are involved with sanitation system governance. The paper contributes to the literature by addressing a neglected theme of investigating the challenges and their probable solution strategies about Ajmer district of Rajasthan. The study will provide background of various challenges faced in various cities in Indian perspectives and how they can be dealt by proposed suggestions. This study will be beneficial in the area of sanitation systems, urban governance, etc. Novelty/Originality of this study: This study is significant in highlighting the type of challenges and what could be possible solutions in Indian perspectives with special reference to Ajmer.

In search of the last malaria cases: ethnographic methods for community and private-sector engagement in malaria elimination in Vietnam, Laos, and Cambodia

BackgroundDespite significant strides made in reducing malaria morbidity and mortality in the Greater Mekong Subregion, malaria transmission continues amongst the most ‘hard-to-reach’, such as forest-goers and mobile and migrant populations, who face access obstacles to malaria diagnosis and treatment. As such, regional malaria elimination strategies endeavour to incorporate the private sector and local communities in improving surveillance and detection of the last malaria cases in remote forested areas. The question remains, however, whether such strategies can reach these hard-to-reach populations and effectively reduce their disproportionate burden of malaria. This paper evaluates the strategy of community and private sector engagement in a malaria elimination project in Vietnam, Laos, and Cambodia.MethodsEthnographic research, incorporating in-depth interviews, participant observations with informal discussions, and group discussions were conducted in Bu Gia Map commune, Binh Phuc province of Vietnam; in Phouvong district, Attapeu province of Laos; and, in nine newly established and informal communities in the provinces of Mondul Kiri, Steung Treng, Kratie, Kampong Thom, and Prah Vihear of Cambodia.ResultsDifferent types of factors limited or enhanced the effectiveness of the participatory approaches in the different settings. In Vietnam, inter-ethnic tensions and sensitivity around forest-work negatively affected local population’s health-seeking behaviour and consequent uptake of malaria testing and treatment. In Laos, the location of the project collaborative pharmacies in the district-centre were a mismatch for reaching hard-to-reach populations in remote villages. In Cambodia, the strategy of recruiting community malaria-workers, elected by the community members, did manage to reach the remote forested areas where people visited or stayed.Conclusions‘Hard-to-reach’ populations remain hard to reach without proper research identifying the socio-economic-political environment and the key dynamics determining uptake in involved communities and populations. Solid implementation research with a strong ethnographic component is required to tailor malaria elimination strategies to local contexts.

One year of COVID-19 and its impact on private provider engagement for TB: A rapid assessment of intermediary NGOs in seven high TB burden countries

The COVID-19 pandemic has impacted health systems and health programs across the world. For tuberculosis (TB), it is predicted to set back progress by at least twelve years. Public private mix (PPM)has made a vital contribution to reach End TB targets with a ten-fold rise in TB notifications from private providers between 2012 and 2019. This is due in large part to the efforts of intermediary agencies, which aggregate demand from private providers. The COVID-19 pandemic has put these gains at risk over the past year. In this rapid assessment, representatives of 15 intermediary agencies from seven countries that are considered the highest priority for PPM in TB care (the Big Seven) share their views on the impact of COVID-19 on their programs, the private providers operating under their PPM schemes, and their private TB clients.All intermediaries reported a drop in TB testing and notifications, and the closure of some private practices. While travel restrictions and the fear of contracting COVID-19 were the main contributing factors, there were also unanticipated expenses for private providers, which were transferred to patients via increased prices. Intermediaries also had their routine activities disrupted and had to shift tasks and budgets to meet the new needs. However, the intermediaries and their partners rapidly adapted, including an increased use of digital tools, patient-centric services, and ancillary support for private providers.Despite many setbacks, the COVID-19 pandemic has underlined the importance of effective private sector engagement. The robust approach to fight COVID-19 has shown the possibilities for ending TB with a similar approach, augmented by the digital revolution around treatment and diagnostics and the push to decentralize health services.

Key recommendations to strengthen public-private partnership for adolescent health in resource constrained settings: Formative qualitative inquiry in Mongolia, Myanmar and the Philippines.

BackgroundPublic health services can be inaccessible for adolescents. The private sector provides many services, but often in parallel to the public sector. This study aimed to understand current private sector engagement in adolescent health service delivery and develop recommendations to strengthen partnerships.MethodsThe study focussed on Mongolia, Myanmar and the Philippines. An initial participatory workshop in each country was followed by semi-structured key-informant interviews (32 in total) with public and private sector actors and adolescents to explore: perceptions of the public and private sectors, strengths and challenges, existing models of partnership, and insights for successful public-private partnership (PPP). Interview transcripts were analysed thematically, with findings and recommendations verified through a second workshop in Mongolia and the Philippines.FindingsThe private sector already plays a significant role in adolescent health care, and stakeholders reported a genuine willingness for partnership. Strengthened PPP was identified as necessary to improve service accessibility and quality for adolescents, unburden the public sector and introduce new technologies, with advantages for the private sector including improved access to training and resources, and an enhanced public image. Recommendations for strengthened PPP included the need to establish the foundations for partnership, clearly define roles and co-ordinate stakeholders, ensure capacity and sustainability, and monitor and evaluate efforts.InterpretationThis is the first comprehensive study of public-private partnership for adolescent health in the Asia Pacific region. It identifies stakeholders are willing for stronger partnerships and the benefits this partnership will bring. We define eight key recommendations to enable this partnership across sectors.

Research Letter: Antihypertensive Drugs Market in India: An Insight on Size, Trends, and Prescribing Preferences in the Private Health Sector, 2016-2018.

Background:India has a high burden of hypertension. While the private sector provides 70% of out-patient care in the country, a significant proportion of patients seeking care from the public sector buy drugs from private markets. This study aimed to describe India’s private sector antihypertensive drugs market at the national and state levels over 2016–2018.Methods:Antihypertensive drugs sales in India from 2016–2018 were analysed using a large nationally representative dataset for the private pharmaceuticals market. In addition, data for five states (Punjab, Madhya Pradesh, Kerala, Telangana, and Maharashtra) that were the foci of a large hypertension control program were studied.Results:The Indian hypertension drug market grew at a rate of 6.9% from 2016 to 2018 with a total of 21,066 million pills sales in 2018. Single-pill combinations (SPCs) contributed to 39.1% of total sale volumes. The market comprised of 182 different antihypertensive drugs including 134 SPCs. Total volume of sales covered a maximum of 26% of treatment need for the estimated population with hypertension. Two-drug SPCs had the highest market share (36%), followed by calcium channel blockers (18%), beta-blockers (16%) and angiotensin receptor blockers (14%). Among SPCs, amlodipine+atenolol had highest sales (9.8%). Twenty-five drugs, a mix of single drugs and SPCs, accounted for 80% of total sales. There were large state-to-state variations in sales per capita, preferred therapeutic classes and drugs.Conclusions:Despite the large antihypertensive drugs market, there exists a high unmet need for treatment in India. Inter-state differences in product sales indicate variable treatment practices, underscoring the need for private sector engagement to improve hypertension care practices aligned with national and international guidelines. SPCs contributed to a large share of the private market and inclusion of select antihypertensive SPCs in the national list of essential medications should be considered for the public health system.

Mobilizing private adaptation finance: lessons learned from the Green Climate Fund

The mobilization of effective private sector engagement is considered to be critical to address the adaptation challenge, but literature demonstrates that it has proven difficult. In the context of international climate finance, the focus has been on mobilizing private finance for adaptation and in addressing barriers that prevent investments from materializing. In contrast, this article identifies options to engage the private sector in adaptation beyond finance and focuses on market imperfections instead of barriers. This moves the focus away from simply mobilizing more private adaptation finance towards identifying market forces that innovate, engage, and direct investments towards adaptation. The Green Climate Fund (GCF) and its portfolio of 74 adaptation projects serve as a case study. Two of these projects are categorized as private sector projects and an additional nine mobilize private co-finance or non-financial private contributions. Beyond these two indicators, we demonstrate that an additional 60 projects engage the private sector in other ways, thus indicating the important broader role of the private sector in adaptation. Furthermore, our ordinal regression demonstrates that by addressing the market imperfections of positive externalities, imperfect financial markets, and incomplete and/or asymmetric information, all have a significant positive effect on private sector engagement in the GCF’s adaptation portfolio. Both findings indicate that there is a large potential for the GCF—and other climate finance providers—to increase private sector engagement in adaptation. It must be noted, however, that the mobilization of private sector engagement in adaptation is a means to an end, not an end in itself. The main aim should be to adapt society as a whole in an efficient manner, including the most vulnerable groups and people.

Advice for Food Systems Governance Actors to Decide Whether and How to Engage With the Agri-Food and Beverage Industry to Address Malnutrition Within the Context of Healthy and Sustainable Food Systems Comment on "Challenges to Establish Effective Public-Private Partnerships to Address Malnutrition in All Its Forms".

The effectiveness of public-private partnerships (PPPs) to address malnutrition will depend on the issue, engagement purpose, policy context and actors’ interactions. This commentary offers advice for governments, United Nations (UN) and civil society organizations to decide whether and how to engage with industry actors to improve diets for populations. First, food systems governance actors must acknowledge and reconcile competing visions, harmonize numerous corporate-engagement principles, and support a shared narrative to motivate collective actions toward healthy sustainable diets. Second, food systems governance actors have tools to guide engagement through many alliances, networks, coalitions and multi-stakeholder platforms with different levels of risk and trust. Third, food systems governance actors must prioritize accountability by setting corporate-performance threshold scores to justify private-sector engagement; evaluating engagement processes, outcomes and consequences; using incentives, financial penalties and social media advocacy to accelerate time-bound changes; and revoking UN consultative status for corporate actors who undermine healthy people and planet.