the right pacing is and you learn what the benchmarks are, and you learn how to do this well.” (NCV-16-USG)

For some long-term partners, the transfer of money was not the sole issue or concern. Performance was identified as equally important—the transfer of work once the money is transferred (NCV-5-USACA; NCV-8-USACA). Once programs and services have been transferred, other practical considerations were raised: “What are the parameters to monitor and who is responsible for it? How do you see the effect beyond the actual transition of the money?(NCV-5-USACA). The measure itself might also determine whether there is success:

If competitive awards for money to local groups were the measure, then we would say it’s successful because the local groups and government could actually win the funds. Most of these efforts are just being started, we will have to see over time how implementation goes.” (NCV-5-USACA)

Private-Sector Capacity Building and Involvement

In its eighth annual report to Congress in 2012, OGAC identified public–private partnerships (PPPs) as a tool to enhance country health system strengthening and to leverage PEPFAR resources and complementary technical focus. The report further stipulates that the business sector has other specific skills and technical expertise, such as marketing, distribution networks, and laboratory and information capacity, and PEPFAR is working to establish more linkages and partnerships to contribute to a collective effort toward sustainability (OGAC, 2012c).

PPPs were also important for health workforce development and health system strengthening, themes that were described in every single country the IOM committee visited as tremendous challenges. PPPs had similar roles for health and other workforce development, national policy development including clinical guidelines, and provision of services for both adult and especially pediatric care and treatment services, including the establishment of Centers for Excellence for training and capacity building (Damonti et al., 2012). Salient examples of other critical roles for PPPs in the HIV/AIDS response include Becton, Dickinson and Company’s expertise to improve laboratory infrastructure, quality, and operation; the Partnership for Supply Chain Management role in strengthened supply chains; Together for Girls’ focus on prevention and reduction of sexual violence; and Voxiva’s role in supplying information technologies to deliver interactive mobile health services (Sturchio and Cohen, 2012). In September 2011, the Pink Ribbon Red Ribbon initiative was launched by PEPFAR, along with the PPP among the



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