Public-Private Integrated Partnerships (PPIPs) are a novel way for resource-constrained governments in developing countries to simultaneously improve health infrastructure and healthcare service provision, while creating a platform for addressing other system-wide inefficiencies. PPIPs enable national governments to prudently leverage private sector expertise and investment to serve public policy goals—specifically the provision of high quality, affordable preventive and curative care to all citizens. The PPIP model delivers a “complete bundle” of services, while simultaneously providing a vehicle for local economic empowerment.

PPIPs are a special form of public-private partnership (PPP) that comprise long-term, highly structured relationships between the public and private sectors designed to achieve significant and sustainable improvements to systems at national or sub-national levels. PPIPs position a private entity, or consortium of private partners, in a long-term relationship with a government to co-finance, design, build, and operate healthcare facilities, and to deliver both clinical and non-clinical services at those facilities over a decade or more. The new, state-of-the-art facilities or renovated facilities that result from a PPIP are owned by the government during all phases of the contract.

Unlike other PPPs, PPIPs go beyond private investment in buildings and maintenance. The private partners are also responsible for delivering all clinical and non-clinical services at the facilities, from surgery to immunization to ambulances. Most importantly, PPIPs aim to be “cost neutral” to patients, who incur the same out-of-pocket payments, usually zero or minimal, as they did in the previous dilapidated and poorly run public facilities.

Since 2008 the Global Health Group has focused specific research on the PPIP model, publishing a range of articles and organizing a series of international conferences and south-south learning exchanges, to facilitate discussion of their potential uses to strengthen health infrastructure and service provision in the developing world.

PPIP Publications

• UCSF/PwC Fellowship case study on the Lesotho PPIP:
  Health System Innovation in Lesotho: Design and early operations of the Maseru public-private integrated partnership (April 2012)
• The Global Health Group and colleagues published an article on PPIPs in the August 2011 edition of Health Affairs, delving deeper into the benefits and risks inherent in this innovative model.
• PPIP Atlas
  Published in September 2010 as a summary document for a Wilton Park conference on PPIPs, Public-Private Investment Partnerships for Health: An Atlas of Innovation identifies the primary goals and structures of PPIPs and provides high-level overviews of the 12 most innovative PPIPs worldwide.
• PPIP Overview
  For a concise explanation of PPIPs, including descriptions of three flagship PPIPs, please see the PPIP Overview (2009).

Landmark PPIP Conferences

Following a baseline-setting conference on PPIPs at Wilton Park, UK in April 2008, the Global Health Group’s work on PPIPs has included several meetings with Ministries of Health across sub-Saharan Africa to inform them about the PPIP model, determine their interest in exploring it further, and assist them to identify potential projects, as well as second meeting on PPIPs at Wilton Park in September 2010.

• Public-Private Investment Partnerships: Innovations for Quality and Efficiency in Health Systems
  September 20-22, 2010 Wilton Park, United Kingdom
  On September 20-22, 2010, the Global Health Group hosted its second Wilton Park conference on PPIPs. This follow-up meeting brought together leaders from governments, the private sector, and development agencies to explore opportunities, challenges, and next steps in the development of PPIPs.
  2010 Wilton Park Conference Report
• Enhancing Health Systems through Public-Private Investment Partnerships: Lessons Learned from Lesotho
  March 31-April 2, 2009, Maseru, Lesotho
  On March 31 - April 2, 2009, the Global Health Group co-hosted a learning conference in Maseru, Lesotho on Sub-Saharan Africa’s first-ever large-scale public-private partnership to include infrastructure development and a service delivery contract. The conference was co-hosted by the Global Health Group, the Lesotho Ministry of Finance and Development Planning, and the Lesotho Ministry of Health and Social Welfare. The focus of the conference was on the cross-sector collaboration around the rebuilding of the country’s main referral hospital, the Queen Elizabeth II. Ministers of Health and Finance for six other African countries traveled to Maseru to learn from the Lesotho PPIP experience.
  Lesotho Conference Report
• Public-Private Investment Partnerships in Health Systems Strengthening
  April 9-11, 2008, Wilton Park, United Kingdom
  On April 9-11, 2008, the Global Health Group hosted its first Wilton Park conference on PPIPs. The conference explored the concept of PPIPs to better understand its current and potential application as a model for further country adoption. Several country examples were presented, critical success factors and potential strengths and weaknesses were identified, and a range of potential next steps were set out.
  2008 Wilton Park Conference Report