Apr 23, 2009

Global Philanthropy Forum: Are Partnerships the Only Answer?

by Laura Starita

Philanthropy Action is live blogging this week from the Global Philanthropy Forum.

Early today in the Expanding Access to Healthcare plenary at the Global Philanthropy Forum, I was thinking about a certain tautology of logic that is the risk of an event such as this. The key motivation for most attendants is to make contacts which may advance investments or bring in new ones. Collaboration and partnership, therefore, is the name of the game. So the overarching theme of public-private partnership that is very much in play here is self-reinforcing. All the panel members, with few exceptions, are either government officials trying to urge philanthropy and business to use their ‘freedom’ to innovate, and then partner with the government to scale; or they are philanthropists or business representatives who have partnered successfully with government organizations. The idea that government must be involved and that governments have responsibilities and that each player has a certain role has been taken in most instances as given, rather than debated or in any way grappled with—a particularly ironic result given that post-conflict philanthropy is one of the tracks of the conference.

It was with some relief, therefore, that I saw some of the touchy issues of public-private partnership taken up during a well-conceived health infrastructure break out later in the morning. For starters, the panel members were truly coming from different perspectives: Michael Chu, an HBS professor and co-founder of the IGNIA fund, Jean Duff, Executive Director of the Center for InterFaith Action on Global Poverty, Donna Barry from Partners in Health, among others. Predictably given his business focus, Chu asserted that working with the government is not in fact the only way to deliver private-sector health solutions, and Barry made the, perhaps, more nuanced point that in the beginning it is often easier for nonprofits to set up their own health infrastructure in developing countries rather than work through the government networks—build their own clinic, source their own medications, employ their own personnel. In her view, such efforts cannot be sustained or scaled, and the likelihood of duplication and cancellation is high. The problem of mixed incentives was also raised, a thorny issue in the case of health delivery, in which doctors recommend interventions which bring more income, rather than those that fulfill the health need of the patient—a not unfamiliar dynamic in the United States, and one that is growing elsewhere. There were no clear answers to the questions of what the concrete and respective roles and responsibilities of government, philanthropy and private delivery are? How we create the right incentives at the right portion of the value chain? When do philanthropy or government, respectively, in fact have no role to play? But is important that they be raised—and often.