International Public Private Partnerships as Part of the Solution to Infectious Disease Threats: Operational, Legal, and Governance Considerations

Abstract

While global health law as a conceptual and academic field is relatively new, efforts to coordinate international measures against the outbreak and spread of disease are more than a century old. The history of global health law is, for the most part, a story of traditionally conceived sovereign states bargaining and coordinating to address common international challenges even as they coped with the collective action problems inherent in those kinds of negotiations. However, the maturation and proliferation of for-profit corporations and nonprofit organizations over the course of the 20th century and into the 21st century have offered alternative approaches to international public health challenges.

This chapter analyzes how the traditional state-centered model of cooperation has evolved to include actors not traditionally recognized under international law in order to optimize global health outcomes. The international public-private partnerships behind this evolution have mobilized advantages offered by state and private actors while overcoming many of their relative disadvantages. After first examining the operational structures and legal formalities that characterize public-private partnerships, this piece assesses common attributes of public and private entities, and how these attributes may run in tension with one another. It then turns to three public-private partnerships prominent in the global health field - the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Global Alliance for Improved Nutrition; and Gavi, the Vaccine Alliance – to analyze and contract their activities, financing, and governance structures. The choices these partnerships have made in these areas affect their legitimacy as international actors and effective global health organizations.

Keywords: Public-Private Partnerships, Global Health, Infectious Disease, Corporate Governance, Global Fund, GAIN, Gavi

JEL Classification: I18, L22, L31, L32, L33