Buse K, Walt G
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8034, USA.
Bull World Health Organ. 2000;78(4):549-61.
The proliferation of public-private partnerships is rapidly reconfiguring the international health landscape. This article (part I of two on the subject) traces the changing nature of partnership, and discusses the definitional and conceptual ambiguities surrounding the term. After defining global public-private partnerships (GPPPs) for health development, we analyse the factors which have led to the convergence of public and private actors and discuss the consequences of the trend toward partnership between UN agencies (including the World Bank) and commercial entities in the health sector. Generic factors such as globalization and disillusionment with the UN, and factors specific to the health sector, such as market failure in product development for orphan diseases, are examined. Reviewed are the interests, policies, practices and concerns of the UN, the private-for-profit sector, bilateral organizations, and governments of low-income countries with respect to public-private partnership. While GPPPs bring much needed resources to problems of international health, we highlight concerns regarding this new organizational format. Part II, which will be published in the May issue of the Bulletin, presents a conceptual framework for analysing health GPPPs and explores the issues raised.
公私伙伴关系的迅速扩张正在快速重塑国际卫生格局。本文（该主题的两篇系列文章中的第一篇）追溯了伙伴关系不断变化的本质，并讨论了围绕这一术语的定义和概念上的模糊之处。在界定了促进卫生发展的全球公私伙伴关系之后，我们分析了导致公共和私营行为体趋同的因素，并讨论了联合国机构（包括世界银行）与卫生部门商业实体之间伙伴关系趋势的影响。研究了全球化和对联合国幻想破灭等一般因素，以及卫生部门特有的因素，如罕见病产品开发中的市场失灵。回顾了联合国、营利性私营部门、双边组织以及低收入国家政府在公私伙伴关系方面的利益、政策、做法和关切。虽然全球公私伙伴关系为国际卫生问题带来了急需的资源，但我们也强调了对这种新组织形式的担忧。将于《公报》5月刊发表的第二篇文章，将提出一个分析卫生领域全球公私伙伴关系的概念框架，并探讨由此引发的问题。
