COMMITTED TO

IMPROVING THE STATE

OF THE WORLD

Public-Private Partnerships in Health

The Private Sector’s Role in Public-Private Partnerships

The World Economic Forum is an independent

international organization committed to improving
the state of the world by engaging leaders in
partnerships to shape global, regional and
industry agendas.

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in Geneva, Switzerland, the World Economic
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Global Health Initiative

of the World Economic Forum
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CH-1233 Cologny/Geneva
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This report was prepared in

partnership with Booz Allen Hamilton.
This material was prepared with
the support of Sudler & Hennessey.
 The Private Sector’s Role
in Public-Private Partnerships
Over the past 10 years, partnerships between the
public and private sectors have become common
strategies for responding to the global public health
crises of AIDS, tuberculosis and malaria at both the
national and international levels. Through these
public-private partnerships (PPPs), partners from
multiple sectors combine skills, expertise and
resources to implement programmes larger in scope
than the reach of individual partners. Some have been
highly successful, while others have failed to make an
appreciable impact, often at significant financial and
opportunity costs.
Companies have many reasons to engage in PPPs.
In addition to pursuing philanthropic programmes or
a commitment to the improvement of public health,
there are sound business reasons – such as
maintaining a healthy workforce or increasing market
access – that motivate a company to get involved.
The private sector can provide critical know-how to
PPPs, such as major programme management, R&D
and/or supply chain expertise.
Advantages of PPPs in Health
• Enable companies to meet public needs,
strengthen their brand and penetrate
new markets
• Advance public health strategies and policies
• Improve health education and conditions
worldwide
• Foster trust and improve collaboration between
sectors to leverage resources and relationships
• Identify new and better ways of operating
PPPs are a critical tool in the battle against
public health crises, but they are not the only means
for the private sector to engage in global public
health issues. Depending on a company’s objectives
and capabilities, a partnership may not be the optimal
form of collaboration. Indeed, in some cases unilateral
action may better serve a company’s needs.
Alternative forms of engagement might include:
• Making one-off product donations
• Underwriting public health campaigns
• Providing subject matter expertise through
consulting or training engagements
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• Developing fellowships to advance non-profit and
civil servant capabilities and enhance corporate
intelligence of an issue or government
• Sharing research insights or market analysis
But, if based on the right objectives and designed
well, PPPs can be highly successful in advancing
corporate interests while also achieving significant
advances in international public health. The World
Economic Forum Global Health Initiative partnered
with leading consulting firm Booz Allen Hamilton to
uncover underlying principles of successful PPPs by
researching the real-world experience of leading
companies, governments and non-governmental
organizations. Booz Allen conducted nearly 60
interviews with senior executives of multinational
corporations, governments, multilateral agencies,
foundations and not-for-profit organizations and
researched over 40 PPPs, primarily in international
health. The research explored the conditions under
which PPPs are the right form of collaboration and
what optimizes success.
Common themes from the interviews and
research confirm that having a good idea and
wanting to make a difference are important
motivators but not a strong enough foundation to
ensure the success of a PPP. In fact, a key finding
is that a company’s engagement in a PPP must be
based on a solid business case – this includes
compelling quantitative and qualitative benefits – and
cannot be based solely on corporate social
responsibility motives. Companies must be willing to
commit the time and flexibility needed to work with
other organizational cultures to achieve results.
Another key finding is that PPPs are successful when
there is a “driver” who not only helps to start up the
partnership, but also remains involved throughout the
PPP to ensure partners stay engaged and meet their
commitments. Furthermore, it is important to design
plans that enable participants to transition to new
partners and to prepare exit strategies in case the
partnership needs to be disbanded.
Key Research Findings
Successful PPPs…
• Are based on a solid business case, including
quantitative and qualitative benefits
• Include a driver who helps establish the PPP
and remains involved to ensure success
• Include strategies to transition to new partners
or to disband the partnership
This guide, organized in three main sections,
expounds upon these and other findings:
• When is a PPP the right form of collaboration?
PPPs are often the right form of collaboration
when a company:
— has a strong business case
— understands what contributions it will make to
the partnership (and these are complementary
to the PPP mission)
— is ready to make a commitment of time and
flexibility and cede some control to others
• What core pre-design and design elements
optimize success and impact?
Specific actions should be completed when
designing a partnership, including:
— conducting robust planning and comprehensive
partner analysis
— identifying and ensuring the ongoing presence
of a driver, a participant in the PPP who guides
the process and remains invested to ensure the
partnership’s success
— designing for “quick wins” to demonstrate
results and engaging the right players
— planning for potential partner transition,
including engagement of local actors and
partnership conclusion
• How does the Global Health Initiative help
PPPs work successfully?
The Global Health Initiative provides expertise in
catalyzing PPPs in health and driving action on
HIV/AIDS, TB, malaria and health systems at the
regional, national and international levels. Specific
activities include:
— acting as a catalyst and convener of
partnerships, by identifying needs, developing
ideas and launching partnerships
— identifying appropriate partners and ensuring
the ongoing presence of a driver in PPPs
— acting as the initial driver in partnerships and in
some cases, ensuring smooth transition to a
permanent driver
1. When is a PPP the right form
of collaboration?
The primary reason partners come together to form
a PPP is to achieve a mission that calls for skills,
capabilities and resources beyond what each
organization possesses individually. However, each
partner must have the right reasons and the
necessary information before engaging in a PPP.
Prior to forming a PPP, interested companies should
ask themselves:
• Is my engagement in the partnership supported by
a strong business case?
• Do we know what contributions we can make (and
what we need) to achieve the mission? Do our
planned contributions align with the PPP mission?
Can we identify potential partners?
• Is my company prepared to make a commitment
(even if complex barriers and shifting priorities may
impact timelines)? Are we willing to be flexible and
cede some control?
Business Case:
Primary Step in Forming a PPP
First and foremost, a company’s engagement
in a PPP needs to be supported by a strong
business case. Research demonstrates that there
must be a correlation between the partnership
objectives and the day-to-day mission of
participating organizations. For companies, this
means that wanting to “do good” is not enough.
Corporate social responsibility, public relations or
employee retention/satisfaction may be benefits of
participation, but cannot be prime motivators. PPPs
driven by these factors are less likely to be
sustainable over the longer term.

Business Case Examples
• A power company operating in an HIV-
prevalent country co-founded a PPP because it
is reliant upon a healthy labour force and
customer base
• A multinational producer of an anti-malarial
product entered into a PPP to gain access to
distribution channels, expand market
penetration and build future brand loyalty
• A global beverages company conducted an
extensive risk assessment, which became the
foundation for the business case that enabled
several initial projects to be funded
A strong business case includes both quantitative
and qualitative benefits envisioned as a result of the
partnership. Economic advantages may include:
• Supporting a healthy workforce
• Access to markets
• Strengthened relationships with government
decision-makers
• Support for the long-term economic growth of
new markets
• Expansion of distribution channels
• Development of stable and positive
business conditions
If the PPP is founded on a strong business case, it
will be more likely to meet its objectives, secure
ongoing executive leadership support and corporate
resources and be sustainable.
“Effective PPPs will deliver something positive for
everybody; each participant must see the value of
their participation.”
Klaus Ostergaard, Regional Director,
Vestergaard Frandsen Group SA
Partner Contributions:
Ensure Alignment With the Mission
Building upon a solid business case, a company
considering a PPP must ensure its contributions
to the partnership will align with the PPP
mission. This involves assessing the firm’s own skills
and available resources to ensure that they match
4 5
the partnership’s core mission and will help
accomplish its objectives. Aside from financial
contributions, the private sector can provide
programme management experience, supply chain
and operations support, R&D and other subject
matter expertise, and credibility and legitimacy to the
PPP. Perhaps even as important as understanding
one’s own strengths and contributions is identifying
those areas in which the company does not have a
capability and will be reliant upon partners.
Organizations must be identified that have
complementary skills and are committed to the
mission of the partnership (see Section 2, below, for
details on conducting partner assessments).
Commitment: Results Take Time
And finally, a company considering a PPP must
be ready to make a commitment of time and
flexibility and be ready to cede some control.
Successful partnerships can often take one to two
years to begin delivering intended results; thus, a
commitment of time (and keeping it) is essential.
Companies have different expectations and needs,
and bring different skills to partnerships than do
governments, NGOs and other partners. Inevitably,
each partner will play a unique role in the PPP,
requiring a different type of commitment. While one
partner may serve as a catalyst to help form a
relationship requiring a short-term commitment,
another may serve as a producer contributing
products, thus requiring a commitment of a few
years. Meanwhile, the driver will need to commit for
the duration of the project. Companies must make a
commitment to remain involved as long as their
specific roles require and encourage flexibility among
internal management regarding when results might
be realized.
Partners may also face differing organizational
cultures, national cultures, geographic and language
barriers, and shifting priorities among participants.
Making a partnership work is a challenge for any
company and requires significant flexibility. Managed
well, the diversity of the partners adds to the
success of the relationship and the outcome of the
partnership; but, this is a process that requires
careful planning, management and review. And,
most importantly, both the company and potential
partners must be willing to cede a degree of control
to the partnership and accept a degree of
uncertainty.
“One should have a profound understanding of
his/her own critical path, and how partnering
with other organizations can accelerate your
organization down that path.”
Jonathan Greenblatt, Co-founder,
Ethos Water
2. What core pre-design and
design elements optimize
success and impact?
Once a company has determined that a PPP is the
right form of collaboration, it must begin designing
the PPP. The experience of nearly 60 leaders in
PPPs provides some key practical steps to ensuring
that PPPs are successful.
• Conduct robust planning and due diligence
• Identify a driver to continually lead the PPP to
success
• Engage the right players and design quick wins for
sound execution
• Anticipate transition and exit plans
Upfront Planning:
Go in “Eyes Wide Open”
Partnerships can successfully function in many
different shapes and sizes: there is no “one size fits
all” in terms of structure and governance. Indeed,
flexibility – especially in the early phases of a
partnership – is often critical to navigating different
organizational cultures and clarifying roles and
expectations. And while there is no right or wrong
governance structure for a PPP, conducting upfront
planning for design and implementation is critical.
Potential partners should not assume that a general
agreement on the partnership purpose is the sole
satisfactory entrance criterion for a PPP. All partners
need to have a full understanding of the environment
and the role each will play.
A situational analysis is a powerful way to
understand the landscape in which the partnership
will operate and the various players involved. This
helps companies to identify potential partners as well
as potential advocates, naysayers and the risks the
partnership may face. Companies cannot stop here,
however. Not only must partners express interest,
but they must also possess the necessary and
complementary skills, capabilities and resources to
contribute to the solution. Before entering into a
PPP, companies should understand what each
potential partner can bring to the partnership.
In-depth partner analysis is an excellent due
diligence tool to identify the strengths and weakness
of potential partners as well as their performance
record in the areas of anticipated contribution.
And ultimately, upfront planning should include an
agreement on the nature, scope and duration of
each partner’s commitment. All partners entering
the PPP should understand each others’ roles and
responsibilities.
“Effective communication at the outset – borne
of careful listening – and capitalizing on synergies
amongst participants are critical aspects of
planning for a successful partnership.”
Reggie Van Lee, Senior Vice-President,
Booz Allen Hamilton
Driver:
The Critical Ingredient to Success
While several best practices are important in shaping
a well-functioning partnership throughout the PPP
lifecycle, only one is a consistent determinant of
success: the sustained presence of a driver.
The driver guides the pre-design and design process
and remains invested to ensure that partners stay
engaged, meet commitments and strive toward
ultimate success. The driver consistently serves as
the lead communicator across the lifecycle of the
PPP. The driver can play multiple roles, including
acting as the broker, translator, enforcer, subject
matter expert and/or motivator.
• As a broker, the driver helps bring the right parties
together
• As a translator, the driver speaks to those parties
as a trusted neutral interlocutor
 • As an enforcer, the driver maintains accountability,
follows through on commitments and ensures that
best practices are adhered to
• As a subject matter expert, the driver understands
domain issues, provides credibility and ensures
that the partnership is on the right track
• As a motivator, the driver creates publicity and
visibility, and pushes participants toward the PPP’s
aims and achievements
The types of roles the driver may play depend on the
complexity and number of partners involved,
regardless of whether the partnership operates at
the national or global level. A driver may be an
invested partner or an objective party, but the
central role is to ensure forward motion
throughout the life of the PPP.
“There needs to be one partner that is willing
to serve as the driver, to lead the effort. This
partner’s role can be to influence, to motivate,
to ensure that all participants see the benefits of
participation for themselves – to serve as a
neutral party to move the partnership forward.”
Emma Schmitt, Group Sustainability,
Standard Chartered Bank
Execution:
Design for Support and Success
It is commonly recognized that “quick wins” are a
critical component in any programme or partnership
to demonstrate early credibility and build momentum
for future success. However, “quick wins” are not
easily attained unless thorough planning is
completed during pre-design. As noted earlier,
cultural, geographic and language barriers, and
shifting priorities can impact timelines and expected
results. PPPs need to define goals, objectives, target
populations and specific activities designed to
“The strategy must include early tangible
deliverables on the ground and other quick
wins. These are critical to sustain the partnership
during the first year and to secure new partners
and resources.”
Hugh G. Jagger, Chairman,
Hugh Jagger Associates
6 7
demonstrate early progress. It is only through
effective pre-planning that PPPs can quickly deliver
positive results.
While it may be obvious that all successful
partnerships must have measures of accountability,
communication, decision-making and evaluation,
what may be less obvious is how evaluation
strengthens the partnership. Using metrics to
monitor and evaluate tangible results can create trust
among partners (let alone stakeholders served by
the partnership) while sustaining enthusiasm to meet
new challenges. Monitoring, documenting and
communicating the benefits of collaboration can
increase buy-in of existing and potential partners.
This requires the active and consistent contributions
of a representative from each of the partnering
organizations. This motivated “technocrat” must not
only exhibit strong collaboration skills and local
knowledge, but also ensure that his or her own
organization remains committed to and supportive of
the partnership.
Companies should also plan to secure two other
types of support. Successful PPPs often engage a
high-level champion to demonstrate credibility for the
partnership and garner broad-sweeping interest and
support. Given the other commitments of these
champions, PPPs should also plan for their likely and
eventual disengagement (see box below). Perhaps
most importantly, the support of the host country
government is critical to any PPP, regardless of
whether the government plays a passive or active
role in the PPP. At a minimum, the host government
should understand and endorse the partnership’s
mission and ensure goodwill.
Engaging and Disengaging a
High-Level Champion
• A multinational technology firm engaged its
CEO to introduce a PPP concept to other
firms to gauge interest
• After the concept was designed, the CEO
supported the launch
• Once the project management office was
established, the CEO curtailed direct
engagement
technical advice and guidance, and launching
“The real glue of a PPP is mutual interest…
the second critical element is champions at high
partnerships
levels, individuals who have personal involvement • Identifying appropriate partners and ensuring the
and leadership with authority.”
ongoing presence of a driver
Alex Matter, Director,
Novartis Institute for Tropical Diseases • Acting as the initial driver in partnerships and, in
some cases, ensuring smooth transition to a
permanent driver
Transition and Exit Strategies:
Plan for Sustainability
Through its involvement in global
The reality is that not all partnerships are successful. and regional PPPs, the GHI:
But even when they are, one or more partners may
• Delivers innovative workplace programmes to
need to transition out of the partnership. By building
tackle HIV/AIDS, tuberculosis and malaria across
procedures into the partnership that allow for the
Africa and South, East and South-East Asia.
transition of one or more partners, the impact of
Through these programmes, more than 9 million
such changes on the mission and other partnering
people have access to life-saving information,
organizations is minimized. Likewise, when PPPs are
prevention, testing and treatment services
not successful, or elements of the partnership begin
to decline, established exit strategies identify other • Strengthens the health system in sub-Saharan
mechanisms for addressing the mission once the Africa, starting with a pilot project in Ghana
partnership is disbanded.
• Supports global and regional public-private
partnerships, such as the Global Fund to Fight
These procedures are critical for other reasons as
AIDS, Tuberculosis and Malaria, the Stop TB and
well; transition strategies are particularly important to
Roll Back Malaria Partnerships, the China Health
allow local institutions to succeed other partners and
Alliance and the India Business Alliance
ensure the creation of sustainable activities. To plan
for sustainability and ensure ease of transition, For further information on the Global Health
engaging local partners early on in the establishment Initiative and its activities please go to
of a PPP is critical. http://www.weforum.org/globalhealth or contact
+ 41 (0)22 869 1212 to speak with a GHI team
member. For further information about the study
3. How does the Global
conducted by the GHI and Booz Allen Hamilton,
Health Initiative make PPPs please contact a GHI team member or
work successfully? Margaret Lidstone, Booz Allen Hamilton, at
lidstone_margaret@bah.com or +1 240 314 5500.
The Global Health Initiative was launched by Kofi
Annan at the World Economic Forum Annual Meeting
2002 in Davos. The GHI’s mission is to catalyse new
PPPs in public health and drive existing ones in India,
Africa, and South, East and South-East Asia. Currently,
the GHI partners with companies, governments, UN
agencies and other international organizations,
foundations and civil society.
The GHI can assist member companies in their
public health efforts by:
• Acting as a catalyst and convener of partnerships,
by identifying needs, developing ideas, providing