Global partnerships are collaborative relationships among multiple organisations, usually including the private sector, which transcend national boundaries, and where risks and benefits are shared in pursuit of a common goal.

Global health partnerships (GHPs) seek to tackle the major communicable diseases of poverty, especially where efforts have been poorly co-ordinated and financed, and have resulted in weak and fragmented programmes at country level.

The Global Fund to Fight AIDS, TB and Malaria was established in 2002, and to date has committed US$4.9 billion in 131 countries for effective programmes that are developed and managed at country level. GAVI, the Global Alliance for Vaccines and Immunisation, had delivered over $447 million by the end of 2004. Other partnerships focus on polio, river blindness, trachoma, malaria, tuberculosis and HIV/AIDS.

Funding role of partnerships
Although not highly significant in terms of overall funding for health in developing countries, the financing partnerships play a major funding role in some low-income countries. Together with other health initiatives such as the USA President’s Emergency Response for HIV/AIDS Relief and the World Bank’s Multi-country AIDS Programme (MAP), these global partnerships are likely to double the level of resources for health in around ten countries and significantly increase it in many others.

What are the challenges?
Challenges include the need to integrate additional funds with national plans to strengthen health systems and services for the poor; managing public finances to ensure that the increased aid flows can be absorbed without compromising macroeconomic stability; and the increased aid dependence and sustainability issues for activities supported by the global partnerships.

Our work

Trends in international funding for TB and Malaria. HLSP Institute staff carried out two studies for the Roll Back Malaria Partnership and the Stop TB Partnership reviewing the external resource flows earmarked for TB and malaria, and the attitudes of key development agencies to financing for the two diseases. The findings form these studies are summarised in a Technical Brief: TB and malaria: trends in donor funding. The full reports can be downloaded from the the Roll Back Malaria› and Stop TB› websites.

Studies on global health partnerships. In 2004 HLSP Institute staff participated in a series of studies commissioned by the DFID Global Health Initiatives and Partnerships team. Our inputs were related to the economic and financial aspects, determinants of effectiveness, and country case studies. The overall aim of the studies was to fill gaps in understanding related to increasing the impact of global health partnerships. The GHP study papers are available on the DFID Health Resource Centre website›

Evaluation of the Global Partnership to Stop TB. The Stop TB Partnership is one of a large number of global health alliances which have been established in recent years. In 2003 we were commissioned to evaluate its relevance, efficacy, efficiency, sustainability, institutional development impact, process, governance and implementation, with particular emphasis on issues of structure and functions.
View the evaluation report

GAVI Alliance (The Global Alliance for Vaccines and Immunization). HLSP Institute staff have been working on various issues for GAVI since 2000. This has included support to DFID in their interaction with GAVI, input to the work of the monitoring and evaluation sub-group, work on future GAVI support and work with the Financing Task Force.

GAVI Lessons from Phase 1 and Design of Phase 2. GAVI is now embarking on a second phase (2006-2015). The HLSP Institute led a consultation exercise with GAVI-eligible countries and partner representatives to identify lessons learned from the first five years of support, and to help design the next phase of support.
Final report: Lessons learned from GAVI Phase 1 and design of Phase 2 - findings of the country consultation process

The summary› of the consultation with GAVI-eligible countries and Regional Working Groups (May 2005) is available on the GAVI website.

GAVI Investment Case for support to Health Systems Strengthening.
The Institute also worked with GAVI, WHO, UNICEF and partner agencies to produce a detailed investment case to justify and describe proposed support by GAVI to health systems strengthening (and guidelines for countries to apply for support). This investment case was presented to the GAVI Alliance Board meeting in December 2005, where it was approved. HLSP Institute staff are assisting the GAVI Secretariat to design detailed criteria for support and funding flow mechanisms.
The investment case and country guidelines will be available on the GAVI website.

GAVI Financial Sustainability Evaluation. GAVI has introduced an interesting innovation among the global health partnerships - asking countries to develop a 'financial sustainability plan' (FSP) for their immunisation activities. FSPs look at how the country and its partners can sustain the services after the end of current commitments from GAVI. In addition to support to developing FSPs, we led the evaluation of the financial sustainability planning process after the first round of countries developed their plans. View our report