Public-Private sector handshakes address intractable climate & health problems
Public-Private sector handshakes address intractable climate & health problems
It’s not that all such efforts will succeed, but the experimentation must be untrammeled and rampant.
Dear readers,
I write this newsletter once every month or so. It features my reflections on the deployment of creativity to making the world’s economic systems (and by extension social and to some extent political systems) more inclusive and, therefore, fairer. That sounds like a tall order – and it is!
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Recently the Lancet Citizens Commission (LCC), of which I’m a co-chair, published a short opinion piece on India’s journey towards universal healthcare (UHC) to commemorate the country’s 75th independence anniversary. One signature achievement of this commission – whose activities are fueled by dozens of high-powered researchers and professionals backing the LCC’s 24 commissioners– has to do with the progress we’ve made bringing public sector and private sector actors together to strive for UHC for the first time, in a country where these groups view each other with suspicion.
India has not lacked for blueprints for UHC, going back to the Bhore Committee Report of 1946. However, these blueprints mostly ignored the private sector, presumably on the theory that health is a so-called public good, and, as such, it should fall under the purview of the state. But when the state machinery is weak – as it is in most developing countries – the private sector ends up playing a giant role in healthcare delivery. Ignoring the private sector is patently unrealistic.
Of course, the private sector is beset with its own problems. As such, the Commission’s starting point was that ideologies and preconceptions have to be left at the door. The private sector has to leverage the best the public sector has to offer, while the public sector must also learn from private entrepreneurs. Mutual demeaning and mistrust do not get us anywhere. My fellow co-chairs and I discuss this in a Times of India podcast here and I have written about the lubricating effect of trust on such symbioses here.
In fact, it’s easy to find such complementarity mushrooming if one looks closely. For example, colleagues at the Indian Institute of Science, Bengaluru, told me of private and public sector colleagues getting together to launch a SARS-CoV-2 genomic surveillance platform that provided timely information on which strains of the virus were proliferating in the city. These same groups are trying to jointly build a virology institute in New Delhi. It’s not that all such efforts will succeed, but the experimentation must be untrammeled and rampant.
Turning to climate, entrepreneurs at Social Alpha (courtesy my friend Manoj Kumar) which is dedicated to finding creative solutions for the toughest problems, have an informative schematic showing the roles of different entities in addressing climate change in India. A quick look at this graphic clarifies that the private sector dominates some roles, the public sector others, and yet other require a handshake-duet between the two. Ultimately, it’s the coalescing of these efforts that catalyzes change.
It's one thing to advocate for such symbioses, but how do we practically raise the odds of these coming to be? I can think of at least two approaches. First, leverage the recent rise of a spate of specialized private equity funds for particular sectors - in India, these target agribusiness, climate, sports and wellness, and so on. Perhaps these provide a practical venue where the fund-entrepreneurs might use their deep knowledge of the sector to bring the public and private sectors together. At the end of the day, such specialist knowhow is perhaps best-suited to the task of bridging the information divide and overcoming the mistrust between public and private sectors endemic to many developing countries.
The second approach rests on the idea that individual entrepreneurs can make a difference. Empirically, it appears harder for would-be entrepreneurs to transition from public sector success to a private sector role, than it does for private sector success to provide a platform for public advocacy of various sorts. In India, for example, entrepreneurs behind the iconic success story of Infosys, as well as more recent successes at Chryscapital and Teamlease, have transitioned into working more closely with the public sector. In East Africa, the Equity Group Foundation embraces private sector techniques to address intractable problems, as has BRAC in numerous countries in the Global South, starting with Bangladesh fifty years ago.
I’ll close by noting that there are plenty of public sector entities that take on private-sector like characteristics, and plenty of private entrepreneurs who take on public advocacy. That is, there is a lot of mixing of public and private roles even in individual organizations. In the long-running fight against HIV/ AIDS for example, Yusuf Hamied and Cipla have played an outsized role as for-profit private entrepreneurs taking on public advocacy and education, while the private sector music giant MTV has long nurtured the Staying Alive Foundation as a way to modify behavior among youth in the vast majority of countries afflicted by HIV/AIDS.
Indeed, there is endless room for such handshakes between spirited change-agents across the developing world in the quest for better health and more sustainable climate policies.