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公私合营中的风险可以分类吗?

Can the risk in public-private partnerships be classified?

作者信息

Silva Vera Luiza da Costa E, Turci Silvana Rubano Barretto, Oliveira Ana Paula Natividade de, Richter Ana Paula

机构信息

Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.

出版信息

Cad Saude Publica. 2017 Oct 19;33Suppl 3(Suppl 3):e00086316. doi: 10.1590/0102-311X00086316.

Abstract

In the coming years, public-private partnerships (PPPs) should play an increasingly relevant role as an important alternative for financing projects and infrastructure in public services. However, especially in public health, PPPs are not always a good alternative, since they may introduce distortions in the agenda that sets health needs, favoring companies' interests. Public agencies can benefit from collaboration with the private sector in areas where there is a lack of specialization, such as the development of research and technologies. Even in these cases, each institution's role needs to be defined in order to avoid conflicts of interest. This can be challenging when dealing with the formulation of public and regulatory policies, on the impacts of certain policies, especially in developing countries. To engage with the private sector without compromising the integrity of government actions requires a broad discussion by public health stakeholders, for clear reasons of conflicting visions and scopes between corporations and public health. Combined with this is the need for multi-sector approaches, with a high load of financial investments in the various dimensions of policies to control the most prevalent diseases, especially chronic non-communicable diseases (NCD). This article classifies PPPs in categories in order to minimize the potential risks of conflicts of interest than can impact public health. These categories are defined as possible, possible with caveats, and impossible for involvement with certain institutions.

摘要

在未来几年,公私伙伴关系(PPPs)作为公共服务项目和基础设施融资的重要替代方案,应发挥越来越重要的作用。然而,特别是在公共卫生领域,公私伙伴关系并不总是一个好的选择,因为它们可能会在确定卫生需求的议程中引入扭曲,偏袒公司利益。在缺乏专业化的领域,如研发和技术开发,公共机构可以从与私营部门的合作中受益。即使在这些情况下,也需要明确每个机构的角色,以避免利益冲突。在制定公共政策和监管政策、以及某些政策的影响方面,尤其是在发展中国家,这可能具有挑战性。出于企业与公共卫生在愿景和范围上存在冲突的明显原因,公共卫生利益相关者需要进行广泛讨论,以便在不损害政府行动完整性的情况下与私营部门合作。与此同时,需要采取多部门方法,在控制最常见疾病(尤其是慢性非传染性疾病)的政策的各个层面进行大量财政投资。本文对公私伙伴关系进行分类,以尽量减少可能影响公共卫生的利益冲突潜在风险。这些类别被定义为可能、有条件可能以及某些机构不可能参与。

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