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Private Businesses Help Deliver Healthcare in Mozambique

Information teams are chosen from the communities to disseminate information about residual spraying. They go door-to-door explaining the process and when it will take place, Mozambique, Nov. 13, 2014. (Gillian Parker/VOA)

Health budgets across Africa are under immense pressure, with foreign aid agencies saying they are strapped for cash. Governments are increasingly looking to leverage funds from private companies to close the deficit.

Present in all African countries, with 900,000 retail outlets, from the foot of Kilimanjaro to shack bars in Timbuktu, Coca-Cola is everywhere in Africa.
“The obvious question was - if Coca-Cola can go to any corner of the world, why can’t our medicines reach there?" said Gabriel Jaramillo.

Jaramillo is the general manager of the Global Fund fighting AIDS, Tuberculosis and Malaria. His question prompted the Clinton Health Foundation to partner with Coca-Cola in Mozambique to improve the procurement, storage and distribution of essential medicines.

The soda pop giant lends trucks during the third and fourth week of the month, when beverage sales are at their lowest, to distribute medicines from warehouses in six provinces to health facilities.

Lise Ellyn, country director of Clinton Health in Mozambique, says that private investment in local supply chains is a win-win situation.

“Expanding the base of donor partners is critical to moving forward with a lot of these areas and really engaging with the expertise that they have. We have a lot of funding but it is not being used efficiently. And so if you bring in the private sector, they are helping make it more efficient and they are also here long-term," said Ellyn.

And that, she says, could eventually be a catalyst for job creation and a more skilled workforce.

Despite decades of foreign assistance, few countries in Sub-Saharan Africa spend the minimum $34 to $40 per person annually that the World Health Organization is needed to provide a population with basic health care.
Leveraging private money and expertise is fast becoming a route for bolstering development efforts in Africa.

Last year, the U.S. Agency for International Development (USAID) said it had brought in almost $400 million in new money through partnerships with the private sector.

In Boane province, in southern Mozambique, women swarm outside a clinic run by Jhpiego, a non-profit health organization with financial support from Mozal, an aluminum company.

Boane has a 20 percent prevalence rate of HIV - almost double the national average.

The province borders Swaziland and South Africa, with Boane town straddling the only road into these countries. A high volume of traffic encourages casual, transactional sex contributing to the high rates of sexually transmitted diseases.
Leonardo Chavane is the Jhpiego project director.

“Within the Mozal project we counsel[ed] and tested more than 30,000 people in the last 12 months through the community counselors, so they can [make] a difference. If all of these companies working here [in Mozambique] takes one or two districts then support the work they are doing there, that can be great," said Chavane.

But private sector involvement has come under fire from aid watchdogs - some of whom worry of aid delivery will be exploited in the name of profit margins and expanding markets.

Nick Dearden, director of the World Development Movement, is critical of companies like Mozal who get lenient fiscal terms from the Mozambican government.

“The amount of lost wealth through tax evasion and through profit repatriation and so on, it would absolutely dwarf aid budgets," said Dearden. "This is money that is being fleeced from countries like Mozambique and so it is a little bit rich [hard to believe] then for the very same companies that are fleecing countries like Mozambique to turn round and say, 'We’ll provide your public provision of services as well.'”

Where the private sector can really excel, say many in Mozambique, is by employing people locally and incorporating better work conditions and ethics into their core business models.

Gillian Parker traveled to Mozambique with the International Reporting Project.