Public-Private Partnerships from Below
Remaking a hospital in the wake of “Global Health” and health sector reform
Séance du séminaire Anthropologie et santé mondiale.
Invitée : Noelle Sullivan, Northwestern University, USA
The WHO first outlined the potential of global public private partnership (PPP) paradigms for health sector development in the late 1990s. Transnational public private partnerships such as the Global Fund to fight AIDS, tuberculosis and malaria have since garnered significant attention among development workers, donors, and social scientists alike. Yet the Tanzanian Ministry of Health and Social welfare started promoting the establishment of PPPs in the sector in 2001, the year after health sector reforms decentralized governance to the local level. Unlike global PPPs outlined by the WHO, these PPPs were meant to enable government health facilities to strike up novel alliances in order to meet needs beyond the state’s capacity to provide. In this paper, I explore how public hospital staff and administrators actively attempt to establish partnerships with a variety of entities in order to attend to hospital priorities beyond state/donor priorities, or those most commonly highlighted under the policies and approaches characteristic of “Global Health”. These cases unsettle easy distinctions between “public” and “private”. They point instead to the ways that health sector staff actively and strategically draw upon, constitute, and strategically engage public and private entities in hopes of moving beyond the restrictive targets characteristic of Global Health in the post-reform health sector.