Legal News
New PPP model for universal healthcare

23 - 05 - 2019
Vietnam Investment Review

new ppp model for universal healthcare
New PPP model for universal healthcare, photo AFP

In anticipation of the growing importance of public-private partnership, Vietnam and partners are working on a new model to strengthen primary healthcare services as the foundation to achieve universal healthcare coverage by 2030.

The Vietnamese Ministry of Health (MoH), the World Economic Forum (WEF), the Harvard Medical School Center for Primary Care, and Novartis last week jointly organised the first-ever primary healthcare partnership dialogue, aiming to help Vietnam find a suitable approach to public-private partnership (PPP).

“Vietnam sees a growing number of partners interested in PPP who see huge growth potential. Thus, the country’s problem in developing the PPP in the healthcare sector is not a lack of interest or financial resources, but the connection among involved parties and their alignment with the MoH’s visions,” David Duong, deputy director of the Programme in Global Primary Care and Social Change at Harvard Medical School, told VIR. “I have been studying many PPP models worldwide and find that the principles for any successful models are co-ownership, shared vision, shared voice, and mutual respect – without these, any PPP model would fail.”

At the event, a consensus among the MoH, development partners, and private sector, as well as industry partners was achieved around a shared vision for primary healthcare transformation in Vietnam, marking the first step for the MoH and the government and partners to achieve a shared vision, co-ownership, and shared objectives, with improved transparency among partners.

In this light, committed partners reached a consensus on the creation of a major PPP initiative and the formation of the Working Group for Primary Healthcare Transformation, which would be under the existing Health Partnership Group mechanism. The working group, which consists of representatives from the Vietnamese government, the WEF, Harvard Medical School, and Novartis, will develop an innovative PPP project to help Vietnam reach its universal healthcare coverage (UHC) goal by 2030 by leveraging the various partners’ experiences, investments, and expertise to strengthen the existing pilot programmes by the MoH in creating a new comprehensive primary care model across the country.

The working group will plan activities to complement and strengthen the MoH’s existing demonstration projects and initiatives in 30 provinces for primary care transformation. Learnings from these projects will be applied to scale up model nationwide.

With this promising new PPP, partners no longer need a risk-sharing mechanism like other traditional PPP projects being deoloyed in Vietnam because they are not focusing on building new healthcare centres, but on how they can draw on the capabilities and knowledge of different partners.

At present, there are some successful PPP models in the world, including in the management of medical devices, contract services or specialty clinical services or paraclinical services. Precedent shows that suitable PPP models not only bring benefits to the locals but also open more opportunities for hospitals and multinational corporations to join up. Indonesia and Australia are particularly apt examples for this.

Vietnam has made improvements to develop its health system. Nearly nine out of 10 citizens possess health insurance, protecting them against the kind of catastrophic health expenditure which ruins families. According to the latest Global Monitoring Report on UHC, published jointly by the World Health Organization and the World Bank, 97 per cent of Vietnamese children receive standard immunisation – a higher percentage than in most high-income countries.

In spite of this, Vietnam is still challenged by taking care of healthy people and fighting non-communicable diseases. Therefore, it is encouraging the private sector to invest in PPP projects in the healthcare sector, especially in hospitals, grassroots health centres, and primary healthcare facilities.

In the MoH’s vision to achieve UHC and the United Nations Sustainable Development Goals (SDGs), especially the SDG 3 on health is based on three pillars to support primary care development, namely the Healthy Vietnam Programme, Grassroots Health Development, and targeted health-population programmes.

Kenan Yorucu - Industry advisor, Digital Transformation Office Cisco System (USA) Pte., Ltd.

Healthcare costs are growing across the ASEAN, and the government is looking to reduce them by bringing in private organisations to deliver more efficient healthcare, especially through technology.

A disadvantage is that private firms want to monetise their services. We must allow them to be more innovative, for example by allowing more trials or proofs of concept, not only from larger tech groups but also from smaller startups.

The country can learn from success cases. The medication supply chain shows how PPP works on a local scale. On a national scale, multiple private organisations need to gather.

David B. Duong - Deputy director Programme in Global Primary Care and Social Change Harvard Medical School

PPP investment in healthcare in Vietnam has yet to lure in many investors because they do not understand this model yet.

They only think of co-operating with the authorities to build hospitals, which is only a small part of it – they can supply services or train staff. If they understood that, they would see massive opportunities. At present, the Ministry of Health (MoH) is calling for investment in three sectors, including primary healthcare, grassroots healthcare development, and PPP in hospitals. However, regardless of the sector of their choice, investors will prioritise high-end healthcare services. There are already successful PPP co-operations in Vietnamese healthcare, like the co-operation between DHA Corporation and a number of districts in Ho Chi Minh City which allowed people to gain more from their social insurance.

Deborah Gildea – Head Novartis Social Business Asia

As committed partners, we are excited about the development of this innovative public-private partnership which will help deliver on the MoH objectives to achieve universal health care in Vietnam by strengthening existing primary care demonstration projects.

Building on our ongoing work in Vietnam and the Asian region, we are keen to bring our expertise into this new partnership. between the MoH, Harvard Medical School, the World Economic Forum and Novartis.

It is not a PPP project that is often seen in Vietnam because it focuses on how we can draw on the capabilities and knowledge of different partners to ultilise facilities at primary healthcare centres, convincing locals to visit. Novartis engages the community to teach them about non-communicable diseases and managing their health, and then encourages them to use facilities in primary healthcare centres. We do not need a risk-sharing mechanism, only that the government open up opportunities for companies like Novartis to establish a legal presence in Vietnam, enabling us to perform our long-term commitments which require public-private collaboration.

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