The Impact of Public-Private Partnerships (PPPs) in Infrastructure, Health, and Education

This paper summarizes what is known about the impact of public-private partnerships (PPPs) in the three sectors where they have been used intensively: infrastructure (energy, transport, water and sanitation, and telecommunications), education, and health. It lays out the main elements of economic theory relevant to analyzing the trade-off between PPPs and the public provision of complex projects. It places PPPs within a historical perspective. It reviews empirical evaluations of the effectiveness of PPPs and, whenever possible, the implications for social outcomes. Finally, it draws conclusions on cross-cutting issues that influence the efficiency of PPPs, from contract design and regulation to renegotiations and institutional issues. The paper straightens out and qualifies the record of existing evidence and signals some of the main areas and topics for future fruitful research. (JEL D04, H54, I11, I21, L33)