Doing Good Business: HIV/AIDS Public-Private Partnerships
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A public-private partnership launched by USAID is allowing these
children in Namibia to receive a daily cup of nutritious yogurt, coupled
with HIV/AIDS prevention education. Source: Mary Jordan/USAID |
As part of its endeavor to fulfill the need for quality HIV/AIDS services, the U.S. Agency for International Development (USAID) – in cooperation with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) – designs and enters into public-private partnerships in developing countries. The reauthorization of PEPFAR in 2008 brought a new focus on sustainability of services in partner countries, which USAID works to support through its public-private partnerships. These collaborations include USAID and a corporate partner, be it a local firm or a national or multinational enterprise. Such a partnership may also include a non-governmental organization (NGO), the government of a host country, or both. With more than 20 years of experience in meeting the challenges of the epidemic, USAID understands that efforts against HIV/AIDS must be sustained for true development to exist.
Dynamic Partnerships for a Complex
HIV/AIDS Epidemic
Maintaining successful HIV/AIDS partnerships that have a real impact is key to stemming the epidemic. With this in mind, USAID embodies the international development belief that a commitment to local ownership is the best way to support host countries’ investments in their futures. For this reason, USAID enters into public-private partnerships, drawing on unique abilities from local resources in an effort to keep long-term sustainability on the forefront of program design. No two partnerships are identical, but they all share a common feature: Each uses its own distinct set of combined resources to fill a well-defined need. In doing so, these partnerships are able to help people who are at risk of HIV/AIDS, living with the disease, or otherwise affected by it. Public-private partnerships serve one or more purposes, such as providing HIV/AIDS prevention services, treatment and care for HIV-positive individuals, and care and support for orphans and other vulnerable children. Other more programmatic purposes include creating jobs and providing skills training for AIDS-affected individuals, broadening the base of private-sector partners engaged in public health efforts, and strengthening national AIDS policies in host countries.
Why HIV/AIDS Public-Private Partnerships
Make Effective Development Programs
The HIV/AIDS public-private partnerships established by USAID in developing countries help not only those affected by the disease, but also the partners themselves by offering a variety of benefits.
Business
Partnerships fulfill a crucial role in corporate responsibility for a business. They drive the growth of that entity, while increasing the chances of sustainability for the partnership. Many businesses indigenous to host countries have experienced financial setbacks as a result of the AIDS epidemic. Many confront such problems as employee absenteeism, declines in skilled workers, high rates of turnover, and increased training and health care costs. Moreover, HIV/AIDS reduces the demand for consumer goods. When people are ill and unable to work, they do not have resources to spend on consumer goods and services. By entering into partnership with USAID, a business can reduce costs, better protect the health of its employees, or improve conditions for its customers. By partnering with USAID, larger multinational corporations can expand their reach into local host country communities, building relationships with families and networks of local leaders, and, in some cases, offering business opportunities to vulnerable populations.
Nongovernmental Organizations
In developing countries, many NGOs serve children and adults who have a complex set of needs resulting from HIV infection and other factors, such as poverty, malnutrition, and insufficient sanitation. By participating in a USAID public-private partnership, an NGO is able to avail itself of resources it otherwise might not have and use those resources to strengthen and expand its portfolio of services.
Host Governments
Host country governments in developing nations understand the challenges of keeping their citizens healthy, productive, and secure. In many cases, governments have not fully established national systems or the institutional capacity to implement HIV/AIDS programs of sufficient quality and scope. Through public-private partnerships, host governments gain access to varied networks, resources, and knowledge, which they can use to inform and fortify the systems and institutions they have in place. They also can help ensure that joint initiatives are appropriate to the needs and culture of the country. In these ways, governments can participate in the development of services that are effective, enduring, and ultimately owned by the country. Another advantage to HIV/AIDS public-private partnerships is that their effects frequently spill over to influence broader efforts in sustainable development. Public-private partnerships also play a pivotal role in country ownership by creating a bridge between the public and private sectors.
How USAID Identifies and Sets in Motion
HIV/AIDS Public-Private Partnerships
There is a lot of variation in how HIV/AIDS partnerships are identified and initiated. This flexibility is essential. Often, USAID must find ways to patch HIV/AIDS services together with resources and systems that were originally intended for a different use. To repurpose effectively, USAID cannot rely strictly on convention; it must see the possibilities that lie beyond it. USAID nurtures this ingenuity by keeping an ear to the ground – in both the business and human service sectors of the developing world. Knowing the capacities of the former and the needs of the latter – and what it will take to link the two together – is one reason USAID remains a leader in HIV/AIDS prevention, treatment, and care.
One challenge in establishing partnerships with businesses is developing a contribution that is practical for the company and useful for the benefactors. In one instance, USAID suggested that a multinational company that manufactures personal care items sell uncut soap to grandmothers caring for grandchildren whose parents were lost to AIDS. The company had contributed the first level of inventory, or soap, for the women to begin the project. Dividing the large soap into small, single-use sachets, the women were able to sell their product to local residents living in rural villages. After generating income from initial sales, the women were able to purchase the soap in bulk from the company. Within a short period of time, the grandmothers were able to support their families.
| Five Steps to Building an HIV/AIDS Public-Private Partnership |
| USAID experts say there are five steps one must take to establish a dynamic public-private partnership. |
| 1. ASSESS: |
Identify industry sectors in-country, such as textiles, and the likely supply chain vendors
needed to support the industry (e.g., transportation). |
| 2. OBSERVE: |
Pinpoint other businesses in the country. Be aware of who is advertising, and where they advertise. |
| 3. ANALYZE |
Recognize and identify U.S. Government program needs and the gaps in-country. |
4. STRATEGIZE &
COLLABORATE: |
Develop a public-private partnership strategy of mutual benefit. Bring stakeholders together through
open dialogue. |
| 5. HARMONIZE: |
Leverage existing U.S. Government resources and current investments to strengthen and scale up programs. |
A Quick Look at More USAID HIV/AIDS
Public-Private Partnerships
There are certain activities that are central to the success of enterprises. They include marketing, recruiting, training, logistics, manufacturing, and policy and advocacy. Because these are core competencies in business, many companies have personnel who excel in these areas. With the right guidance and assistance, companies can apply their in-house expertise to enhance the HIV/AIDS response, often doing so in innovative ways.
Some examples of initiatives resulting from USAID partnerships include:
Coca-Cola – Working in 56 of 57 countries in Africa, The Coca- Cola Company is the largest private-sector employer on the continent. Its alliance with USAID supports HIV/AIDS treatment, prevention, and care for Coca-Cola employees and families. Coca-Cola is also one of USAID’s nine corporate partners in a job creation program for orphans and other children affected by AIDS and their caregivers, having them serve as vendors in their own communities. As a result, these individuals are able to earn wages without leaving their home communities. The program, which currently runs in Ethiopia, will soon be launched in Mozambique. In addition, Coca-Cola has provided skilled staff to help develop and execute strategies to disseminate accurate HIV/AIDS information. For example, Coca-Cola has lent marketing executives to assist in shaping effective prevention messages. The company also has contributed its extensive distribution network to the dissemination of HIV/AIDS-related commodities, including prevention pamphlets.
IAVI-DNAVEC Collaboration – In 2007, the USAID-funded International AIDS Vaccine Initiative (IAVI) began collaborating on the development of a novel AIDS vaccine technology using the Sendai virus as a vector to deliver HIV antigens that, researchers hope, will stimulate protective immunity against HIV. IAVI plans to develop and advance into clinical trials a Sendai-based AIDS vaccine candidate in partnership with DNAVEC Corporation, a biotech company based in Tsukaba, Japan. The IAVI-DNAVEC agreement includes preclinical testing for immune response and safety, process development for manufacturing, and a Phase 1 clinical trial for the candidate, with further development to be evaluated after the results of early testing. IAVI and DNAVEC will each contribute scientific and technical expertise. Sendai, an RNA (ribonucleic acid) virus that does not cause disease in humans, is a promising vector in part because it elicits mucosal immune responses. Scientists have discovered that the primary sites of HIV replication following infection are the gut-associated lymphoid tissues, which are part of the mucosal immune system. It is therefore possible that in order to provide protection against HIV, a vaccine candidate will need to spur mucosal immune responses.
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“Cultivating HIV/AIDS public-private
partnerships pays off. A collective
effort can be so much greater than the
sum of its parts. Whenever such talent,
commitment, and resources cross-pollinate,
you get results.”
Mary Jordan, Senior Technical Advisor
for Public-Private Partnerships,
USAID Office of HIV/AIDS |
| Source: Bill Lyons |
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Pfizer's Global Health Fellows - Skilled Staff Spanning the Globe
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Pfizer Global Health Fellow Craig Cook with Gloria, an
m2m peer trainer, and her healthy daughter in Cape
Town, South Africa
Source: Pfizer |
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Identifying a Need
In 2003, the Pfizer Corporation demonstrated public health leadership by establishing its Global Health Fellows program. Through this effort, Pfizer contributes its most valuable asset – its employees – to HIV/AIDS efforts. Through this approach, the company is helping address the considerable challenges in expanding access to, and delivery of, health care in developing countries. Pfizer has since joined forces with USAID to help increase the breadth, quality, and efficiency of HIV/AIDS programs provided through PEPFAR.
Initially, the Fellows program was created in response to the high demand for qualified health care workers in Africa. Pfizer began by loaning medical personnel, such as nurses and clinical practitioners, to partner with NGOs and local hospitals and teaching institutions, such as the Pfizer-initiated Infectious Diseases Institute in Uganda. Over time, however, it became clear that HIV/AIDS efforts in developing countries needed help overcoming a wider range of challenges in relation to the support of basic health infrastructure. In order for local providers to offer quality health services, they would need additional skills, such as ways to attract, train, and retain skilled staff; install computer and software technologies; improve financial and management systems; and develop operational and strategic plans. To assist in the building of health systems and local capacity, Pfizer is now helping PEPFAR address broader challenges by lending not only medical personnel, but also staff with skills in financial and organizational management, human resources, and health education. A Commitment to Sustainability
With the support of Pfizer fellows, PEPFAR program grantees are able to address challenges to growth. The Global Health
Fellows program has a focus on sustainable impact and transference of skills and knowledge that is bolstered by a significant
investment in
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"Employees who participate in the Fellows
program return to Pfizer stronger leaders
with new, expanded perspectives on
health care and a renewed passion and
energy for their work. We are committed
to developing and expanding the Fellows
program to provide the most appropriate
and effective support to African and
indigenous organizations like m2m."
Caroline Roan, Vice President, Corporate
Responsibility, Pfizer Inc and President of
the Pfizer Foundation
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monitoring and evaluation. For example, the mothers2mothers program (m2m) in Cape Town, South Africa, is expanding efforts to care for HIV-positive mothers and prevent transmission of infection to their children. With the help of one Global Health Fellow with expertise in financial management, m2m enhanced and standardized its operating systems; computerized its accounting processes; developed financial reports that could be easily understood; and hired and trained financial support staff. As a result of this capacity-building effort, m2m was able to open 15 new sites and plan for 17 more. With the help of two additional Pfizer Fellows, the program continued to expand its services in South Africa, where it is now operating in more than 342 sites. With support from PEPFAR, it also has been able to expand its services to six other sub-Saharan African countries.
Long-Term Benefits
Health service providers in the developing world are the intended primary recipients of the Pfizer Global Health Fellows program, but the company and its employees also gain extraordinary benefits. When Fellows return to their positions within the company, they bring with them a broader world vision, a renewed focus on their work at Pfizer, and new ideas for innovation.
Seeing Results
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A young Namibian boy enjoys a cup of nutritious yogurt. Source: Mary Jordan/USAID |
Leveraging Resources
Has Multiplying Effects
USAID launched a Namibian public-private partnership in cooperation with Standard Bank, the largest bank on the African continent; Namibia Dairies; Namdeb, a subsidiary of DeBeers; and the Namibia Business Coalition on AIDS. Specifically, USAID is providing sachets of nutritious yogurt to young children, coupled with HIV/AIDS prevention education. The yogurt offers children at least one healthy meal supplement per day, helping them to be less vulnerable to HIV/AIDS. Already, the program is having an impact. In February 2008, the program reached 400 children per day across two sites. As of March 2008, the number of children attending HIV/AIDS prevention programs has increased twofold.
Modeling Best Practices: Reducing Funding Bottlenecks and Reaching More Vulnerable Children
Building on USAID’s successful partnership with Pfizer and the Global Health Fellows program, Standard Bank collaborated with USAID to loan its personnel and expertise in financial management and reporting to local U.S. Government-funded NGOs. Child Welfare is the largest NGO of its kind in South Africa, with more than 150 affiliates. Yet the organization had little, if any, formal policies and processes in place for financial management and reporting. Today, with Standard Bank’s assistance, Child Welfare has reduced reporting delay from 9 months to fewer than 12 weeks. USAID is supporting the temporary placement of Standard Bank’s personnel, aiding local staff in the development and implementation of permanent business procedures. These systems are crucial for the local NGO to fulfill its mission, as well as develop and maintain sound fiduciary practices to enhance long-term institutional capacity and organizational growth.
The U.S. Agency for International Development works in partnership with the U.S. President's Emergency Plan for AIDS Relief.
November 2011 |
