an Eldis Resource

Efforts to tackle public health problems in developing countries increasingly rely on international alliances, such as the Global Polio Eradication Initiative. But while there are clear advantages to pooling resources and capabilities in order to address the massive health problems of developing countries, there are also difficulties in getting global health alliances to work effectively. Commissioned by the Bill and Melinda Gates Foundation, this paper by McKinsey and Company assesses whether global health alliances are working, and outlines the practices which maximise the success of such alliances.

A paper commissioned by the Bill and Melinda Gates Foundation reviewed the available evidence on global health alliances and conducted interviews with leaders of public health organisations in order to assess whether alliances were working, and to identify practices which made successful alliances possible. The research found that:

• In most cases, alliances were necessary to address public health problems difficult to tackle by organisations working alone.
• Most public health alliances were 'working'. In 80 per cent of cases, the alliance had meant that the reduction in diseases had sped up, improved, or been achieved at a lower cost compared to organisations working alone.
• However, many global health alliances were not reaching their potential. Some were not exploiting the opportunities of the alliance to the full, others were too slow getting started, while still others were being hindered by slow decision-making processes or resource constraints.
• The alliances that were best placed to maximise success shared key characteristics, including a clear and compelling goal and a clear scope, in terms of regional coverage or functions and activities.

As well as having clear goals and scope, the research found that the most successful global health alliances had addressed five issues:

• Value added: successful alliances had clearly identified the advantages of cooperation, and the actions needed to capture these.
• Structure of alliance: success also depends on whether the alliance structure fits its needs and goals. For example, if a loose alliance is needed to meet the alliance goals, the structure should be simple and flexible, rather than tightly integrated.
• Specific performance indicators and contributions of partners: these need to be agreed early on, to focus efforts and to ensure efficiency.
• Balance between participation and effectiveness: successful alliances tend to encourage input from and consultation with all parties, without necessarily involving all in lengthy decision-making processes.
• Staffing: crucially, strong alliances need staff whose main objective is its success, rather than being staffed entirely by part-timers.

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