Interrogating Public-Private Partnership in African Healthcare within the Lenses of Capitalist Philanthropy in Nigeria’s Primary Health System

This study examined how partnership between Nigerian government and international private entities shape primary healthcare development in Nigeria. At the global level, partnership in healthcare between the national governments and international private entities takes the form of Global Public Private Partnerships (GPPPs) mostly driven by global capitalist philanthropic foundations whose influence in healthcare funding and agenda-setting has mushroomed, particularly since the adoption of the Millennium Development Goals (MDGs) and subsequently the Sustainable Development Goals (SDGs) which articulated specific healthcare targets to be achieved globally. The study is anchored on the gatekeeper state theory and employed documentary approach to collect secondary data analyzed via qualitative descriptive method. Two key arguments are presented in the study. First, the study argued that weak governance structure of Nigeria’s primary healthcare system undermine efficacy of GPPPs in the primary health system. Second, with specific focus on the philanthropic activities of Bill and Melinda Gates Foundations (BMGF) in Nigeria’s healthcare, the study argued that the self-serving capitalist interest of philanthropic foundations involved in GPPPs undergird their episodic and disease-specific interventions in primary healthcare. This rather enervates the primary healthcare system and undermine the efficient health service delivery through the primary health system in Nigeria. The Nigerian experience demonstrates that government partnership with international private capitalist entities is weakened by weak national health governance on the one hand, and the capitalist interests of the private entities on the other hand. This situation undermined the attainment of ‘health for all in 2000’, the attainment of MDGs 4, 5 & 6, and also threatens attainment of health components of the SDGs and Africa’s Agenda 2063.