1. Botswana Experience on Public- Private Partnerships Joconiah Chirenda, MD, MPH, MBA jchirenda@gov.bw/chirenda1@yahoo.co.uk Global Business Coalition on TB, HIV-TB Co- infection and Global Fund Partnership Johannesburg, South Africa 11-13 October 2010

2. Traditional Government Partners Technical – UN agencies – Private hospitals – Pharmaceutical – International Development agencies Health financing – Insurance – International development agencies Other – Communities, CBOs, local NGOs 10/9/2015 Private Sector Investment in Health is Best Practice

3. Botswana Best Practice 10/9/2015 2010 World TB Day Commemoration with His Honor, Vice President of the Republic of Botswana

4. Institutionalized Partnership Government Policy recognizing importance of partnerships with all stakeholders – National HIV/AIDS policy (1998) – Public service code of conduct on HIV/AIDS in the workplace (2001) Successful implementation of policies – Private sector provider initiative for ARVs Conducive environment 10/9/2015 Private Sector Investment in Health is Best Practice

5. Benefits Sustained number of funding partners Achieved universal coverage for ART – One of the few countries in the region – Successful prevention of mother to child transmission of HIV programme – Successful implementation of TB programme Relatively easy to attract new funding partners Efforts aimed at attracting domestic partners 10/9/2015 Policies, conducive environment and effective implementation are key to sustained partnership

6. Main Domestic Partners DEPSWANA – Owns two hospitals – Offer primary health care to employees and government patients – Provide TB and HIV/AIDS care to employees and immediate families – Participates in the AFA coordinated model Associated Fund Administrators – Coordinate provision of ARVs to Government patients through general practitioners 10/9/2015 Policies, conducive environment and effective implementation are key to sustained partnership

7. Challenges Policies refer to HIV/AIDS only – Other opportunistic infections (TB) – Addressing this anomaly at policy level Involvement of private partners through joint planning, training on TB case management and quarterly feedback meetings started 2009 TB still perceived as the responsibility of MOH – Advocacy activities with industry on-going Minimal funding to TB, unless branded with HIV Minimal private sector participation in TB 10/9/2015 Private Sector Investment in Health s Best Practice

8. Conclusion Government still main funder of health services Minimal private sector support Critical to have coordinated private sector response to TB/HIV/AIDS care to improve cost effectiveness How can more funding be mobilized for TB care? How can other private companies be encouraged to participate in healthcare provision? 10/9/2015 Private Sector Investment in Health s Best Practice