Public-private partnerships : strengthen Thailand's health security in confronting emerging infectious diseases

Abstract

The emergence/re-emergence of pathogenic organisms is putting national healthcare systems under severe strain. Infectious diseases are among the root causes of death and disability in an outbreak. As such, ensuring the development of adequate resources and access to healthcare services has become an increasing priority for the national agenda. Governments across the world are increasingly turning to PPPs as the primary mechanism for delivering healthcare services to meet this growing demand for national health security. Currently, there is a large number of public health PPPs that have been established in the public health sector over the past few decades. However, there is a little information available on the necessary conditions leading to public health PPPs for pandemic influenza preparedness in Thailand. To address this need, this dissertation will explore whether these PPPs projects are effective in strengthening the national preparedness for Thailand in the future. It examines the underlying philosophy of PPPs, their objectives and the rationales for PPPs partnerships, as well as their implementation and the effective management of PPPs.

There appear to be several 2 key PPPs for pandemic influenza preparedness; The Influenza Foundation of Thailand (IFT), and the Technical Assistance of GPOKaketsuken projects (GPO-Kaketsuken). These projects aim to create public health readiness for pandemic influenza preparedness. They provide public health actors with the support and technical assistance needed at the initial stage of a national strategic plan by helping public actors increase their capacity to deal with influenza outbreaks. The PPPs also serve as the first step in creating an integrated national strategic agenda, given that PPPs are fundamental to the overall strategy of the nation.

This dissertation also sets out the key components of public health PPPs that are the essential elements for pandemic influenza preparedness. National pandemic preparedness plans are central to mitigating public health consequences and the social and economic disruption caused by a pandemic. It is, therefore, critical that any determinant of the effectiveness of PPPs for public health reflects their success in mitigating the impact of a pandemic influenza outbreak in the future. Meanwhile, governments should be encouraged to update, or develop comprehensive preparedness plans. The private organizations that participate in PPPs projects, IFT and the collaboration of GPO-Kaketsuken, are committed to playing a part in supporting pandemic preparedness. The main contributions from private to public, which serve the greatest need for the public, are technical and financial support. Whereas, the main contributions from the public, which serve the greatest need for private institutions, are financial and access to policy makers.

Effective training and education of the IFT PPP reflects, not only the needs of pandemic influenza preparedness, but also the administrative capacity of a government in confronting emerging/re-emerging infectious disease outbreaks in the future. However, there is no delivery instrument to determine the effectiveness of the GPO-Kaketsuken at the moment. Product development PPP projects will depend on a clear and consistent national plan and strategy for promoting drug development research, which needs to be evaluated once the project outcome delivery is available.

This dissertation will also develop a, resource dependence and interorganizational relationship theory driven, empirical framework that demonstrates the effectiveness of PPPs in public health. This will be the most important contribution of this thesis to the literature. Current literature on PPPs in public health, in particular for pandemic influenza preparedness, pays little attention to integrating theoretical elements into a cohesive framework that helps explain the domains of building PPPs. The proposed framework of this dissertation will fill these gaps.