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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Exploring Partnership Governance in Global Health: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25069.
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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Exploring Partnership Governance in Global Health PROCEEDINGS OF A WORKSHOP Rachel M. Taylor and Joe Alper, Rapporteurs Forum on Public–Private Partnerships for Global Health and Safety Board on Global Health Health and Medicine Division PREPUBLICATION COPY: UNCORRECTED PROOFS

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This project was supported by Anheuser-Busch InBev; Becton, Dickinson and Company; Bill & Melinda Gates Foundation; Catholic Health Association of the United States; ExxonMobil; Fogarty International Center of the National Institutes of Health; General Electric; Global Health Innovative Technology Fund; Intel Corporation; Johnson & Johnson; Medtronic; Merck; Novartis Foundation; PATH; PepsiCo; Procter & Gamble Co.; The Rockefeller Foundation; Safaricom; United Nations Foundation; University of Notre Dame; UPS Foundation; U.S. Agency for International Development; U.S. Department of Health and Human Services Office of Global Affairs; U.S. Department of State; U.S. Food and Drug Administration; and The Vitality Group. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/25069 Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2018 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Exploring partnership governance in global health: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25069. PREPUBLICATION COPY: UNCORRECTED PROOFS

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY: UNCORRECTED PROOFS

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY: UNCORRECTED PROOFS

PLANNING COMMITTEE ON EXPLORING PARTNERSHIP GOVERNANCE IN GLOBAL HEALTH1 CLARION JOHNSON (Co-Chair), Private Consultant, ExxonMobil REGINA RABINOVICH (Co-Chair), ExxonMobil Malaria Scholar in Residence, Harvard T.H. Chan School of Public Health JO IVEY BOUFFORD, Immediate Past President, The New York Academy of Medicine; Clinical Professor, New York University College of Global Public Health KEVIN ETTER, Director, United Parcel Service Loaned Executive Program LAUREN MARKS, Director, Private Sector Engagement for The U.S. President's Emergency Plan for AIDS Relief (PEPFAR), U.S. Department of State JOHN MONAHAN, Senior Fellow and Senior Advisor for Global Health Initiatives to the President, Georgetown University CATE O’KANE, Independent Consultant BT SLINGSBY, Chief Executive Officer and Executive Director, Global Health Innovative Technology Fund 1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for this published Proceedings of a Workshop rests with the workshop rapporteurs and the institution. PREPUBLICATION COPY: UNCORRECTED PROOFS v

FORUM ON PUBLIC–PRIVATE PARTNERSHIPS FOR GLOBAL HEALTH AND SAFETY1 JO IVEY BOUFFORD (Co-Chair), Immediate Past President, The New York Academy of Medicine; Clinical Professor, New York University College of Global Public Health CLARION JOHNSON (Co-Chair), Private Consultant, ExxonMobil ANN AERTS, Head, Novartis Foundation SIR GEORGE ALLEYNE, Director Emeritus, Pan American Health Organization; Chancellor Emeritus, University of the West Indies RAJESH ANANDAN, Senior Vice President, Strategic Partnerships and UNICEF Ventures, U.S. Fund for UNICEF (until February 2018) NATASHA BILIMORIA, Director, U.S. Strategy, Gavi, The Vaccine Alliance DEBORAH L. BIRX, U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy, U.S. Department of State, The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) SIMON BLAND, Director, New York Liaison Office, UNAIDS ROBERT BOLLINGER, Professor of Infectious Diseases, Johns Hopkins University School of Medicine (until December 2017) STEPHEN CHEGE, Director, Corporate Affairs, Safaricom BRENDA D. COLATRELLA, Executive Director, Corporate Responsibility; President, Merck Foundation; President, Merck Patient Assistance Program Foundation, Merck & Co., Inc. BRUCE COMPTON, Senior Director of International Outreach, Catholic Health Association of the United States PATRICIA DALY, Associate Vice President, Global Health, Save the Children KATE DODSON, Vice President for Global Health Strategy, United Nations Foundation JENNIFER ESPOSITO, Worldwide General Manager, Health and Life Sciences, Intel Corporation RENUKA GADDE, Vice President, Global Health, Becton, Dickinson and Company ELAINE GIBBONS, Vice President for Global Engagement and Communications, PATH (until March 2018) ROGER GLASS, Director, Fogarty International Center DANIELLE GREENBERG, Senior Director, Global R&D; Senior Fellow, Nutrition Sciences, PepsiCo (until March 2018) RICHARD GUERRANT, Thomas H. Hunter Professor of International Medicine, University of Virginia (until December 2017) TREVOR GUNN, Vice President, International Relations, Medtronic JESSICA HERZSTEIN, Preventive Medicine Specialist BEN HOFFMAN, Chief Medical Officer, Baker Hughes, a GE Company (until March 2018) JAMES JONES, Manager, Community Investment Programs, ExxonMobil ALLISON TUMMON KAMPHUIS, Global Program Leader, Gender Equality and the Children’s Safe Drinking Water Program, Procter & Gamble Co. SEEMA KUMAR, Vice President, Innovation, Global Health & Science Policy Communication, Johnson & Johnson 1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for this published Proceedings of a Workshop rests with the workshop rapporteurs and the institution. PREPUBLICATION COPY: UNCORRECTED PROOFS vii

MARISSA LEFFLER, Senior Strategy and Innovation Advisor, Global Health Center for Accelerating Innovation and Impact, U.S. Agency for International Development EDUARDO MARTINEZ, President and Chief Diversity & Inclusion Officer, United Parcel Service Foundation MICHAEL MYERS, Managing Director, The Rockefeller Foundation (until December 2017) JOHN MONAHAN, Senior Fellow and Senior Advisor for Global Health Initiatives to the President, Georgetown University ANDRIN OSWALD, Director, Life Sciences Partnerships, Bill & Melinda Gates Foundation REGINA RABINOVICH, ExxonMobil Malaria Scholar in Residence, Harvard T.H. Chan School of Public Health SCOTT C. RATZAN, President, Anheuser-Busch InBev Foundation B. T. SLINGSBY, Chief Executive Officer and Executive Director, Global Health Innovative Technology Fund KATHERINE TAYLOR, Associate Director and Director of Global Health Training, Eck Institute for Global Health, University of Notre Dame MARY LOU VALDEZ, Associate Commissioner for International Programs; Director, Office of International Programs, U.S. Food and Drug Administration TADATAKA “TACHI” YAMADA, Venture Partner, Frazier Healthcare Partners Health and Medicine Division Staff RACHEL M. TAYLOR, Senior Program Officer and Forum Director PRIYANKA NALAMADA, Research Associate KATHERINE PEREZ, Senior Program Assistant DANIEL CESNALIS, Financial Associate JULIE PAVLIN, Director, Board on Global Health Consultant JOE ALPER, Science writer PREPUBLICATION COPY: UNCORRECTED PROOFS viii

Reviewers This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this proceedings: JO IVEY BOUFFORD, New York University College of Global Public Health PATRICIA DALY, Save the Children JESSICA HERZSTEIN, Preventive Medicine Specialist ALVIN MARCELO, University of the Philippines VERONIKA WIRTZ, Boston University School of Public Health Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by ROBERT S. LAWRENCE, Johns Hopkins Bloomberg School of Public Health. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies. PREPUBLICATION COPY: UNCORRECTED PROOFS ix

Acknowledgments A number of individuals contributed to the development of this workshop and proceedings. These include several staff members from the Health and Medicine Division and the National Academies of Sciences, Engineering, and Medicine: Daniel Cesnalis, Sarah Kelley, Mariam Malik, Priyanka Nalamada, Julie Pavlin, Katherine Perez, Bettina Ritter, and Rachel Taylor. The planning committee contributed hours of service to develop and execute the agenda. Reviewers also provided thoughtful remarks in reading the draft manuscript. The overall successful functioning of the Forum on Public–Private Partnerships for Global Health and Safety (PPP Forum) and its activities depends on the generosity of its sponsors. Financial support for the PPP Forum is provided by Anheuser-Busch InBev; Becton, Dickinson and Company; Bill & Melinda Gates Foundation; Catholic Health Association of the United States; ExxonMobil; Fogarty International Center of the National Institutes of Health; General Electric; Global Health Innovative Technology Fund; Intel Corporation; Johnson & Johnson; Medtronic; Merck; Novartis Foundation; PATH; PepsiCo; Procter & Gamble Co.; The Rockefeller Foundation; Safaricom; United Nations Foundation; University of Notre Dame; UPS Foundation; U.S. Agency for International Development; U.S. Department of Health and Human Services Office of Global Affairs; U.S. Department of State; U.S. Food and Drug Administration; and The Vitality Group. PREPUBLICATION COPY: UNCORRECTED PROOFS xi

Contents ACRONYMS AND ABBREVIATIONS xvii 1 INTRODUCTION 1 Organization of the Proceedings, 3 2 GLOBAL HEALTH AND GOVERNANCE OF PUBLIC–PRIVATE PARTNERSHIPS IN THE CURRENT CONTEXT 5 The Core Roles of Transparency and Accountability in the Governance of Global Health Public–Private Partnerships, 5 Addressing Major Challenges in the Governance of Global Health Public–Private Partnerships, 9 Discussion, 12 3 LEGAL CONSIDERATIONS FOR PUBLIC–PRIVATE PARTNERSHIP GOVERNANCE IN GLOBAL HEALTH 15 Discussion, 20 4 EXAMINING LESSONS LEARNED FROM THE DEVELOPMENT AND ITERATIVE IMPROVEMENT OF PUBLIC–PRIVATE PARTNERSHIPS AND THEIR GOVERNANCE 23 Access Accelerated (AA), 23 Determined, Resilient, Empowered, Aids-Free, Mentored, and Safe (DREAMS), 25 Global Health Innovative Technology (GHIT) Fund, 26 African Comprehensive HIV/AIDS Partnerships (ACHAP), 27 The Avahan Experience, 29 Discussion, 30 5 EVALUATING AND REPORTING ON PUBLIC–PRIVATE PARTNERSHIPS IN GLOBAL HEALTH 37 Discussion, 39 6 IDENTIFYING KEY ISSUES IN THE GOVERNANCE OF PUBLIC–PRIVATE PARTNERSHIPS IN GLOBAL HEALTH 41 Closing Remarks, 41 APPENDIXES A Commissioned Paper: The Core Roles of Transparency and Accountability in the Governance of Global Health PPPs, 43 PREPUBLICATION COPY: UNCORRECTED PROOFS xiii

B World Café Report on Internal Governance of Individual Partners and Impacts on Approaches to Public–Private Partnerships, 61 C Speaker and Moderator Biographical Sketches, 63 D Workshop Agenda, 73 E References, 81 PREPUBLICATION COPY: UNCORRECTED PROOFS xiv

Box, Figures, and Tables BOX 1-1 Statement of Task, 3 FIGURES 2-1 Different types of public–private partnerships, 6 A-1 Graph of usage of “governance” in Google Books, 1940–2008, 44 A-2 Two dimensional model of governance, with transparency and accountability, 47 TABLES 2-1 PPP Governance Matrix: Assessing Transparency and Accountability for a Hypothetical PPP, 7 4-1 Partnerships Presented at the Workshop on October 26, 2018, 32 A-1 Two-by-Two Table of Low and High Levels of Transparency and Accountability, 47 A-2 Governance Matrix for PPPs: Assessing Transparency and Accountability for a Hypothetical PPP, 54 B-1 Responses to World Café Question 1: What Are the Main Barriers Your Organization Has Experienced When Engaging in PPPs?, 61 B-2 Responses to World Café Question 2: How Have You or Your Organization Overcome or Managed These Barriers to Engagement?, 62 PREPUBLICATION COPY: UNCORRECTED PROOFS xv

Acronyms and Abbreviations ACHAP African Comprehensive HIV/AIDS Partnership CBO community-based organization DREAMS Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe Gates Foundation Bill & Melinda Gates Foundation GSK GlaxoSmithKline IFPMA International Federation of Pharmaceutical Manufacturers and Associations MOU memorandum of understanding NGO nongovernmental organization PEPFAR The President’s Emergency Plan for AIDS Relief PPP public–private partnership PPP Forum Forum on Public–Private Partnerships for Global Health and Safety UICC Union for International Cancer Control UNAIDS Joint United Nations Programme on HIV/AIDS WHO World Health Organization PREPUBLICATION COPY: UNCORRECTED PROOFS xvii

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Solving the world’s health challenges requires multidisciplinary collaborations that bring together the talents, experiences, resources, and ideas from multiple sectors. These collaborations in global health frequently occur through public–private partnerships (PPPs) in which public and private parties share risks, responsibilities, and decision-making processes with the objective of collectively and more effectively addressing a common goal. However, these numerous stakeholders bring varying strengths and resources to global health partnerships, but they also bring their own organizational cultures, regulations, and expectations. Managing partnerships among them is complex and requires intentional and thoughtful governance. Over the last several decades, as the number of interested stakeholders, resources invested, and initiatives launched within the global health field has grown, effective governance of global health PPPs has become increasingly critical.

To explore the role of governance in PPPs for global health, the Forum on Public–Private Partnerships for Global Health and Safety convened a workshop. Participants explored best practices, common challenges, and lessons learned in the varying approaches to partnership governance. They also highlighted key issues in the governance of PPPs for global health with the goal of increasing their effectiveness in improving health outcomes. This publication summarizes the presentations and discussions from the workshop.

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