Intended for healthcare professionals


Use of private management consultants in public health

BMJ 2021; 374 doi: (Published 07 September 2021) Cite this as: BMJ 2021;374:n2145
  1. Joseph Dov Bruch, researcher1,
  2. Justin Feldman, researcher2,
  3. Zirui Song, assistant professor of health care policy and medicine13
  1. 1Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
  2. 2François-Xavier Bagnoud Center for Health and Human Rights, Harvard T H Chan School of Public Health, Boston, MA, USA
  3. 3Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
  1. Correspondence to: J D Bruch jbruch{at}

Rigorous evaluation is needed to ensure greater transparency and accountability

Governments across the globe use management consultancies to help implement and advise on public health policies. Yet data on the effect of this help are generally lacking. As public officials increasingly enlist private management consultants to address public health needs—including those related to the covid-19 pandemic—more rigorous evaluations are needed to understand the returns from these investments for society’s limited public resources.

The management consulting industry is valued at about $130bn (£95bn; €110bn) globally.1 The public sector has increasingly become a target for management consultants. Through contracts with national and local governments, management consultants advise on strategy, logistics, technology, implementation services, and human resources to improve the efficiency of governmental operations.2 They also have a role in global health through their influence in the World Health Organization, major international global health foundations, and other global public-private partnerships.3

Proponents of management consulting advocate that outside experts provide innovative solutions to public health needs stemming from their business oriented expertise, which adds value beyond public sector …

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