Department of Engineering and Technology Management, University of Pretoria, Private Bag X20, Hatfield, Pretoria, 0028, South Africa.
Health Res Policy Syst. 2018 Mar 27;16(1):30. doi: 10.1186/s12961-018-0303-3.
Public-private partnerships (PPPs), widely used as a means of leveraging the skills, expertise and resources of the private sector to mutual advantage, were similarly adopted by South Africa to support public sector delivery. This study has evaluated one such partnership, namely the Biovac Institute, which was established in 2003 to cover vaccine research and development, manufacturing, and supply. The initiative was highly unusual given that it attempted to combine all three aspects in a single PPP.
The research has followed a concurrent mixed methods approach. In the quantitative study, data for prices and product volumes were extracted from secondary data sources and used to calculate the economic cost and value-for-money of the PPP. Simultaneously, a qualitative study was undertaken in which a number of key stakeholders were interviewed using a semi-structured questionnaire on their perceptions of the PPP's value.
The institute earns a premium on the procurement cost of a broad range of vaccines required by the South African National Department of Health for its immunisation programme, the net value of which was US$85.7 million over the period 2010 to 2014. These funds were used to finance the institute's operations, including vaccine research, distribution and quality control. Capital expenditure to support the establishment of facilities for laboratory testing, packaging and labelling, filling, formulation and, finally, active pharmaceutical ingredient manufacture, approximately US$40 million in total, had to be secured through loans and grants. According to the respondents in the qualitative survey, the principal benefit of the PPP has been the uninterrupted supply of vaccines and the ability to respond quickly to vaccine shortages. The main disadvantages appear to have been a slow and ineffectual establishment of a vaccine manufacturing centre and, initially, a limited ability to negotiate highly competitive vaccine prices.
Overall, it is concluded that a positive value-for-money has been achieved and the institute has been of significant public benefit. Relationships of this nature can be used to achieve public health goals, but need to be realistic about timeframes, costs and the limitations of relational governance in ensuring that complex programmatic outcomes are achieved. It is recommended that a more incremental approach, with clearer contractual goals, penalties and incentives, is adopted in attempting initiatives aimed at the localisation of manufacturing technology by leveraging public procurement.
公私合作伙伴关系（PPP）被广泛用作利用私营部门的技能、专业知识和资源实现互惠互利的一种手段，南非也采用了这种模式来支持公共部门的服务。本研究评估了这样的一个合作伙伴关系，即 Biovac 研究所，该研究所成立于 2003 年，旨在涵盖疫苗研究与开发、制造和供应。该倡议非常不寻常，因为它试图将这三个方面结合在一个单一的 PPP 中。
研究采用了并行混合方法。在定量研究中，从二手数据源中提取价格和产品数量数据，并用于计算 PPP 的经济成本和物有所值。同时，进行了一项定性研究，对若干关键利益攸关方进行了访谈，使用半结构化问卷了解他们对 PPP 价值的看法。
该研究所为南非国家卫生部免疫规划所需的广泛疫苗采购成本赚取了溢价，2010 年至 2014 年期间，这一溢价总额为 8570 万美元。这些资金用于资助研究所的运营，包括疫苗研究、分发和质量控制。建立用于实验室测试、包装和标签、填充、配方以及最终的活性药物成分制造的设施所需的资本支出约为 4000 万美元，必须通过贷款和赠款来筹集。根据定性调查的受访者的说法，PPP 的主要好处是疫苗的不间断供应和对疫苗短缺的快速反应能力。主要的缺点似乎是疫苗制造中心的建立缓慢且效率低下，以及最初在谈判极具竞争力的疫苗价格方面的能力有限。
总体而言，研究得出的结论是，实现了物有所值，研究所对公共利益具有重要意义。这种性质的关系可以用于实现公共卫生目标，但需要对时间框架、成本以及关系治理在确保实现复杂计划结果方面的局限性有现实的认识。建议在利用公共采购实现制造技术本土化的尝试中，采用更渐进的方法，明确合同目标、处罚和激励措施。
