- Examine what role governance assumes in public-private partnerships for global health and how governance impacts the effectiveness of these partnerships in improving health outcomes
- Consider the range of stakeholders and sectors engaged in global health partnerships and how specific organizational attributes impact a partnership’s governance and decision-making processes
- Explore best practices, common challenges, and lessons learned in the varying approaches to partnership governance
- Illuminate potential cross-cutting principles for the governance of public-private partnerships for global health with the goal of increasing their effectiveness in improving health outcomes
Definitions of governance are varied and depend on factors such as the relevant actors, level of analysis, and existing political and social contexts. Broadly, governance is conceived of as the “art of steering societies and organizations” (IOG). Within the context of public-private partnerships (PPPs), governance refers to the structures, processes, and practices for decision-making and for ultimately accomplishing the goal of the partnership. Governance defines the power structure of a PPP by regulating who makes decisions and how and when the decisions are made, as well as how other stakeholders are represented in the process. Effective governance mechanisms can be a tool for providing direction and monitoring performance, promoting accountability and transparency, enhancing legitimacy and ownership, and managing both real and perceived conflicts of interest.
The governance of a partnership impacts its efficiency and effectiveness in meeting its stated goal: strong governance can improve the performance of PPPs while weak governance can undermine it. In global health, PPPs have played a critical role in addressing global health needs; however, they require careful steering to avoid potential pitfalls (Reich, 2002). An examination of PPPs in global health has revealed some common shortcomings in their governance, including weakness in or absence of strategic direction, accountability mechanisms, monitoring and evaluation systems, and risk management; lack of clarity in roles and responsibilities; confusion between the roles of management versus governance; and inadequate attention to resource mobilization and to the human resources required to deliver programs and achieve objectives (Bezanson & Isenman, 2012).
While the importance of governance in global health partnerships has been identified, there is, in general, a lack of agreement on best practices for their governance structures, policies, and practice (Stenson, 2010). This is partly because of the significant variation across global health partnerships in size, including the number of partners engaged, resources allocated, geographic focus, and scope of the goals; the focus area, ranging from infectious diseases to pandemic preparedness and to non-communicable diseases and injury prevention; the level of formality; and the intended outcomes. Over the last several decades, with the increased number of interested stakeholders, resources invested, and initiatives launched within the global health field, effective governance of global health PPPs is critical.
These PPPs are formal collaborative arrangements through which public and private parties share risks, responsibilities, and decision-making processes with the goal of collectively addressing a shared health objective. While it is assumed that both government and a private sector actor will be formally engaged in the partnership, it is worth noting the range of stakeholders engaged in global health partnerships, such as national governments, bilateral development cooperation agencies, United Nations agencies, multilateral and regional development banks, hybrid global health initiatives, philanthropic organizations, civil society organizations and nongovernmental organizations, private businesses, and academic institutions. Given the broad range of determinants that affect and are affected by health, there are many sub-categories within these stakeholder groups that are engaged in global health partnerships, for example within national governments, ministries of health, finance, telecomm, and transportation, among others. These numerous stakeholders bring varying strengths and resources to global health partnerships, but they also carry their own organizational cultures, regulations, and expectations. Managing PPPs among these stakeholders is complex and requires intentional and thoughtful governance.
This workshop will explore the governance of partnerships that are defined by the following parameters: 1) a clearly defined shared goal that centers on meeting the health needs of disadvantaged populations; 2) the inclusion of at least three partners with a government entity and business represented among them; 3) development of formal joint agreement among the partners with defined set of rules; 4) contributions of resources from all partners (resources can include financial, technical expertise, innovation, personnel, relationships, research); and 5) expected value for all partners.
Registration for this meeting is now closed. Videos and presentations from the meeting are available on this webpage.
Bezanson, Keith A and Paul Isenman. 2012. Governance of New Global Partnerships: Challenges, Weaknesses, and Lessons. Center for Global Development Policy Paper 014, Washington, DC.
Institute on Governance (IOG). 2017. Defining Governance.
Reich, Michael R. 2002. Public-Private Partnerships for Public Health. Cambridge, MA: Harvard Center for Population and Development Studies.
Stenson, Bo. 2010. Strengths and Weaknesses in the Governance of Selected Global Health Initiatives. Global Partnership for Education. Washington, DC.