African unity has proved a somewhat elusive concept. So it is interesting to note that October sees the first Africa Health Business Symposium (AHBS) on October 6-8 in Nairobi, Kenya which brings together private healthcare associations and operators from across Africa. Several themes are sure to emerge – the importance of India, PPPs and how far African governments are willing to welcome the private sector.

First perhaps will be the importance of India a destination where Africans spend billions of dollars a year on healthcare.  For instance, AHBS organiser Amit Thakker, the CEO of Avenue Healthcare, a Kenyan hospital with 30 outpatient centres has sold a stake in his business to Abraaj, the big Dubai-based private equity house which recently bought Care hospitals, the fourth largest Indian hospital group. Thakker says the plan to is export Care’s expertise and to build a hub and spoke model to cover Nairobi.

Meanwhile, Indian group Medanta has already set up a hospital in Nairobi. Another, Naryana, is looking at the region. A third, Fortis, has a joint venture with Ciel in Mauritius which has invested in Lagoon in Nigeria and International Medical Group in Uganda, and Thakker says that Apollo, the largest Indian hospital group, is talking to Kenya and Tanzania at government level.

The big question is whether Indians can set up profitable hospitals in Africa rather than importing patients. The lack of qualified staff is a big issue. Kenya trains around half the 18,000 medical staff it needs every year.

So how far are African governments prepared to welcome the private sector? Here, things are changing fast. Governments and NGOs can not continue to ignore the capacity offered by the private sector which often meets half all needs.

Expect a lot of talk of PPPs. Whether private hospital operator-led PPPs will take off is another matter.  We think that, all too often, they end in tears.

The big question is whether private operators will be allowed to become part of the delivery of new policies promising the population some level of universal healthcare cover. Here it is far from clear that private operators, who often target wealthier patients, want to serve the mass market. Abraaj here is the stand out exception but it has yet to prove a model.

Like governments the world over, African governments are keen to build their private providers into healthcare tourism destinations. That may prove difficult. Every year tens of thousands West Africans transit through Nairobi en route for India. Around 20,000 Kenyans spend $200m in India.