Published October 2, 2015, last updated on October 3, 2015
By Jennifer Cook, Innovations in Healthcare
Onno Schellekens, Managing Director of the Netherlands-based PharmAccess Foundation, visited DGHI recently to talk about how public and private stakeholders can work together to make health markets work for the poor.
PharmAccess was founded in 2001 by the late Joep Lange to pioneer HIV/AIDS treatment in Africa. Today, PharmAccess improves access to affordable, quality healthcare for people in sub-Saharan Africa by mobilizing public and private resources for the benefit of African doctors and patients through health insurance, loans for healthcare providers (Medical Credit Fund), clinical and operational quality standards (SafeCare) and private equity (Investment Fund for Health in Africa). The organization collaborates with the Dutch Ministry of International Trade and Development and many other global health innovators.
Schellekens emphasized the importance of bringing the public and private sectors together in low-income countries to expand access to healthcare. “When the state doesn’t have the means or the ability to care for everybody, what do you do?” he asked. Recalling PharmAccess’ early days, he is proud of colleagues like Lange who believed that it was better to start treating people for HIV/AIDS in Africa with private sector resources rather than “wait until the public money is there for everybody.”
His colleagues started working to fight HIV/AIDS in Africa, he said, when few others saw the feasibility of working there. “They started on the mother-child transmission studies and treatment programs far ahead of any public money.” It was politically incorrect at the time, he said, “to call a cat a cat” and agree that treatment was the right thing to do. “They took their role as a medical doctor beyond the interventions and the proof of interventions. They became activists and we all need more activists, especially from doctors. We should bypass political correctness and stand up to big institutions that simply don’t deliver on what their mandate is,” he said.
Reflecting on Lange, he said: “He was a medical doctor and scientist and also a pragmatist. Then he became an activist.” Schellekens went on to say that Lange campaigned against ideas that it was not feasible to begin treatment for HIV/AIDS in Africa because of myths such as the idea that poor people would be unable to take medications on time, or that it was impossible to distribute and sell medication on the scale that was needed. He continued this fight by working to expand access to health insurance and explore the possibilities offered by mobile technologies.
PharmAccess demonstrated that private financing for HIV/AIDS treatment could work. Today, the organization continues to expand access to healthcare in Africa by encouraging the building of risk capital by leveraging public money. “You really need a public and a private system all together. In developing countries there is a lot of interest in our work because they know they depend on the private sector to a much larger extent than we want to believe in our parts of the world,” he said.
When asked about advice he had for students interested in global health, Schellekens encouraged them to pay attention to the role of women in microfinance and the importance of mobile technology in expanding access to healthcare.
He also encouraged activism: “We should all become activists. We already have problems in our own countries changing things through democracy,” he said, adding that it is even more challenging in systems where citizens have less power.
“The time of the big conglomerates is changing, he said. “I think we are moving to technology that empowers people and makes it possible to work on a smaller scale at lower transaction costs. That’s really important. Big data has real possibilities to work on a microlevel.”
Listen to an interview with Schellekens here.
