Zanzibar: Beyond the stunning beaches, let’s set a science conversation on PPPs

For many years, Zanzibar's reputation has revolved around its stunning beaches, historical Stone Town, and vibrant culture, attracting countless travelers seeking relaxation, exploration, and adventure.

In recent years, however, a fresh perspective on Zanzibar’s development is underlined with a narrative about its growing proactive approach to Public-Private Partnerships (PPPs), especially in healthcare.

The PPP approach, of course, has also been used to enhance infrastructure development, and attract foreign investment. In the coming weeks or so, the narrative on PPPs and healthcare is taking a scientific discourse in the Isles.

As October sets in, over a thousand health stakeholders: scientists, healthcare investors and policymakers from around 20 countries, in Africa and globally, will convene in the Indian Ocean Archipelago for the 11th Tanzania Health Summit (THS), where the President of the United Republic of Tanzania, Samia Suluhu Hassan, flanked by Dr. Hussein Ali Mwinyi, the President of Zanzibar and Chairman of the Revolutionary Council, is expected to witness and inspire a conversation themed: "Igniting Progress: Joining Efforts for Quality Healthcare Through Public-Private Partnerships." 

As an academician and convener who has facilitated dialogues between scientists, healthcare investors, and policymakers for over a decade now, I have observed the significant challenges that our countries and Africa in general faces in achieving Universal Health Coverage (UHC) as per World Health Organization (WHO).

Evidence-based decisions are crucial in this journey. Public healthcare funding often falls short, and reaching underserved communities remains a hurdle. PPPs offer a promising solution, but their success hinges on effective communication and collaboration between scientists and policymakers.

I feel compelled to highlight that we need a rigorous, scientific conversation that will lead us to an evidence-based way forward. That’s why I am pinning my hopes on the upcoming THS in Zanzibar, where I do believe a scientific discourse and case studies will inspire workable PPP models across Africa.   

Why Zanzibar?

Zanzibar exemplifies the power of effective PPPs in healthcare, making it a fitting location for this scientific discourse. The island nation recently passed the Zanzibar Health Services Fund Act (2023), establishing mandatory health insurance with household contributions.

This decisive action paves the way for UHC, ensuring access to essential healthcare services without financial hardship. However, achieving UHC requires more than legislation.  

Zanzibar's experience with the Health Improvement Project Zanzibar (HIPZ) demonstrates the transformative power of strong scientific partnerships. Since 2006, HIPZ has collaborated with the Zanzibar government to significantly improve healthcare delivery at Makunduchi and Kivunge hospitals.

This partnership prioritizes long-term sustainability, focusing on capacity building and improved service provision without commercial gain.

For scientists, investors and innovators who are convening for THS, it's time to pick lessons on successful PPP models as compelling evidence for workable public-private collaboration models in African healthcare. Policymakers will engage in open discussions to adapt these models to their specific contexts.

In the spirit of ensuring that PPPs work better for healthcare systems of our countries, a report by the World Bank along with key studies on how science discourse can fuel public-private sector collaboration, provide valuable direction for this conversation.

But, if I should say, the World Bank has conducted in-depth research on PPPs  under the initiative "Building Stronger Institutions to Deliver Better PPPs," resulting in six practice notes, one of which focuses on the role of the PPP framework.

Contrary to the notion that PPP laws or units are redundant, countries with successful PPP programs, such as South Africa, Chile, Brazil, Australia, and South Korea, have developed robust legal frameworks over time.

The World Bank's "Guidance on PPP Legal Frameworks" provides practical advice on drafting PPP-specific legislation. I do believe that creating a supportive environment for PPPs requires a comprehensive approach.  

Beyond legislation, as advised by WB, I still emphasize that when scientists, investors and policymakers meet under one roof in Zanzibar, it will be time to identify common roadblocks to successful PPPs across Africa and beyond. Collaborative discussions will lead to the development of best practices for structuring and implementing effective PPPs, especially in healthcare.

Scientists will share their expertise with policymakers, ensuring that evidence guides best practices for PPPs.

This open dialogue will foster transparency and accountability within PPPs, ensuring they prioritize public health outcomes.

The aim here is to break the silos between academia and industry, and foster collaborations that shape development through research and development.

The 11th THS takes this a step further by bringing together the entire healthcare ecosystem – scientists, policymakers, private sector representatives, and civil society. In turn, this will bridge the gap in financing and expertise, ultimately paving the way for a healthier future for Africa.

Dr. Omary Chillo is the President of Tanzania Health Summit and a Lecturer in Physiology at Muhimbili University of Health and Allied Sciences (MUHAS). He is a Fellow Bernard Lown Scholars in Cardiovascular Health - Havard T. Chan School of Public Health, USA, and Fellow Scientist Walter Brendel Center for Experimental Medicine - Ludwig Maximilian University, Munich, German. He is also Member Steering Committee - InterAcademy Partnership, Young Physician Leaders