Healthcare financialisation in the Global South: examining the role of the World Bank Group in promoting public private partnerships in health in Africa

In recent development policy discourse, an ambition to deliver comprehensive healthcare to all citizens in the Global South via publicly financed provisioning systems has been replaced by calls for universal health coverage (UHC). At the heart of today’s promotion of UHC in the Global South is a strategy to involve private actors as providers and financiers of healthcare. This is presented as an apt approach to overcome an acute financing gap to achieve the Sustainable Development Goals (SDGs), including SDG 3 on attaining UHC. As part of these efforts, public private partnerships (PPPs) are celebrated as an efficient way of mobilising private sector resources and expertise, including in Africa. The World Bank Group (WBG), as a lead actor in international development, is at the forefront of promoting such a policy solution, despite mounting evidence of the pernicious implications of the increased prevalence of health PPPs across both Global North and South. Our contribution to this Special Issue on healthcare financialisation is twofold. First, we demonstrate how health PPPs can act as vehicles of healthcare financialisation, posing significant threats to equitable healthcare delivery. Second, we examine the WBG’s role in promoting health PPPs in Africa. By doing so, we shed light on the ways in which health PPPs can serve as an important channel for the advancement of financial actors, instruments and practices in national healthcare systems. The WBG’s use of diverse tools in support of health PPPs significantly impacts African healthcare systems, highlighting the scope for ‘financialisation by development policies’.