Audrey Hinchcliffe | COVID-19: All hands on deck for public-private partnerships
I became a strong advocate for public-private partnerships while doing research for a course of study in health economics. This is based on my belief that government, business, and society are all inclusive to the development thrust. However, in a situation of resource constraints, for example, the coronavirus pandemic, it requires all hands on deck as the world was not prepared for the high cost of the required response. We must take steps to focus on its eradication, or at least, reducing the spread of infection until a cure is found.
National governments cannot bear all the costs, hence private-sector and non-governmental organisations (NGOs) must play their roles with monetary, social, and technological help. The case for vaccines gives proof to this notion. In my recently published book, The Will to Overcome; Reflections on Circumstances, Vision, Service, I wrote about the relationship between the public and the private sector (reference Part 2. Perspectives on Leadership, Chapter 8, The Relationship Between the Public and the Private Sector, pages 69-74). Now that the subject of the role of the private sector in response to the coronavirus pandemic is topical, particularly as it relates to vaccines, I decided to enter the conversation to add my proverbial two cents.
UNDERSTANDING PUBLIC-PRIVATE PARTNERSHIPS
First, we must understand the meaning and intent of public-private partnership. A public-private partnership, also referred to as P3, is defined as “a cooperative venture between the public and the private sector, built on the expertise of each partner, that best meets clearly defined public needs through the appropriate allocation of resources, risk, and rewards. (The Canadian Council for Public-Private Partnership 2015).
P3s essentially combine the best resources of the public and private sectors to deliver much-needed public amenities and infrastructure across all sectors of the economy. P3s do not necessarily include service contracts. The latter is reserved for public-procurement projects or the privatisation of, for example, utilities where there is a limited ongoing role for the public sector. Further, P3s can assume many forms and can range from broad-based statutory consultations to small, informal meetings between corporate executives and government officials. The protocols and economic climate that prevail in a country frequently determine the type of partnership that is feasible in that context. This is the background against which the conversation is taking place on public-private partnership for vaccines as part of the response to the coronavirus pandemic announced jointly by the Ministry of Health Wellness (MOHW) and the private sector.
Communication is the key to the success of P3s for the provision and administration of the referred vaccine. I was contemplating writing this article and mentioned P3s to colleagues when the announcement was made that the Jamaican private sector would be partnering with the Government in the vaccine programme. “Private-sector partners with Ministry of Health to boost vaccination deployment” ( The Gleaner, January 27, 2021). The intent jumped out: “A public-private partnership has been forged to assist Jamaica with achieving herd immunity against COVID-19 in the shortest possible time.”
What will the private sector do? “It will assist in sourcing and resourcing the acquisition of vaccines, assisting with the provision of transportation and storage, human resources in areas of the administration of training, marketing and public relations, and the allocation of trained inoculators.” I believe this bold statement, which is most welcome, has now led to the questioning by the members of the Opposition and others regarding the ‘how to’, and, I believe, the roles and responsibilities, benefits (including profiteering) and the practical application of P3s in this case.
My interest was further piqued when I heard that the resources of the Government in the first instance are to vaccinate 16% of the population when it is stated that herd immunity occurs when a large portion of the population, through vaccination, becomes immune to the disease. While I understand that 16% is the starting point, my question has to do with the projection for the percentage of us to be vaccinated, or not, to acquire the referenced herd immunity.
I was heartened to hear from Christopher Zacca, president and CEO of Sagicor Group, when he opined that “the private sector will be pushing for the vaccination of workers and staff to enable the full resumption of all productive activities which require close proximity”. Well said, Mr Zacca, but what is the price tag for “those of us who can help have an obligation to do so in order for our nation to rise to this one”. I take it to be the vaccination programme. The interest of the private sector is for an early return to a productive economy. “From an internal perspective as the private sector, we want to ramp up productive capacity as quickly as possible” (JCC President Lloyd Distant).
On the other hand, the Health and Wellness Minister states that “the partnership is appropriate, timely, and in keeping with the governance structure contained in the Interim National Vaccine Deployment Plan, which was recently approved by the Cabinet”. My curiosity has led me to want to know what is in this plan that forms the underpinning for the public-private partnership between the Government and the private sector.
I discovered that Cabinet approved the COVID-19 Deployment and Vaccination Interim Plan as the strategy and authority on the deployment of COVID-19 vaccines in Jamaica. As usual, this document is sitting on the Internet and is not given much- needed voice beyond the JIS article of January 20, 2021. This very important policy position needs a voice. (In search of a Czar or a Czarina) I am now satisfied that this public-private partnership has a grounding.
KEYS TO PARTNERSHIPS
The easy part is that the requirements are set out in the COVID-19 Deployment and Vaccination Interim Plan. This will inform the respective roles and responsibilities.
Integral to the success of the public-private partnership is a well-thought-out plan that outlines all the expectations and outcomes and clearly defined methods for dispute resolution. Attendant to these are specific milestones and goals, reporting of metrics and frequency, and should address issues such as risk allocation and reward sharing.
Like a marriage, a public-private partnership relationship must include partners who have the stamina and wherewithall to stay the course. Partners should have the commitment, technical compatibility, financial capability, and motivation to maintain the partnership and achieve its goal – short, medium, and long term. The partnership will go haywire if the key elements are missing. For the desired benefit to be accrued – in this case vaccination for herd immunity – the partnership must be built on a solid foundation with good communication and leadership.
The case of public-private partnership for vaccinations provides the light at the end of the tunnel for a resource-deprived cash-strapped and overburdened public-health system. My caution to the private sector is not to overpromise as you seek to participate in the COVID-19 response. You may be already aware that you are partnering within a complex sector – health and wellness and related industry for not only services, but goods, equipment, and the ever-changing technologies. In whichever area you choose to make valued contribution in cash or kind, workers’ health and safety must be at the forefront, and I agree that vaccinations will give some effect to this. The coronavirus has a playing field, and that is humans, and the vaccine will disrupt the games it plays. But when it becomes available, people must be willing to take it. Hence, public education must be included in the roles and responsibilities of the partners.
ROLES AND RESPONSIBILITIES
The National COVID-19 Deployment and Vaccination Interim Plan, 2021 covers, and I quote: “planning and coordination of vaccination introduction in Jamaica; target populations and vaccination-delivery strategies; human resources management and training, supply-chain management, risk assessment and mitigation, vaccine programme communication, vaccine safety monitoring; and evaluation.”
It is now clear which are the areas for the roles and responsibilities of the partners to be developed. I feel confident that progress can be made on the vaccines initiative feeding off the energy and drive of both partners.
The starting point for the roles and responsibilities is for both partners to speak the same language. In the corporate world, the language spoken is that of customer satisfaction, risk evaluation, and return on investment. On the other hand, government technocrats and politicians speak the language of responsibility, risk avoidance, and accountability, but although the landscape is disparate, there is really no fundamental difference if both are addressing the coronavirus as both seek the same outcome, which is to return to economic stability and prosperity.
For public-private partnerships to be successful, the private sector brings management and workplace efficiency, enhanced technologies, cash-flow management, human resource development, research and development, and most critically, funding resources.
The public sector brings dedicated personnel, capital resources, legal and regulatory authority; comprehensive procurement policies, and broad perspective and understanding of balancing competing goals to meet public needs.
Standing in the midst is the coronavirus pandemic and the demand for vaccines as soon as practicable. A checklist for the partnership needs to be developed with focus on the roles and responsibilities and related resource requirements and measurable advantages for social, economic, financial, and political advancements. This list, in my humble opinion, is the proposed starting point. Each partner must appoint a dedicated office, with the appropriate resources. This is not the place for another committee. The pandemic requires an all-hands-on-deck approach, and this is already taking place worldwide. Jamaica is no less, but communication and transparency must not be curtailed if trust is to be fostered for compliance with existing protocols, and more importantly, for acceptance of the upcoming role out of vaccines. The vaccine, like all other medicines, is of no good if it is not taken. Hence, the voice of influencers among the partners must be heard.