A presentation from the Global Financing Facility (GFF) in Support of Every Woman Every Child Workshop, held in Nanyuki, Kenya.

1. Global Financing Facility in support
of Every Woman Every Child
Private Sector Engagement
November 2015

2. Introduction
• GFF is positioned as a pathfinder for a new era of sustainable
financing for development by moving beyond just ODA to:
– Mobilize domestic resources (from both public and private
sources)
– Attract additional external resources
– Employ innovative strategies for resource mobilization and service
delivery
• Private sector is key to realizing the GFF objectives:
– Flow of international private finance dwarfs ODA: US$135 bn ODA
vs. US$778 bn FDI and US$400 bn remittances
– Private expenditure on health is >50% of total health expenditure
in more than 60% of GFF countries
– Many countries already have mixed health systems, although the
private sector is not sufficiently leveraged to deliver on national
health goals
2Source: World Bank; review of national health accounts

3. Objectives of the GFF’s engagement with the private sector
• Overarching objective:
– To use the GFF to draw in the financial resources and capacity
of the private sector to help countries achieve RMNCAH
outcomes
• Three pathways:
1. By developing innovative financing mechanisms to draw in
private sector capital for Investment Case financing
2. By facilitating partnerships for Investment Case needs
between global private sector and countries
3. By leveraging private sector contributions in countries to
deliver on Investment Case objectives
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4. 1. GFF innovative financing mechanisms
The GFF has a unique opportunity to broker impactful financing structures
and effective, market based solutions for investments into RMNCAH. With
the right incentive structures in place, countries could raise additional
financing through vehicles such as:
• Pay for Performance Structures: IBRD loan buy-downs, development
impact bonds to strengthen health systems, preparedness and
surveillance, and support longer term, diversified financing needs;
• Working Capital Financing: risk-sharing facilities to encourage greater
domestic/local funding for service providers, production or technology
upgrades;
• Private Equity/Debt Structures: health bonds, investments leveraging
grants and concessional finance to support infrastructure, technology or
scale up of new innovative global health products
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5. 5
1. GFF innovative financing mechanisms: performance-based
IBRD loan buy-down
Performance
indicators
Outcome payers (donors,
private sector)
GFF
IBRD
Results
Loan at IBRD rate
Performance-based
buy-down of IBRD
interest to
concessional terms**
Capital Market
Investors
Health Programs
Borrowing
Country*
Funds for performance payments
*If the borrowing country is an IDA one, there is an additional requirement for a guarantor to allow IBRD lending
to IDA countries
Buy IBRD bonds
 Incentivizes greater domestic investments in health systems by enabling countries to
access resources beyond constrained IDA envelopes

6. 2. Facilitating partnerships for Investment Case needs
• Great interest among private sector actors at global level; keen to be
involved along continuum of care through sustainable business models
• Partnerships closely linked to country Investment Cases: GFF facilitates
partnerships for innovation, global public goods and resource
mobilization to match specific needs in Inv. Cases (e.g.; TA for supply
chain improvement, medical technology procurement, innovative
service delivery)
• Partnerships may be:
– Between private sector and countries
• Safaricom, Merck, Philips, GSK, Huawei and Kenya Healthcare
Federation PPP in Kenya to provide resources and expertise for
RMNCAH
– With private sector for global public goods
• DITTA*, WHO, medtech companies for country procurement of
medtech
6*Global Diagnostic Imaging, Healthcare IT, and Radiation Therapy Trade Association

7. 2. Wide range of private sector actors to be leveraged for RMNCAH
• In most countries, achieving GFF goals is unlikely without engaging with
actors outside government system
• Range of possibilities at global, regional, and national levels:
– Service providers (e.g., private doctors/clinics/hospitals, including FBOs)
– Pharmaceutical manufacturers
– Medical technology companies
– Financial sector:
• National
• International (e.g., private investors in IBRD or IFC bonds, private equity
firms investing in healthcare companies)
– Private insurers: purchasing technical services for government sponsored
health insurance schemes
– Mobile technology providers/mHealth companies
– Management and logistics:
• Supply chain/distribution companies
• Management consulting firms supporting development of management
capacity (Technical Support Units)
– IT firms (e.g., tech firms working on big data, such as in the context of CRVS)
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8. 3. Leveraging private sector to deliver on the Investment Case
• Heterogeneity across countries and services – on level of private
utilization and composition of private sector
 Country private sector engagement will be tailored to health system
context: ensure Investment Cases set priorities to guide leverage of
private sector resources, capacity and innovation
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Chad
Niger
Nigeria
Benin
Rwanda
Guinea
Mali
Cameroon
DRC
Malawi
Kenya
Liberia
BurkinaFaso
Lesotho
Uganda
CongoRep
Zimbabwe
Senegal
Madagascar
Ghana
Tanzania
Zambia
Swaziland
SierraLeone
Ethiopia
Mozambiq…
Namibia
Source of care for pediatric curative care, poorest quintile by type of
provider (Sub-Saharan Africa, latest survey)
Other Non-Formal
Friends/Relatives
Traditional Practitioner
Shop
Other Formal
Mobile clinic
CHW
Religious Hospital
Private Doctor
Pharmacy
Hospital/Clinic
Public
Source: DHS data
Source: DHS data

9. 3. Leveraging private sector to deliver on the Investment
Case: proposed country approach
• Establish the country platform
• Conduct core analytics and stakeholder consultations
(building on Health in Africa and any existing private sector
work, expanded to fit GFF scope)
• Identify private sector engagement opportunities for
Investment Case and health financing strategy priorities
• Develop timelines for implementation of selected
opportunities
• Support government and partners to implement through
relevant tools of engagement
• Document process and lessons learned
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