How Public-Private Partnerships Can Mitigate Urban Health Challenges

September 16th, 2021 | Viewpoint


Cities are growing exponentially, which is straining city budgets and limiting their ability to provide services to citizens. Some estimates place the annual gap between need and investment of two sectors alone—health, and water and sanitation—at $620 billion. Especially in the context of COVID-19 and the acceleration of noncommunicable diseases, improving urban health is a priority for governments and civic leaders throughout the world. It is clear that current efforts are not enough to solve this growing and complex problem. One solution is to use public- private partnerships (PPPs) to fund urban health initiatives. 

The World Bank defines a PPP as “a long-term contract between a private party and a government entity, for providing a public asset or service, in which the private party bears significant risk and management responsibility and remuneration is linked to performance.” Historically, PPPs have been used for infrastructure projects such as roads and airports, but the model has been applied increasingly to social sector needs, particularly projects that are complex and costly, including those that affect public health. 

The USAID-funded Building Healthy Cities (BHC) project works to refocus city policies, planning, and services with a multi-sectoral health equity lens while improving data-driven decision-making for Smart Cities in Indore, India; Makassar, Indonesia; Kathmandu, Nepal; and Da Nang, Vietnam. BHC found that while individual sectors have succeeded in developing private-sector relationships, the same is not true for multi-sector urban health projects. 

To fill the knowledge gap on multi-sector urban health projects, BHC, through its partner Urban Institute, began researching the use of PPPs to meet local urban health needs. The result was a brief that introduces key concepts and summarizes the benefits, challenges, and opportunities of PPPs . Digging even further, the team prepared a companion brief that offers guidance to local leaders and reviews the PPP landscape in the three BHC partner cities. Urban Institute has also released a blog that summarizes some of the findings across these two briefs.

At the same time, after four years of working to identify evidence-based, innovative investment opportunities to ensure healthy urban growth, the BHC team is finalizing action plans for city governments in Indore and Makassar. The actions outlined are the perfect opportunity to see PPPs in action. Now, the BHC team is working to find investors for these initiatives. 

Building Healthy Cities is proud to find new and creative ways to use existing methodologies to solve complex problems. As urban health gains a growing audience, the BHC team looks forward to talking with Kunal Kumar, the mission director of the National Indian Smart Cities to discuss the importance of the private sector in urban development, and how to more effectively engage it. Please join us for this important and timely conversation.

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