A powerful lever of progress and effective private sector engagement in improving women’s health
It began with a high-profile announcement at the 2017 World Economic Forum in Davos: Merck, through its Merck for Mothers initiative, was committing $10 million and our business expertise to the Global Financing Facility to help end maternal mortality.
We were the first private sector partner to join the GFF, launched in 2015 by the United Nations in partnership with the World Bank Group to close the financing gap in reproductive, maternal, newborn, child and adolescent health and nutrition. We joined because we believed the GFF would open new channels for leveraging private sector resources, innovation and expertise, and fulfill its pledge to catalyze high-impact country-led investments in support of the UN’s Every Woman Every Child initiative.
And we saw an excellent opportunity to demonstrate the important role private sector can and must play in addressing critical public health issues in low resource countries, where the vast majority of all preventable mother and child deaths occur, and advancing progress toward the Sustainable Development Goals for 2030. We saw a promising vehicle through which to multiply Merck for Mothers’ impact far beyond what we could achieve on our own.
Nearly two years later, we see significant momentum to expand meaningful private sector engagement at both the global and country level. Here’s a look at how the GFF is catalyzing change in health financing and drawing in the private sector to drive innovation.
Altering the Health Financing Landscape
The GFF leverages its Trust Fund, the pot of money that all GFF partners (including Merck for Mothers) pay into, in several ways to help close the multi-trillion-dollar financing gap that stands in the way of achieving the global goals. Because the GFF is housed within the World Bank, it can link its spending to other World Bank funding sources, effectively generating seven times more in additional financing for country-led health initiatives. (For details, see the 2017-2018 annual report.)
The GFF Trust also uses loan buy-downs, co-financing grants and other innovative financing instruments to allow countries to access greater resources, including private sector capital on more concessional terms – on the condition they make results-focused, evidence-based investments in health and nutrition for women, children and adolescents. In June, the GFF Trust issued its first series of Sustainable Development Bonds, marketing them to private investors interested in social impact investing. The series raised nearly $1 billion in two months.
Driving Innovation to Meet Public Health Challenges
The GFF’s private sector partners also bring knowledge and expertise that can be leveraged by GFF countries to build capacity and increase efficiencies across their health systems. For example, we recently partnered with The Bill and Melinda Gates Foundation and The UPS Foundation through the GFF to help governments improve their health supply chains. And now we are teaming up to share best practices in critical areas such as transport, warehousing and distribution, and support countries looking to develop innovative public-private models like Senegal’s to improve access to essential medicines and health commodities.
Among the 27 countries currently receiving GFF support, we’re seeing several governments contracting with local private health care providers to reach underserved populations and regions with essential maternal and child health services. Cameroon, The Democratic Republic of Congo and Nigeria (to name a few) have done some form of “strategic purchasing” of private services, basing payments on performance. Kenya has started regulating private providers, strengthening routine inspections of facilities and institutionalizing quality assurance toward certification – an acknowledgment of the critical role of the private health sector in meeting the health needs of citizens.
Another key development that grew out of GFF’s efforts: country teams that have begun integrating the private sector into their health investment plans have started sharing their experiences with fellow ministers of health and finance during workshops and other cross-country learning forums. “How do we engage the private sector?” has become a running theme.
Time to Step Up
GFF Director Mariam Claeson has long argued that while many of the world's poorest countries have made progress toward improving the health of their citizens, they could save and improve many more lives – more efficiently, and with greater reach, equity and sustainability – with better coordination among stakeholders and smarter financing. This is what the GFF partnership is striving for, and what we believe it can accomplish provided that the private sector is invited – and steps up – to do what it does best.
We know that transformational change – particularly within large bureaucratic institutions – doesn’t happen overnight. Those who operate in the public sector vs. the private still speak different languages. The public sector needs to create mechanisms to optimize the comparative advantage of the private sector in addressing large, complex public health issues – to create space for the private sector to contribute its innovation. And in kind, the private sector needs to showcase through evidence generation their value and contributions to these issues.
As a member of the GFF Investors Group, Merck for Mothers will continue to support and help shape the private sector engagement strategy going forward. We realize it takes time and enduring focus to create systemic change. But I’m optimistic that this will come; that the GFF partnership will keep growing; and that we’ll see more countries dedicate more of their own resources to maternal and child health, and employ private sector thinking more explicitly, and deliberately.
Mark Allen is Director of Strategic Partnerships for Merck for Mothers, Merck’s 10-year $500 million initiative to help create a world where no woman dies giving life. Merck for Mothers, known as MSD for Mothers outside the United States and Canada, is a member of the Global Financing Facility Trust Fund Investors Group. To learn more, visit www.globalfinancingfacility.org