Introduction: In Brazil, the majority of the population relies on the public health care system (PHCS). Due to funding restrictions, PHCS has some limitations, as a large part of the budget must be designated to basic health needs, a priority condition in a developing country. In the last years, some initiatives were developed in order to mitigate this condition and improve public access to specialized health care, including the treatment of intestinal failure (IF).

Methods: A model of public-private partnership (PPP) was developed, involving the Federal Government (FG) and Hospital Sirio-Libanes (HSL), a private hospital considered a center of excellence. By this model, HSL is responsible for the development and management of specialized medical programs not available in the PHCS, in exchange for fiscal incentives.

Results: In 2009, a project named PROADI-SUS was initiated between the FG and HSL. This partnership was responsible for the development of a pediatric liver transplant program, which performed more than 1000 pediatric liver transplants, promoted research activity and diffusion of medical education to other centers. Due to the scarce of intestinal rehabilitation centers in Brazil, and the absence of a pediatric multivisceral transplant team, by the end of 2016 the same strategy was utilized to develop a program specialized in the treatment of IF in the PHCS. The program was instituted in a pediatric public hospital (Hospital Menino Jesus), and due to the complexity of IF patients, improvements were performed in several areas of the hospital, benefiting not only the IF patients, but the general population. Medical resources not available in the public hospital are obtained in the private hospital; transplants are performed in the private hospital and as soon as the patient is stable, the post-operative is followed by the same team in the public hospital. The intestinal rehabilitation center is now receiving patients from all over Brazil, and has started to teach and support other public hospitals in order to disseminate the treatment of intestinal failure through the country.

Conclusion: The association of a private center of excellence with the public system, through a PPP, promoted a significant improvement in the treatment of IF in the Brazilian PHCS. In the next years, the dissemination of the knowledge acquired with this PPP will permit the creation of new public intestinal rehabilitation centers, benefiting more patients of the public system.