Over the past three decades there has been a growing trend for the state, or public sector, to engage private providers to radically improve infrastructure or the quality of services that are due to its citizens. In Africa, where through historic circumstances, the capacity of many governments and states is acutely limited, public-private partnerships (PPPs) provide a useful mechanism to bring essential affordable services and thus address some of the pressing challenges of development.
For the past 25 years, Riders for Health has been playing one half of these partnerships in many countries across sub-Saharan Africa.
By offering comprehensive vehicle management expertise to ministries of health, we are helping governments to focus on their core competencies of health care, while focusing on shrinking the last mile of health care delivery – effectively, efficiently and reliably. Our simple yet innovative interventions of preventive maintenance of vehicles, is an incredibly effective solution to the problem at the heart of health equity and access – reliable and cost-effective physical access to remote regions.
Riders believes that PPPs offer an opportunity to leverage resources, as well as bringing a focus and core competence from each partner in the collaboration. They attract new forms of financing to fund public services in resource poor environments and create employment, while providing better value for money and an undiluted focus on solutions – if designed well.
Riders believes that to achieve sustainable development, especially in Africa, it is imperative to work with governments, over any other kind of partner. This strengthens health systems by enabling governments to perform their key functions effectively, with a more efficient and co-ordinated use of resources, rather than perpetuating the plethora of ‘vertical programmes’ often implemented by international NGOs and development agencies.
In an effort to strengthen health systems, a government that decides to outsource the management of vehicles, is in no way abdicating its primary responsibilities of delivering healthcare. This is what reduces duplication, confusion and lack of expertise. An effective consortium can create an impact and add value that is far greater than the sum of its parts.
In Africa, Riders has worked to build excellent relationships and support health-focused organisations, from Ministries of Health (MoHs) to community-based organisations, international NGOs to local governments, providing them with the transport infrastructure to deliver their own services on a predictable basis. In the traditional view of a PPP, the private player is usually a profit-making business, with charities only ever playing the role of a sub-contractor.
However, Riders for Health have shown that social enterprises have the capacity to take on that private player’s role in the partnership. What is more, organisations with sound business models, financial discipline, management resources and that run as efficiently as a business but without the need to make a financial profit, have a competitive advantage over other ‘for-profit’ players.
As any private sector provider Riders is committed to providing a service for its partners at the lowest possible cost. We price our service on a not-for-profit basis and are transparent about the project finances. We consider a PPP as a performance-based contract, charging partners only for the service used (kms run on a vehicle). We work together with the regional health teams in designing the utilisation of fleets of vehicles for maximum impact.
In The Gambia, Riders for Health’s provision of national fleet management services in collaboration with the Ministry of Health and Social Welfare has seen us occupy the role of a private partner that is traditionally taken by corporations. In 2013 this partnership saw The Gambia win a Resolve Award from the Aspen Institute and this speaks volumes to the social enterprise model and the graduation of Non-Governmental Organisations (NGOs) in an otherwise risky proposition.
The success of social enterprises, like Riders, can enhance the credibility of public-private partnerships for international development. While traditional charity models have their place, PPPs are fast superseding the models of development marking a gradual shift away from donor model. In areas of market failure where the absence of economic incentives poses a significant barrier to scale, this is a healthy trend.
One of the hopes of public private partnerships has been that the resulting cooperation between multiple stakeholders means peer-accountability will make them somehow less corruptible. At their best, offer greater transparency and accountability, but they are not a panacea to reduce corruption.
For decades traditional models of development and aid have been maligned as resulting in great levels of corruption. There is no doubt that vast sums of money that should have been spent on improving lives of people have found its way into unscrupulous hands. However, even a cursory glance at the news in the developed world will show corporate practices that are just as corrupt as anything in Africa, if not more.
The truth is that corruption is as much a failing of people as of systems. However, with careful design PPPs can be made corruption-proof. Transparency at all stages from project design to implementation, effective pricing mechanisms, accountability to beneficiaries through strong monitoring and evaluation, and a credible regulatory environment are key to pre-empting or addressing corruption.
There are elements of Riders work that make it more resistant to corruption. Riders has a transparent business model, pricing policy, rigorous monitoring and evaluation with strong organizational governance structures. We are answerable to our partners, to the charity commission in the UK, to our trustees, and in a wider sense to the beneficiaries. All our programs operate on a not-for-profit basis, and by charging a performance based fee to our partners we also encourage effective budgeting procedures.
Corruption is an ill that has permeated many spheres of public life today and international development has not escaped it either. A public-private partnership in itself will not advance good governance in international development nor does it make a venture inherently less vulnerable to corruption. However, a well-designed venture with effectual governance, coupled with credible regulatory frameworks can go a long way in rooting out corruption.
Another key influence to reduce corruption is the influence of the moral imperative – a private partner to the government is a trustee of public resources that have to be used for the benefit of the community. It may be too early to say if this shift to PPPs in the sector is a permanent feature, but it definitely holds promise for an accelerated approach to address the seemingly intractable but shameful problems plaguing today’s world – that of global health, education, poverty and more.
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