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Friday, February 29, 2008

Free Market Health Care in Africa Promoted

From David Almasi:
Project 21 Associate Thompson Ayodele of the Nigeria-based Initiative for Public Policy Analysis recently wrote a spirited commentary on the need for more private health care in Africa that was published in two major Nigerian newspapers: The Nation and The Independent.

Here is a sample of Ayodele's comments from the New Visions Commentary version that Project 21 will soon be distributing to the American media:
In my own Nigeria, for instance, a recent study found that 28 government-run health care centers received no drugs for over two years. Donated drugs such as Vitamin A capsules, Mectizan and Coartem tablets and oral rehydration salt are pilfered and re-sold on the black market. The Global Fund considered suspending two of Nigeria's five-year grants totaling $80 million because of concerns about grant management, transparency of fund allocation and grant implementation and the ability of the Nigerian government to achieve grant goals. Similar grants to Uganda and Chad have already been terminated.

Drug disbursement, however, is just one of dozens of forms of corruption - including mismanagement of funds at the ministry and hospital level, absenteeism, charges for normally free services and abuse of hospital procurement contracts...

It is clear this situation will never improve while health care remains under government control. Except for commitment to one's job, bureaucrats have few incentives to actually deliver care. Any manager of a private company can attest that goodwill alone is useless. Unless there is a significant change in the way the health sector is managed, there will be few improvements no matter how much money donors spend...

The advantages of private control are three-fold. It would reduce corruption. Corruption exists in the private sector, but private enterprises failing to show integrity risk exclusion from future contracts. Secondly, since private businesses care deeply about their reputations, there is pressure to deliver. After all, without a reputation, there are no customers - and therefore no business. Putting private sector bodies into competition also forces them to improve their productivity and patient care. Costs would fall and standards would rise.
Ayodele previously wrote for Project 21 on the health care peril of anti-DDT policies in Africa last July.

New Vision Commentary op-eds by Ayodele and others are available online at the National Center for Public Policy Research website here.
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Posted by Amy Ridenour at 2:08 PM

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