Vol 3, No 2 (2025): Current Issue (Volume 3, Issue 2), 2025
Editorial
Public-Private Partnerships: A Pathway to Health Equity in Developing Countries
Dahat A. Hussein
In the face of mounting healthcare challenges, developing countries grapple with resource constraints, underfunded health systems, and a growing burden of infectious and non-communicable diseases. The question is no longer whether healthcare systems can sustain themselves under these pressures—the evidence says they cannot—but how they can adapt and evolve to meet these needs. One promising approach lies in establishing and strengthening public-private partnerships (PPPs) [1].
PPPs are collaborations in which governments and private entities collaborate to achieve common health goals, leveraging the strengths of both sectors. The public sector offers reach, regulatory frameworks, and an understanding of population health needs, while the private sector contributes innovation, efficiency, and financial resources. Together, they can address healthcare access, quality, and affordability gaps [1].
In many developing countries, healthcare access remains unequal. Rural and underserved populations often lack essential services, while urban areas face overcrowded and overburdened public hospitals. By pooling resources and expertise, PPPs can deliver sustainable solutions, such as building health facilities in remote areas, funding community health programs, or providing cutting-edge technology and training to public hospitals. Initiatives like the African Access Initiative have brought affordable medicines and diagnostic tools to low-income countries by fostering collaborations between governments and pharmaceutical companies. These partnerships ensure the availability of life-saving medications for conditions like cancer and diabetes [2]. In countries like India, PPPs have been instrumental in building state-of-the-art hospitals in rural areas, combining public funding with private expertise. For example, the Karnataka state government’s partnership with private hospitals expanded tertiary healthcare access to previously underserved populations [3]. Partnerships with multinational corporations and NGOs have facilitated training for healthcare professionals, enabling them to provide higher-quality care. In Kenya, PPPs have focused on improving maternal and child health outcomes through community-based education programs [4], in 2010, the Kurdistan Regional Government (KRI) asked for assistance from the RAND Corporation, a U.S.-based nonprofit policy think tank specializing in research and development across various fields, to support the reform of the healthcare system in the Kurdistan Region of Iraq. The primary goal of the reform was to establish a health system that could efficiently provide high-quality services to all individuals, with the support of Public-Private Partnerships (PPPs) [5].
Despite their promise, PPPs are not without challenges. Critics argue that these arrangements can lead to the privatization of public health assets or create inequities in service delivery. For instance, poorly regulated PPPs may prioritize profitability over the needs of vulnerable populations, leaving rural or low-income communities underserved. Transparency, accountability, and robust legal frameworks are essential to mitigate these risks. Governments must ensure that PPP agreements prioritize public health outcomes with clear success metrics and oversight mechanisms.
As the global health landscape evolves, developing countries have an opportunity to harness PPPs as a tool for resilience and equity. By fostering inclusive partnerships that align public and private incentives, countries can mobilize resources, improve service delivery, and ensure sustainable healthcare financing.
The need for innovation and collaboration in healthcare has never been more urgent. Governments, private entities, and civil society must work together to create partnerships that prioritize the well-being of all citizens, particularly the most vulnerable. With the right frameworks, public-private partnerships can move beyond being a stopgap solution and become a cornerstone of sustainable health systems.
Let us embrace the potential of PPPs and work toward a future where healthcare is a right, not a privilege, for everyone, everywhere.
Early View Articles
Asymptomatic Osteonecrosis of the Trochlea in an Adolescent: A Case Report
Abdullah K. Ghafour, Soran S. Raoof, Soran H. Tahir, Rezheen J. Rashid, Dyari Q. Hamad, Pshdar H....
Introduction
Osteonecrosis, also known as avascular necrosis, aseptic necrosis, or ischemic necrosis, results from a temporary or permanent halt in blood flow to a portion of bone. This lack of blood supply can eventually cause the affected bone to collapse. Osteonecrosis around the elbow is not frequently observed. However, its occurrence in the trochlea known as Hegemann's disease is even rarer. Incidence rates of trochlear osteonecrosis have been reported to vary from 0.27% to less than 0.001% across different studies.
Case presentation
A 14-year-old male presented with severe right shoulder pain and swelling, along with mild right lateral-sided elbow pain due to a fall to the ground. The radiograph of the right shoulder revealed a proximal humeral metaphyseal greenstick fracture. Additionally, the radiograph of the right elbow incidentally revealed osteonecrosis of the distal humeral trochlea. The affected shoulder was immobilized and Conservative management was selected for treating the trochlear osteonecrosis.
Conclusion
Trochlear avascular necrosis is a rare condition that might cause mild discomfort or even be asymptomatic, potentially being diagnosed incidentally through radiographs. Typically, it can be managed with conservative treatment methods.
The Hidden Problem of Cross-Reactivity: Challenges in HIV Testing During the COVID-19 Era: A Systematic Review
Berun A. Abdalla, Meer M. Abdulkarim, Shvan H. Mohammed, Rewa Ali Azeez, Talar Sabir Hameed,...
Introduction
Human immunodeficiency virus (HIV) and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) surface glycoproteins, including shared epitope motifs, show similarities. This may lead to false-positive HIV results due to cross-reactivity between the two viruses. This study presents a systematic review of the published studies on their cross-reactivity.
Methods
A systematic review of the published studies of HIV and SARS-CoV2 cross-reactivity was conducted, the studies that met the following criteria were included: 1) Studies in the English language. 2) Studies in which the title included the required keywords. 3) Studies in which false positive results were achieved and confirmed. 4) Studies investigating the possibility of cross-reactivity between HIV and SARS-CoV2.
Results
A total of 11 studies and 466,140 patients were analyzed. Of the specified sexes, 363,786 (82.1%) of the participants were males. A total of 707 false-positive HIV results were recorded, of which 122 (17.3%) had detectable Coronavirus disease 2019 (COVID-19) antibodies. The remaining 585 (82.7%) false positives were either healthy patients or patients recovered from COVID-19 with no detectable COVID-19 antibodies. Twenty-five distinct tests were used as initial and confirmatory tests for both COVID-19 and HIV. Six (24%) unique fourth-generation HIV antigen/antibody combination tests, six (24%) HIV-specific molecular tests, and four (16%) HIV immunoassays were used.
Conclusion
COVID-19 should be considered a potential cause of false-positive results in HIV tests, due to the cross-reactivity between the antibodies or antigens from both viruses.
Differential Diagnosis of Neurogenic Thoracic Outlet Syndrome: A Review
Fahmi H. Kakamad, Saywan K. Asaad, Abdullah K. Ghafour, Nsren S. Sabr, Hiwa S. Namiq, Lawen J....
Thoracic outlet syndrome (TOS) is a complex and often overlooked condition caused by the compression of neurovascular structures as they pass through the thoracic outlet. This compression can result in pain, numbness, tingling, muscle weakness, and vascular complications, with severe cases leading to thrombosis or embolism.
TOS is classified into three types based on the affected structure: neurogenic, venous, and arterial. Neurogenic TOS is the most prevalent, accounting for over 90% of cases, and is more commonly seen in females. Venous TOS represents 3–5% of cases, while arterial TOS is the rarest, comprising only 1%. Diagnosing TOS is challenging due to its symptom overlap with various musculoskeletal and neurological disorders, often leading to misdiagnosis. The absence of universally accepted diagnostic criteria further complicates identification, relying primarily on clinical evaluations and inconsistent diagnostic methods.
Neurogenic TOS, in particular, is difficult to distinguish from other conditions with similar presentations. This study provides a comprehensive review of the differential diagnosis of neurogenic TOS, comparing it with musculoskeletal and neurological disorders that share overlapping clinical features.