1

Introduction¹

Partnerships across sectors are needed to remediate challenges faced in global health because the issues are too extensive to be solved by one sector alone, noted Peter Singer of the World Health Organization (WHO). In a similar vein, Wendy Taylor of The Rockefeller Foundation emphasized that the public sector has acknowledged that it needs private-sector involvement to achieve its development goals. While money used to flow into low- and middle-income countries (LMICs) largely from the public sector, high-income donor government grants now constitute only 9 percent of international financial flows in LMICs—with the majority of the funding coming from the private sector.

Singer noted that all sectors working in global health have the same principal value proposition, which is to save and improve lives. However, John Monahan with Georgetown University suggested that the value proposition has different segments and incentives for each sector and organization involved. It can also be influenced by or influence the type of model through which a company engages, noted Brenda Colatrella from Merck & Co., Inc. According to Jessica Herzstein, a preventive medicine specialist, value can also take different forms such as

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¹ The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants; are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine; and should not be construed as reflecting any group consensus.

saving lives, enhancing an organization’s mission, forming new relations, going into new markets, or learning from partners. Shared-value partnerships, for example, have become more prominent at the United Nations Children’s Fund (UNICEF) because there is a recognition that reasons to work with business, industry, and foundations extend beyond funding. According to Oren J. Schlein with UNICEF, the technical expertise that UNICEF can obtain through partnerships with private-sector actors is often more valuable than the money itself. Along these lines, Brian Brink, who serves as an independent non-executive director at Discovery Limited, suggested that significant opportunities exist to leverage business expertise—particularly in management, finance, and information systems—for health and health systems strengthening. Gaudenz Silberschmidt from WHO emphasized that each partner could consider enacting roles at which it excels as a prerequisite for successful and innovative partnerships.

As such partnerships form, strategies to manage conflicts of interest must be explored in order to better align partners to their shared objectives. For example, noted Brink, conversations around conflicts of interest could be reframed to focus on declared interests, which could enable the transparency needed to engage in the partnership.

Another important variable in the success of partnerships is the creation of an enabling environment that allows for greater cross-sector involvement. According to Singer, the Sustainable Development Goals (SDGs),² particularly SDG 17, promote an enabling environment that facilitates trust and collaboration across sectors. As partnerships form, partners need to be cognizant of how they can build one communication narrative—while still recognizing that they have strong individual brands. By working together, emphasized Schlein, partners can better influence policy at country and global levels.

Equally important is an understanding of the challenges and barriers to multi-sectoral engagement and collaboration in global health. For example, Singer noted that deeply entrenched ideological positions among partners can create perceptions that do not facilitate the dialogue and partnerships necessary to pursue opportunities and achieve innovations that are possible only through collective action. In addition, Brink emphasized that stakeholders need to cease demonizing business in general and the pharmaceutical industry in particular.

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² The 17 SDGs are “a call for action by all countries—poor, rich, and middle income—to promote prosperity while protecting the planet. They recognize that ending poverty must go hand-in-hand with strategies that build economic growth and address a range of social needs including education, health, social protection, and job opportunities, while tackling climate change and environmental protection” (UN, 2019a).

To analyze these concepts and issues and to deepen understanding of them, the Forum on Public–Private Partnerships for Global Health and Safety (PPP Forum) of the National Academies of Sciences, Engineering, and Medicine (the National Academies) convened a 2-day workshop on November 15 and 16, 2018. During the workshop, participants explored value proposition for different sectors that engage in global health—including industry, government, philanthropy, and civil society—and innovative models for multi-sectoral collaboration. The workshop provided an opportunity to bring together cross-sector views and to examine illustrative examples (see Box 1-1).

With a specific focus on industry engagement, the workshop examined how stakeholders within industry define and measure value relative to global health as well as how and why other sectors in the global health community engage with industry. During the opening session, workshop co-chair Seema Kumar, vice president for Innovation, Global Health, and Science Policy at Johnson & Johnson, provided an overview of the workshop’s three major objectives:

1. To explore assumptions about industry’s value proposition for global health engagement. Why does industry engage with global health, and what is the value proposition for industry? What is the value proposition for the global health community to engage with industry?
2. To examine approaches, opportunities, barriers to success, and enabling environments for creating value and for implementing innovative models. What are the critical success factors? What are the barriers?
3. To discuss how to create innovation in multi-sectoral models for global health and how to inspire participants to accelerate progress in testing and building these models.

Kumar explained that the workshop agenda was designed around these objectives, which would be addressed through four sessions that contained a mix of presentations, panel discussions, and input from participants.

ORGANIZATION OF THE PROCEEDINGS

An independent planning committee organized this workshop according to the procedures of the National Academies (see Appendix B for the workshop agenda). The planning committee’s members were Cara Bradley, Brenda D. Colatrella, James Coughlan, Clarion Johnson, Seema Kumar, Gabriella Morris, Shawn Standridge, and Mary Lou Valdez. This publication summarizes the workshop’s presentations and discussions. The content of the proceedings is limited to what was presented and discussed at the workshop and does not constitute a full or exhaustive overview of the field.

After introductory presentations on models for multi-sectoral engagement in global health from both global health and industry perspectives, the workshop included three sessions, each of which addressed one of the three objectives. The final session of the workshop was a facilitated discussion that elucidated key messages from the workshop and explored how the audience could further disseminate the messages to broader audiences, stakeholders, and policy makers.

In accordance with the policies of the National Academies, the workshop did not attempt to provide a comprehensive mapping of value propositions for different sectors or health issues. Instead, it intended to address variations across sectors and health areas at a high level and to illuminate variation using examples. The proceedings focuses on the issues identified by the speakers and workshop participants. In addition, the organizing committee’s role was limited to planning the workshop. The workshop proceedings was prepared by workshop rapporteurs Liza Hamilton and Melissa Maitin-Shepard as a factual summary of what occurred at the workshop.

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