Public-private partnerships – a mechanism towards fiscal responsibility : an overview of issues, trends and options for HIV/AIDS intervention strategies in South Africa

18 March 2008

Public-Private Partnerships are seen as mechanisms that offer the promise to strengthen government’s policy implementation capacity and its ability to deliver services efficiently, effectively, economically and equitably (4Es) to communities. HIV/AIDS-related problems add to the complexities associated with building partnerships and networks as it demands a shift towards horizontal and broader based policy issues that show no respect to boundaries or do not fit neatly into areas of jurisdiction. Traditional models that described public and private relations have become obsolete, forcing governments to revisit their role and the type of outcomes they want to achieve. The symbiotic relationship between the economy, society, political philosophy and public finances increase the difficulty of finding a balance between the relative sizes of public and private health sectors steered by supply and demand functions, against a background of political performance which focus on finding the correct inputs for political, governmental and administrative systems to deliver quality outputs. In this presentation the authors take a critical look at the key issues necessary to ensure that accountable and fiscal responsible measures are in place when PPP networks are built in the health care sector. Their views are supported by the outcomes of a comparative research study that investigates PPP as a mechanism for public finance management in the macro- and micro-economic planning through the application of four international case studies. These case studies are benchmarked against the national situation to identify the best practices and find a best value for money approach to address the core issues, trends and options available to HIV/AIDS intervention strategies in South Africa.