Country Ownership of Health A Private Sector View Krista Thompson VP/GM, Global Health, BD

1. Country Ownership of Health A Private Sector ViewKrista ThompsonVP/GM, Global Health, BD

2. Legal Entities Plant locations Corporate Office About BD (Becton, Dickinson & Co) • Medical technology company • $7.5B • 29,000 employees • Four Areas of Focus • Reducing the spread of infection • Advancing global health • Enhancing therapy • Improving disease management Products relevant to HIV/AIDS AD Immunization Syringes Blood Collection CD4 Testing TB Diagnostics

3. Private Sector View of Country Ownership • Presentation Outline 1. Why country ownership is important to the private sector 2. What BD has learned from health systems strengthening efforts 3. How to leverage private sector competencies to build capacity

4. Healthy Economy Needed to develop markets Healthy Community Creates a better economy Healthy Workforce More productive workforce For Healthcare companies (like BD) Functioning Health Systems Needed for healthcare markets • Healthy Economy • Healthy Community • Market Development • Healthy Workforce Why does the private sector care about health? Specifically large multinational corporations

5. Representing the Private Sector Random sampling of just a few companies working in this area Community Healthcare Strengthening Healthcare Systems Financial and Project Management Support Employee Program

6. “If we define country ownership such that the government serves as the steward for the health of its citizens, we have a chance at success.” Stefaan VanderBorght, Heineken “Engagement from associates on the ground is a crucial first step.” David Pitts, Standard Bank Country ownership through the private sector lens • Some common themes Critical to sustainability of collective efforts Define country ownership at the right level • Too high—nothing will move forward • Too fragmented—not replicable or sustainable Attract and build more in-country resources Needed for effective utilization of resources • Must have integrated processes within countries • Define performance metrics at country level for common benchmarks • Help eliminate waste Not just about what countries should do to take ownership • What are we doing to encourage/inhibit effective country ownership? • We need to care about the communities in which we work

7. Private Sector View of Country Ownership • Presentation Outline 1. Why country ownership is important to the private sector 2. What BD has learned from health systems strengthening efforts 3. How to leverage private sector competencies in capacity building

8. Build Alliances to Develop Local Capacity & Ownership Develop Human resources Plan Strategically Network Laboratories Develop Leaders Ensure Quality Introduce New Technology Improve Infrastructure & Maintain it Strengthening Laboratory Systems Fundamental Building Blocks

9. BD/PEPFAR Public Private Partnerships Building capacity in support of ARV programs • Laboratory Strengthening • 2007 • $18MM over 5 years • ICN Wellness Centers • 2008 • $1.25MM • Safer Blood Collection • 2009 • Train up to 10,000 healthcare workers

10. Goals Support country-specific programs to develop laboratory systems and quality improvement strategies Improve the quality of laboratory diagnostics through health personnel training Implement quality control and assurance guidelines Strengthen TB reference sites Improve access to TB diagnostics Ministry of Health Country Operational Plan MOH CDC BD Other MOA Work plan Laboratory Strengthening Program Original Framework of MOU

11. Technical Assistance Process Improvement Resource Utilization Strategic Facilitation • Training Classroom and Field • Trainer Mentorship • Quality Management • Specimen Referral • Curriculum Development • Leadership Development • Planning Meeting Facilitation • Project Management Ethiopia Uganda South Africa Mozambique Cote d’Ivorie Implementation Phase Initiation Phase Planning Phase Laboratory Strengthening Program Evolution of activities and outcomes

12. Prioritizing capacity building in the face of short-term crises Embracing institutional change Ministry of Health Country Operational Plan Budgeting for implementation following successful pilots Defining what needs to be done and alignment MOH CDC BD Other Per-diem system prevents reaching the “right people” MOA Coordinating multiple stakeholder efforts Work plan Funding restrictions—due to multiple processes Getting commitments Keeping commitments Challenges • Execution a bit harder than it looks on the slide

13. Safer Blood Collection • Started by focusing on one country – Kenya • Launched in June 2010 – pilot training in eight facilities • Post training assessments showed significant improvement • Implementation planning, surveillance, training reinforcement, best practice model development all underway • Country ownership off to a good start • “The MOPHS recognizes the need for partnerships between the private, development partner and the government to achieve its goal of providing quality health services” • “…acknowledge with gratitude the role BD has been playing for the successful implementation of the Kenya Safe Phlebotomy Project” Improving safety for HCW and patients

14. Private Sector View of Country Ownership • Presentation Outline 1. Why country ownership is important to the private sector 2. What BD has learned from health systems strengthening efforts 3. How to leverage private sector competencies to build capacity

15. Private Sector Competencies • Management and Leadership Development • Project Management • Budget Oversight and Financial Management • Governance • Procurement Systems • Human Resources • Communications Capabilities that may be needed for effective country ownership

16. Engaging the private sector in capacity building Points for all parties to consider INCENTIVES Demonstrate corporate social responsibility and global citizenship Boost workforce productivity, morale and attract better employees Invest in capacity and establish long-term business presence in developing markets In a global economy, strengthen links with wider range of overseas partners and collaborators DISINCENTIVES Need for “quick wins” to overcome skepticism on both sides Reputational risk of failed programs Challenging to measure success Transition to and sustainability of local ownership for program efforts SUMMARY Country ownership of health is critical, but is certainly not a one-sided problem The private sector has 1) an economic and human interest; 2) the needed competencies; and 3) the willingness to participate in building the capacity to make effective country ownership a reality

17. Thank You