Asante Augustine D, Zwi Anthony B
National Centre in HIV Social Research, The University of New South Wales, Sydney, NSW 2052, Australia.
Indian J Med Ethics. 2007 Oct-Dec;4(4):176-80. doi: 10.20529/IJME.2007.070.
Health equity remains a major challenge to policymakers despite the resurgence of interest to promote it. In developing countries, especially, the sheer inadequacy of financial and human resources for health and the progressive undermining of state capacity in many under-resourced settings have made it extremely difficult to promote and achieve significant improvements in equity in health and access to healthcare. In the last decade, public-private partnerships have been explored as a mechanism to mobilise additional resources and support for health activities, notably in resource-poor countries. While public-private partnerships are conceptually appealing, many concerns have been raised regarding their impact on global health equity. This paper examines the viability of public-private partnerships for improving global health equity and highlights some key prospects and challenges. The focus is on global health partnerships and excludes domestic public-private mechanisms such as the state contracting out publicly-financed health delivery or management responsibilities to private partners. The paper is intended to stimulate further debate on the implications of public-private partnerships for global health equity.
尽管对促进健康公平的兴趣再度兴起,但健康公平仍是政策制定者面临的重大挑战。特别是在发展中国家,用于卫生的财政和人力资源严重不足,而且在许多资源匮乏地区国家能力不断遭到削弱,这使得促进和实现健康公平及医疗服务可及性的显著改善极为困难。在过去十年中,公私伙伴关系已被视作一种调集更多资源并为卫生活动提供支持的机制加以探索,尤其是在资源匮乏国家。虽然公私伙伴关系在概念上颇具吸引力,但人们对其对全球健康公平的影响提出了诸多关切。本文探讨了公私伙伴关系在改善全球健康公平方面的可行性,并突出了一些关键的前景和挑战。重点是全球卫生伙伴关系,不包括国内的公私机制,如国家将公共资金资助的卫生服务提供或管理责任外包给私人伙伴。本文旨在激发关于公私伙伴关系对全球健康公平影响的进一步辩论。