Public-private partnerships in Latin America. Evidences from healthcare networks

The decision whether to invest is usually a very delicate one, and it requires the analysis of several aspects, first and foremost the risks associated with the investment. This is even more necessary when large infrastructure projects are at stake, as they require the identification of innovative strategies and tools for designing, financing and management activities. Consequently, the public sector has modified its financing methods, going from traditional debt instruments to new tools based on partnerships with the private sector. These are relatively new “alliances” between the public and the private sector referring to infrastructure investments, where the private sector partner cooperates in providing, managing and financing services and structures. These collaborations are called “public-private partnerships” (PPPs), and they have now become a commonly used investment strategy for all public administrations. At international level, healthcare sector represents a promising field for the development of PPP. Latin American countries, after experimenting with public-private cooperation in several sectors, are now designing new healthcare infrastructures by using these innovative financing tools. This paper will analyse public-private partnerships, first at a more general level, and then by considering their application to the healthcare sector, providing a state of the art of relevant experiences in Latin America. The final section will discuss future research perspectives, and it will introduce public network governance and management approaches as a theoretical framework to analyse existing experiences.

Negli ultimi anni si è assitito a livello internazionale ad una proliferazione di forme di collaborazione pubblico-privato finalizzate alla progettazione, realizzazione e gestione delle strutture sanitarie. Quasi tutti i paesi europei stanno sperimentando forme di collaborazione pubblico-privata nel settore saniatrio, a fronte della comune necessità di ammodernamento e riqualificazione delle strutture ospedaliere e sanitarie. Anche in America Latina, molti paesi hanno elaborato un anormativa in materia e sviluppato progetti. Nel presente lavoro si descrive lo stato di diffusione del fenomeno e si anlizzano punti di forza e debolezza e prospettive per il futuro.