RT: Yes–they are trying to train about 3000 new doctors a year right now. Not enough because they need tens of thousands. Last year there was a big conference held by a French consultancy, how do you feel about foreign involvement in the healthcare sector in Iraq? Do you feel optimistic, for example GSK opened a factory last year with their Iraqi partner firm Modern Drug Industries.
SJ: A number of foreign companies–unfortunately it’s not always the fortune top 500, but at least a number of regional and global companies are taking steps to establishing business in Iraq, however there is no trustful source of information or guidance
What there is is primarily built on some of the experience especially from companies that manufacture medical equipment because with medical equipment you don’t have many options, you have to buy from Samsung or GE or Phillips etc. so those companies have been using a hybrid model of local presence through a local company and they have like a regional office in Dubai or Istanbul that supports the local business.
But let me tell you a little bit about what I am doing in Iraq. In 2008 I started this non profit, NGO called Iraq Health. And the concept was exactly what you are talking about, it’s public private partnerships. Unfortunately again, PPPs were not very successful because the govt. has the money but they were not very successful at implementing some of the service delivery. Which is not unique. Many governments failed to deliver service, or the bureaucracy cost them money and time, so here you bring in the private industry and they work with you on the delivery under the governance of a board for example.
So initially I thought we could copy from the UK model as there were a lot of British advisors in Iraq, but on the ground it’s not that easy. So I looked at the Turkish model where Turkey also benefitted a lot from PPPs in the past 15 years, so we formed a small board comprising approximately a 50-50 split of executives and experts from Iraq and experts from the region and globally, and they were all voluntarily dedicating their time and energy to be kind of like the source for a private entity that wanted to work with govt.
But I was quite surprised to find that the concept of PPP was not really known, people have not really understood it, they would kill it immediately, saying PPP is about investment and Iraq doesn’t need investment. So the first thing I have done is started the Iraq Health conference and exhibition. This year will be the 5th. The focus was , “ok let’s educate the public and private sector about PPP first before we suit up and want to sign deals.”
So today I don’t know if GSK have products manufactured in Iraq, the bureaucracy takes a very long time but this is the right way of doing it, you have to prove how serious you are to the govt. which sometimes is difficult because the govt. feels like you should be physically on the ground, ignoring the fact that the security situation is not safe.
It is very difficult to send experts. So that is a challenge. You get people in a state of denial when you tell them its tough, its difficult we cannot start manufacture in Baghdad where there is a risk of a terrorist attack and losing all our money. But the government says “no there are other companies doing it so you should do it.”
But there is an opportunity in the healthcare workforce.You can work on education, not necessarily in the country but outside the country. I know a few universities, I sit on the board of a university here in Dubai, and we were lucky last year we conducted 300 programs for Iraqis, and that’s because there is a budget so if there is a budget you can design a program that is suitable, so we bring the Iraqis here or to Istanbul or Malaysia or the UK, and we train them onto short programs.
Obviously the need is for longer programs, more specialized like degree level programs etc. in addition to education and training now there is a good appetite if the private sector can second or send skilled physicians or surgeons to the country and there are some successful experiences with an Austrian team, there have been some Indian and Jordanian teams, they go in country, they perform surgeries and they also train junior doctors.
This is right now on top of the MOH agenda. They will welcome you with both hands if you come up with a similar approach.