We have more than 1000 followers on Linkedin!

Reaching 1000 followers is a certain social media milestone and we are excited about it. Our followers’ base grows organically by attracting specialised PPP experts in the healthcare and sector’s stakeholders. We invite our followers to celebrate with us and to subscribe to our mailing list or join our ecosystem. Our ambition is to get to know every PPP healthcare professional and to map each PPP healthcare project. We invite all interested parties to collaboration.

PPPHealth4All acts as an integrator,  coordinator and enabler of PPP healthcare ecosystem and is offering service to the public entities, private companies, financial institutions, research organisations, academia and individual experts in:

that facilitate preparation and implementation of healthcare PPPs in sustainable  manner. Our focus is to achieve SDG.3  by 2030.

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Stay with us in touch – more to come!

Invitation to webinar “Collaborative Approach of the European MHealth Hub”

The GHHG Working Group “Implementation of Global Digital Health Agenda” will organize a webinar on the “Collaborative approach of the European mHealth Hub” on February 24th, 2021. 

Organizer: Global Health Hub Germany in collaboration with the GHHG Working Group “Implementation of Global Digital Health Agenda”

Event description: 

The purpose of the event is to present the European mHealth Innovation and Knowledge Hub, a European project which aims at sharing national experiences on mobile health and helping countries and regions introduce mHealth programs.

The International Telecommunication Union (ITU), in partnership with the World Health Organization (WHO) and the Ministry of Health of Andalusia (Spain), established this Hub to support the integration of mHealth services into the national health systems of European countries. The project aims at scaling up evidence-based digital and mobile health solutions.

The Hub project is funded by the European Commission under the Horizon 2020 program and is backed by a powerful and skillful consortium of 18 public and private partners from 12 European countries and led by the Andalusian Public Health System.

Speakers:

Moderator: Natalia Korchakova-Heeb (Coordinator of the GHHG Working Group Implementation of Global Digital Health Agenda) and Founder of PPPHealth4All.

No pre-registration is required. Just use the link below on 24 February at 3 pm (CET).

Click here to take part at the webinar.

PPPHealth4All Persona – Dr. Hela Ben Mesmia, Ministry of Health, Tunisia

Dear Dr. Ben Mesmia, could you please introduce yourself?

My name is Hela Ben Mesmia and my current position is the President of the Management Unit for the societal dialogue for health system reform in the Ministry of Health of Tunisia.  When I joined the Ministry of Health in Tunisia in 2015, I worked in various departments leading the projects in the fields of public health, strategic planning, health policy, quality, patient safety. I have a long track of experience in working with all type of stakeholders: governmental departments, international partners, civil society, academia and unions.

Prior to that, I worked on clinical research, HIV management in various humanitarian settings with NGO “Doctors without borders”. I have PhD in Public Health from the University of Sousse, Tunisia and degree of PharmD specialized in public health from University of Monastir, Faculty of Pharmacy (Faculté de pharmacie de Monastir)

What is the commitment of the Tunisian government to achieve the Universal Health Coverage (UHC)?

Tunisia is a country in the Maghreb region of North Africa with a population of 11 million people. Our government was traditionally centralized and autocratic but it committed to work in a collaborative and participatory manner following 2011 revolution. The WHO is working closely with the Ministry of Health of Tunisia to re-orient the health sector towards primary health care, taking into accounts the needs of vulnerable population, and improving both quality of care and efficiency of the health system. This effort has also led to the establishment of ‘dialogue sociétal’  – public dialogue in health sector – a large-scale consultation to better capture population’s views, needs and expectations. With the second phase launched in 2017, a key expected output is the development of a new national health strategy towards 2030 and the Universal Health Coverage (UHC).

How you present this initiative to stakeholders and organized stakeholder engagement?

The process of the Public Dialogue for health system reform is a process that was launched in a post-revolutionary context in 2012. It is an inclusive process and constitute a large platform for a multidisciplinary participation. Its aim is to elaborate health policies, strategies and plans within a participatory approach. It has been an opportunity to share and exchange between various actors: communities, civil society, health professionals, and government. The Societal Dialogue process created many participatory spaces: Citizen’s Meetings on Health, Open Mic sessions, focus groups, Citizen’s jury, National Health Conference.

We consulted 1199 citizens, 65 associations, 1557 health workers and 207 experts/volunteers and established 130 Steering Committees representing various stakeholder groups.

What is the current situation with healthcare PPP projects in Tunisia?

In the National Health policy 2030 developed within the phase 2 of the societal dialogue the health system consider the health system as a one piece that include both public and private sectors. The complementarity and collaboration between the public and private sectors to achieve public health objectives is crucial. The Ministry of health must ensure a better-regulated private sector to be aligned with public health missions.

In fact, the health system’s responses to the needs of citizens of different regions are optimized through the organization of a functional network of interregional health clusters taking into account the public and private sectors. Besides, both private and public providers of family and local health are responsible for coordinating the care process.

Investments in public-private partnerships (PPPs) have not started yet, as the last legal obstacle has only just been lifted by the Transversal Law on investments in June 2019.

In Tunisia, PPPs are governed by a number of legislative texts. In November 2013, two decrees (Decree N° 2013-4630 and 2013-4631), creating a concessions monitoring unit and providing more detailed guidance on the preparation and roll-out of concession procurement procedures, brought greater clarity and transparency to the overall regime of Concession Law No. 2008-23. The Decrees govern procurement of all PPP concession projects in Tunisia, except where there is a sector specific law and there is no special law in the health sector.

The institutional framework for concessions and PPPs in Tunisia is currently laid out under the November 2013 Decree on Concessions (n° 2013-4631 of 18 November). The main body mandated to coordinate, provide advice on and monitor PPPs and concessions is the Unité de suivi des concessions (or concessions tracking unit, USC). Established under the Prime Minister’s Office (PMO). The USC is responsible for providing support to public entities throughout the procurement process, including the preparation of guidelines and model specifications, capacity building, and encouraging concession projects in Tunisia’s regions.

It is important to note that the concessions and PPP regime in Tunisia is separate from the public procurement regime (régime des marchés publics), which is governed by the 2014 Decree on Public Procurement (n° 2014-1039 of 13 March 2014). Accordingly, public procurement that does not involve concessions or PPPs is managed by a separate set of institutions.

Where do you see PPPHealth4All platform could be instrumental in achieving UHC in Tunisia?

It is difficult to achieve UHC without proper investments in the healthcare infrastructure, medical services and equipment.  Healthcare PPPs could be instrumental in helping us to achieve UHC in Tunisia and PPPHealth4All could assist in sharing best practices and assist in preparation of sustainable and people-centered healthcare PPPs.

This participation on a large scale is linked to the willingness of the actors to join a project of change to participate in the establishment of an efficient and equitable health system within a consensus. This will is the basis of the commitment and the ownership.

However, this commitment has not been well maintained over time. This is the cause of the constraints mainly related to the political stability. But the motivation of a core group of experts established since the first phase of the Societal Dialogue and which continue to this day was very crucial to the sustainability of this process.

PPPHealthH4All expands its network to the Eastern Europe

PPPHealth4All network is growing and extending to the Eastern Europe. We are happy to welcome Academy of PPP (Ukraine) in our network and looking forward to working together on capacity building and promoting sustainable public-private partnerships. The MoU was signed on 11 January 2021 on one side by Natalia Korchakova-Heeb, Founder of PPPHealth4All and Managing Director of SDG.17 Consulting GmbH  and Irina Zapatrina, PhD, Founder PPP Academy, and Irina Shatkovska, the President on the other side.

Natalia Korchakova-Heeb
Irina Zapatrina
Anna Shatkovska

Season’s Greetings from PPPHealth4All

PPPHealth4All thanks its users, partners, team members and the members of the Advisory Board for being with us in 2020 and making our success happen. Our seasonal greetings and best wishes! 2020 brought unprecedented challenges but with every challenge also comes opportunities. Pandemic highlighted the need to harness the potential that exists in collaborations between public and private sector to advance public health goals. PPPs were widely used to combat COVID-19 pandemic.

2020 was marked by extraordinary achievements: PPPHealth4All team received the first prize from the Global Health Hub-Germany presented by the Minister Jens Spahn, was named as Top-20 project in G20 Inaugural InfraChallenge, organized by Global Infrastructure Hub. The top-3 countries were the most active in 2020 were Turkey, USA and India.

 

Subscribers from 45 countries are using our monthly newsletter. More than a hundred of resources was published to enable the #PPPHealth4All community to prepare sustainable healthcare PPP projects. Helpdesk, tools, databases available for use.

In 2021 PPPHealth4All will continue to bring the power of our resources, people and technologies to pursue achieving SDG3 by 2030 and making this world a healthier and more sustainable place for everyone.

African Public-Private Partnership Network (AP3N) – a new network partner of PPPHealth4All.

thePPPHealth4All and Africa Public Private Partnerships (PPP) Network (AP3N)  have signed  a MoU that establishes a collaborative relationship between PPPHealth4All and AP3N to establish an exchange of information, mutual access to networks and best practices.

On behalve of AP3 Network, the MoU was signed by Beatrice Florah Ikilai, Co-President of the Africa PPP Network (AP3N), Vice Chair Bureau of the United Nations Economic Commission for Europe Working Party on PPPs and Africa Coordinator of the World Association of Public Private Partnerships (WAPPP) Units and Professionals and Chidi Izuwah (Snr) , Co-President of the Africa PPP Network (AP3N) and the Director General of the Infrastructure Regulatory Concession Commission of Nigeria Office of the Presidency and the member of PPPHealth4All Advisory Board. On behalf of the PPPHealth4All, Eng. Natalia Korchakova-Heeb, Founder of PPPHealth4All, Managing Director of SDG.17 Consulting GmbH, PPP Speaker of  the German Health Alliance.

The Parties agree to promote principles of transparency and sustainability for PPP healthcare projects that should also clearly demonstrate societal, economic and environmental benefits for the communities.
 

Africa Public Private Partnerships (PPP) Network (AP3N) is a network of PPP Units and practitioners across the continent established out of a greater realization and consensus for the need for collaboration between the Africa PPP Units and Practitioners for the realization of Africa’s infrastructure development.

We are pleased to extend our network to the African continent and looking forward to further cooperation.

Eng. Natalia Korchakova-Heeb
Beatrice Florah Ikilai
Chidi Izuwah (Snr)

PPPHealth4All Persona – Jacek Liput, Head of Public Procurement and PPP at Gawroński & Partners Law Firm

Dear Jacek, could you please introduce yourself?

My name is Jacek Liput and I am Head of Public Procurement and PPP at Gawroński & Partners law firm (Poland). I have many years of experience in government contracting, including public procurement regulations and PPPs. I have been involved in a number of PPP projects, including private partner selection procedures, particularly in the infrastructure, the healthcare sector and the education sector.

What is the current situation with PPP projects in the healthcare sector in Poland?

Data published by the Ministry of Development Funds and Regional Policy suggest that PPP projects in the Polish healthcare sector are still not very popular. Only 4 healthcare-related PPP contracts were concluded between 2009 and 2019, the total value of which is PLN 207 million (approx. EUR 46 million). These numbers are relatively low comparing to other sectors, such as transport, infrastructure, energy efficiency, sports and tourism and – only recently – waste management. Despite the above, I think that there is great potential for PPPs in the Polish healthcare sector. PPPs are increasingly seen to improve the healthcare system, in particular in terms of its performance, efficiency and quality. PPPs may also contribute to bringing new, advanced medical technologies into use. In my opinion a properly structured PPP project in the healthcare sector can be attractive for both the public party and the private partner.

What obstacles in your view blocks the implementation of PPP model in healthcare sector in Poland?

There are various legal and practical challenges for a successful PPP project and these equally apply to the healthcare sector. They relate, for instance, to appropriate allocation of risks between the public authority and the private partner, as well as ensuring stable and long-term financing for the project.

In terms of the Polish healthcare PPPs it is particularly important to take into account the existing legal framework for the financing of the healthcare services from public funds. As a rule, contracts with the Polish National Health Fund regarding such financing cannot be concluded for indefinite periods of time. Standard periods of the financing contracts are relatively short, while PPP contracts are normally concluded for longer periods, even as long as e.g. 30 years. This may cause risks for the private partner and these risks must be properly addressed at the selection phase.

Another challenge is that starting from the year 2021 we will have entirely new public procurement law in Poland. Polish public procurement law has recently been entirely redrafted to focus on efficiency of public-private cooperation rather than formalities. However, both contracting authorities and private partners will have to adapt to the new reality. A significant number of private partners are selected in public procurement procedures, so I am pretty sure that this change will have significant impact for the PPP market.

What is the best-known example of healthcare PPP projects in Poland?

A landmark example of the Polish PPPs and actually the first large-scale multimillion PPP in the sector is the Hospital in Żywiec project. The contract award procedure in this project ended in 2011 with the selection of InterHealth Canada as the private partner. The private partner was mandated to build an entirely new hospital and manage it for the period of 30 years, including the provision of healthcare services. I have been involved in this project at the time of my engagement with my previous law firm, advising financing banks inter alia on the PPP regulations and their practical implications.

The hospital in Żywiec has recently been opened to public, despite the Covid-19 pandemic. The success of this project will hopefully attract more interest in the PPPs in the sector and translate into a steadily growing number of PPP contracts in the years to come.

What is in your view the added-value of PPPHealth4All and how it could help in preparation of sustainable healthcare PPPs?

PPPHealth4All can certainly be helpful for all stakeholders on the PPP market by providing access to best practices, peer-to-peer support and specialized training. All these are very valuable, as know-how and experience are crucial for a PPP project to be successful.

Interview by Natalia Korchakova-Heeb

Opening Session on Sustainable Infrastructure and SDGs for PPPs – 5th Istanbul PPP Week (2 November 2020)

Shortened transcript of the opening Panel on Sustainable Infrastructure and SDGs, 5th Istanbul PPP Week (2 November 2020)

Natalia Korchakova-Heeb: Good morning, ladies and gentlemen! I am happy to greet you at the opening panel of the 5th Istanbul PPP Week dedicated to sustainable infrastructure and Sustainable Development Goals. (SDGs). Let me introduce myself – I am Natalia Korchakova-Heeb, Managing Director of SDG.17 Consulting GmbH, Germany and founder of PPPHealth4All – a global platform to facilitate sustainable and people-centered healthcare PPPs. Today we are very fortunate to have a distinguished panel: well-known experts that don’t really need an introduction.

Let’s me start from the ladies:  I am very pleased to introduce Hulya Pasaogullari, who is Principal Consultant for PPPs, Economics & Finance at IMC Worldwide. Hulya is a former Head of PPP Office within the Turkish Treasury and has a long track of experience in sovereign borrowing and public investments, PPP Advisory, Infrastructure Finance and Governance.

Next speaker is Mark Moseley, who is is Principal of Moseley Infrastructure Advisory Services. He is the former Chief Operating Officer of the G20 Global Infrastructure Hub and a former Lead Lawyer in the World Bank’s Infrastructure Practice Group. It is a special pleasure for me to introduce Mark as he is also a member of the Advisory Board for PPPHealth4All.

Next speaker is Hugues de La Forge, Partner at the Law Firm Fidal, France. He is Head for PPP projects and is in charge of African countries. Hugues has more than 22 years of experience in advising the public and private clients on contract management, disputes and international arbitration. Thanks to all of you for being with us today.

Ladies and gentlemen,

It is very symbolic that our conference is being opened with discussion on sustainable infrastructure- thanks to organisers for giving a priority to this topic.

Sustainable infrastructure is an essential foundation for achieving the Sustainable Development Goals (SDGs) and the objectives of the Paris Agreement. It is not any about building more roads, hospitals, schools – it is about building sustainably by establishing a sustainable life-cycle: sustainable design, sustainable procurement, sustainable financing, sustainable construction, sustainable operation and maintenance and impact assessment. It is also about increased quality, efficiency, innovation of service delivery and meeting all sustainability criteria (social, environmental, institutional, and economic-financial criteria). My first question goes to Mark Moseley:

Mark, during your time with the World Bank and the Global Infrastructure Hub, you worked closely with the G20 in regard to sustainable /quality infrastructure. Can you describe the G20’s approach to sustainability and the achievement of the infrastructure-related SDGs, and could you please also explain us how the G20’s approach relates to other sustainable infrastructure initiatives?

Mark: Thank you, Natalia, for that kind introduction, and thanks also to the organisers of this year’s Istanbul PPP Week for the invitation to join this panel. I had the honour of speaking at the inaugural Istanbul PPP Week in 2015 and it is great to be back at the event – although the extraordinary circumstances of this year have meant that we are not able to enjoy the opportunity to gather in the wonderful city of Istanbul.

Even though all of us have been forced to deal with the immediate impacts of the pandemic, we should not lose our focus on critically important longer-term objectives, such as the achievement of the United Nations Sustainable Development Goals. And, as infrastructure practitioners, we must not abandon our efforts to help achieve the infrastructure -related SDGs, in terms of universal access to basic infrastructure services for both economic infrastructure such as transport, power, water and digital services, as well as social infrastructure such as hospitals and schools. The need for these services remains acute, and we must redouble our efforts to achieve the SDG objectives while recognising the new realities that will arise in the post-pandemic world.

Recently, many infrastructure strategists – including Thomas Barret, Chairperson at OECD Infrastructure Governance Forum in today’s keynote address — have promoted the concept of ‘Building Back Better’. Indeed, I believe that there is some sort of election currently going on in the United States in which the opposition candidate has adopted that idea. But what do we mean by ‘building back better’? I suggest that what the idea should mean is a commitment to pay close attention to the quality of the infrastructure we are building.

And this is what brings me to the G20’s approach to achieving the infrastructure-related SDGs, as raised by Natalia. As Thomas Barrett (OECD) also noted this morning, the G20 has, for the last few years – beginning in 2015 under Turkey’s G20 Presidency – been focusing on the quality of infrastructure investments. This focus ultimately led to the G20 Leaders formally approving, last year, the Principles for Quality Infrastructure Investment, also known as the QII Principles.

But what, exactly, are these QII Principles, and how do they relate to the SDGs?

There are six main QII Principles, as follows:

  • Principle 1 is to Maximise the positive impact of infrastructure to achieve sustainable growth and development. This principle directly incorporates the UN’s 2030 Agenda for Sustainable Development, under which the SDG goals were articulated.
  • Principle 2 is to Raise Economic Efficiency in view of life-cycle cost. This involves taking into account all phases of the life-cycle of an infrastructure project, including planning, construction, operation, maintenance and disposal.
  • Principle 3 calls for the Integration of environmental considerations in infrastructure investments, by taking into account the positive and negative impacts of infrastructure projects on ecosystems, biodiversity, climate, weather and the use of resources.
  • Principle 4 speaks to Building resilience against natural disasters and other risks, and the need to create comprehensive disaster risk management plans which inform the design and operation of key infrastructure facilities. Of course, as Thomas mentioned, Turkey unfortunately knows all about the importance of resilience, as was demonstrated by the recent tragic earthquake near Izmir.
  • Principle 5 is the Integration of Social Considerations in infrastructure investment, and it urges the adoption of policies that provide open access to infrastructure services on a non-discriminatory basis.
  • Finally, Principle 6 addresses the need to Strengthen Infrastructure Governance, in terms of the government institutions and processes that impact on the planning, procurement and management of infrastructure investments.

This last principle is, in my view, particularly important. Very recently, both the World Bank and the IMF have emphasised the relationship between good governance and the efficiency of infrastructure investments. In this regard, I would particularly recommend taking a look at the new book which the IMF produced in September, entitled Well Spent – How Strong Infrastructure Governance Can End Waste in Public Investment, which can be freely downloaded from the IMF’s website.

The important point is that the G20, alongside the United Nations and organisations such as the World Bank and the IMF, is now focusing clearly on the practical problems associated with achieving the infrastructure-related SDGs by 2030 – and this focus is demonstrating the importance of infrastructure quality and infrastructure governance, as key elements in the achievement of the SDG objectives.

Hulya, based on your experience in Turkey plus in various developing countries you have been working with, where do you see the gaps for achieving a better sustainability in the PPP governance, particularly from the public finance and the financiers’ side (i.e. project prioritization, policy alignment, etc)? What needs to be done and where the policies to be re-shaped?  project screening and preparation phase? 

Hulya: I wish to elaborate on what Mark has just presented but in terms of public perspective. Our priority is to understand how sustainability contribute to the the success factors of the public services. Here we are taking about hard/soft infra sectors, the service facilities in investment policies. This all relates to the global development efforts. Politicians and the public authorities are setting the trends and goals of sustainability in their development agenda  and these goals need to be achievable ones.

Considering the project life cycles the critical perspective and the responsibility is in the public side when it comes to the project preparation and the project availability for the private sector. Let me elaborate a bit. When you are working on a country diagnostic study, the first ever thing to understand that country is to look at the high level policy documents.  You will screen the development plans and the high-level investment plans of a country.

The related strategies, goals and targets are all very inter-connected and there is an aim to decrease the existing infra gap with fostering the economic growth with investment. Considering the sectors one by one, I believe we have a new paradigm with the COVID that the priorities have been changed in the public services. I was in Kathmandu (Nepal) last year to support the Investment Authorities for PPP policies. We were drafting the PPP guidelines. The key sectors identified were tourism, energy and transportation when we were discussing the procurement parameters for the candidate airport project. But during COVID pandemic, we start discussing the remote education facilities and healthcare service. This is a remarkable shift in all such discussions. This is the demand side key shift that we face with. The needs are changing.  Coming to the supply side, yes, we know that the public money is limited. Especially now, the resources are more limited with the slowdown in the economy and the urgent budgetary expenditures. This increases the importance of the private sector participation which will also trigger the effective usage of resources including the time  saving!

We need to identify how PPPs may help to close infrastructure gaps and inequalities and seek suggestions from PPP experts to improve:

  • poor planning and project selection: analysis, technology and innovation;
  • inefficient delivery: life cycle management and long-term perspective;
  • limited public resources: private financing.

We need to encourage further discussions on best practices in PPP preparation with the aim of creating a knowledge that could assist governments in doing better PPPs. 

Another consideration: some candidate PPP projects are better in terms of financial viability including the affordability and revenue generation capabilities. However, considering the sustainability and the SDG, there is an increasing demand to showcase the social benefit of the projects.

So, if the key consideration is time (which is more important than money nowadays), the social impact of a project is more critical to highlight the importance of the private sector engagement. All these prioritization shifts also impact the project screening and preparation aspects.

This is also good to see that in the last decade there are plenty of new cases of the ESG -compliant projects and I am sure we will be able to hear more from the speakers in the forthcoming sessions where the real cases and country examples to observe that shift will be demonstrated.

The countries and decision-makers should look at the changing world on how they can integrate better the PPP governance and sustainable development. We have seen plenty of good examples during the last 8 months.

Hulya, where you see the differences in the policies and approaches across the countries related to integration and implementation of the SDG goals within PPP projects? Does it increase the complexity of PPPs? How we can facilitate a better stakeholder engagement in PPPs to foster the implementation of Sustainable Goals?

Hulya: Every country has a different way of doing business, which shapes their the political decision making and even technical valuation and criteria settings.Moreover, it is also very crucial who will hold the flagship of SDGs. It is very clear that the governments and public agencies are the key players in leading SDGs.

Happy to see that the private sector who have more integrations with the public side is  more  and more focusing on the social and development-oriented strategies in their corporate activities.  This is a really good pick for these big scale private sector players having a dominant role which puts people in the centre of all these decisions.

I have been intensively working with the South Asia countries in the last two years and have witnessed that the social benefits and the impact of an infra investment iare very important for the politicians to demonstrate to the public to proof the effective public money spending.  This also relates to the transparency. We observe these sensitivities also in the local level. This also yield an increase in the social infra sectors as top priority in the developing countries.

The key challenge is the local capacity and domestic resources needed both for technical and financial capabilities. The countries who also connect their local development with private sector solutions in terms of domestic mobilization also have a better development impact , especially in mitigating the foreign exchange rate risk and country risks.

Attracting long term investment in private financing is also very crucial for these countries and the

  • tariff regulations,
  • pricing policies,
  • government support tools,
  • creating an enabling environment for the foreign investors like
  • step in rights and arbitration

– are all key elements that require further consideration.

Hugues, you have a lot of practical experience on the ground in Africa, especially with governments and project sponsors. What are the actual trends regarding the inclusion of social impact in infrastructure projects in Africa?

Thank you, Natalia. I would also like to warmly thank the organization of the Istanbul PPP Week for inviting me and especially Dr Eyup Vural Aydin. For sure we would have preferred meeting each other’s in persons and enjoying the view on the Bosporus but for the time being we mainly enjoy our home offices views!

Whereas Africa has been apparently less impacted than others continent by the Covid 19 virus, the current pandemic reveals the weakness of most of African countries as they either depend on importations of goods from outside or rely on exportations of their oil and gas productions. I would like here to remind a few facts:

  • 600 million Africans do not have access to water;
  • the amount of funding needed to achieve the Sustainable Development Goals (SDGs) by 2030 would exceed € 150 billion per year;
  • less affluent and / or isolated social classes are the most affected;
  • investors logically focus on creditworthy and easy-to-serve clients, which excludes the less fortunate and the most landlocked;
  •  Projects affecting a large population – therefore less solvent – are more difficult to finance.

Hence it is urgent to modify the scope of all infrastructure projects to include populations that are less easy to serve, and at the same time finding financial making projects dedicated to make them viable.  

Hugues, could you give us concrete examples on the extent of which infrastructure projects in Africa are modified/adjusted to take into account those social, sustainable and environmental criteria?

Absolutely. The priority list of infrastructures that needs to be addressed is the following :

  • drinking water and sanitation
  • electricity and energy
  • health and education
  • transport and communications

For example :

-a mining train which, although it may find its profitability by its sole mission of evacuating metals or minerals, it can become a structuring axis for entire regions by ensuring passenger trains with adapted (and probably subsidized tariffs) .

– dams are more and more designed to also benefit the surrounding populations, partly as compensation for the nuisance of the building, partly with the consequence of a much greater social acceptability of the entire project.

– off-grid electrical service models are increasingly available, thanks to photovoltaics and mobile phones; the move to a larger scale requires additional capital, and therefore, upstream, studies showing the profitability for the investor, and its conditions. Other specific modes of production or distribution have been developed, in Africa and elsewhere, often thanks to non-profit funding (international aid, NGOs, foundations, CSuR, etc.): shared transport, autonomous management of wells or fountains, multifunctional platforms, subsidized tariffs.

Mark, do you think there is a need to streamline the practices across countries and donors. How should take a lead on that?  Would you please elaborate on this?

Mark: Well, Natalia, your question is a provocative one – because it points to a basic flaw in our system of dealing with international challenges – particularly challenges, like the achievement of the SDGs and the issue of climate change, which require collective action by multiple countries.

Of course, the SDGs are a product of deliberations at the United Nations, and there was a consensus of countries in support of the SDG goals. However, the UN has, historically, struggled to mobilise countries to act on their commitments. In short, it’s fine to agree on aspirational goals, but they are meaningless unless countries actually implement their promises.

Indeed, in response to the long-standing perception that it is very difficult for the United Nations to force countries to honour the commitments which they have made, various states have created other groupings and organisations to take collective action. That was one of the reasons behind the establishment of the G7 Group and, when the G7 was found to be too narrow, a decision was taken to create the G20.

Interestingly, the G20 Group brings together not only advanced economies, but also emerging market countries, such as Indonesia and South Africa. And this gives the G20 a certain ‘moral legitimacy’ in terms of  acting as a coordinating agency. Also, the members of the G20 have significant influence on the boards of directors of the major development organisations, such as the World Bank, the Asian Development Bank, the African Development Bank and their various sister institutions.

Accordingly, I believe that the G20 can and should play a key role in coordinating sustainability practices across countries and onerous – and that is why I wanted to provide some details, in my earlier remarks, on the direction that the G20 is currently taking in regard to quality infrastructure investments.

Natalia Korchakova-Heeb: Thanks a lot for your insights and interesting discussion. Hope we provoked some thinking and inspire our audience to integrate SDGs and make infrastructure projects more sustainable.   Let me close  the session. We wishing our participants a good continuation of the conference.

PPPHealth4All Persona – Askar Khoroshash, General Manager – Medical Component Coordinator, PPP Project Office of the Ministry of Health of the Republic of Kazakhstan

Askar Khoroshash General Manager - Medical Component Coordinator PPP Project Office Ministry of Health of the Republic of Kazakhstan

Mr. Khoroshash, during the Second PPP Investment Forum in Kazakhstan (15 October 2020),  you have presented together with Kanat Tosekbaev, General Director of the Republican Center for Health Development the pipeline of PPP healthcare projects in Kazakhstan during a session “Prospects of using off-take argeements for healthcare PPP projects”. Could you please describe main activities of the PPP Project Office?

The Project Office of the Ministry of Health of the Republic of Kazakhstan  for priority healthcare PPP projects was established in 2019 and consists of a medical team, a technical team, and a team of project managers. Currently there are 10 specialists working in the Project Office, including 1 Chief Manager, 1 PPP Consultant, 5 Project Managers, 1 Legal Support Specialist and 2 Medical Specialists. Our experts take part in every stage of the PPP healthcare project preparation, namely in:

  1. development of project documentation phase–ensuring the quality of planning of the medical component, assistance in introducing amendments to regulatory and legal acts, preparation of sectorial and economic conclusions, initial examination of project documentation, interaction with national and foreign companies.
  2. procurement phase – assistance to the Ministry of Health in procurement procedures, preparation of a tender dossier, consultations with potential private partners, initial screening of technical proposals.
  3. contract Agreement with a private partner – assistance in entering into government obligations and reviewing the project agreement.

What PPP projects are currently supervised by The Project Office?

Let me mention some examples:

  1. Construction of a 300-bed multidisciplinary hospital in Karaganda at KSMU;
  2.  Construction of a 300-bed multi-field hospital in Almaty at KazNMU;
  3.  Construction of a 1265-bed Joint University Hospital in Almaty at KazNMU;
  4.  Construction of a 500-bed multi-profile regional hospital in Petropavlovsk;
  5.  Construction of a 600-bed multidisciplinary hospital in Nur-Sultan.
  6.  Construction of a 600-bed multidisciplinary hospital in Turkestan. 

How is from international donors are supporting development of healthcare PPPs in Kazakhstan?

In December 2019, the Kazakhstani government and the European Bank for Reconstruction and Development (EBRD) signed a Memorandum of Understanding on the implementation of a Comprehensive Program for the Modernization of Healthcare Infrastructure in Kazakhstan. The program envisages the construction of up to 19 new hospitals to replace 40 outdated existing facilities and the upgrade of up to 50% of the hospital bed capacity in Kazakhstan as part of the State Health Care Development Program for 2020–2025. I would like like also ackhowledge support of the Asian Development Bank and the World Bank for supporting healthcare reforms in Kazakhstan.

Many thanks for your time and let me wish you and your colleagues successful continuation of your work on healthcare PPPs in Kazakhstan!  Interview by Natalia Korchakova-Heeb, Founder of PPPHealth4All

'Off-take agreements"

PPPHealth4All needs your feedback!

PPPHealth4All is developing new products to assist the PPP healthcare stakeholders to design and implement sustainable and people-centered PPP healthcare projects.

We need your feedback to validate our approaches and request a 1-hour interview with PPP healthcare experts and stakeholders. The interview will be around your needs for core and non-core expertise, documentation and technical solutions.

You will be rewarded for your time  by receiving a voucher for 200 EUR of PPPHealth4All’s services.

Interested experts are invited to contact , Natalia Korchakova-Heeb, PPPHealth4All Founder at info@ppphealth4all.de or book a meeting here