PEPFARs approach to public-private partnerships emphasizes the importance of local partners in focus countries as a means to create and implement more sustainable and effective programs. This approach is also intended to facilitate large-scale interventions on the ground and engage further resources to maximize impact. Public-private partnerships are encouraged insofar as they are aligned with a countrys programmatic and strategic goals, and the decision to move forward with a public-private partnership rests with the country team.
According to OGAC staff, the role of the Public-Private Partnership office within OGAC is to connect private sector companies, foundations, and even philanthropic individuals to a countrys team leader. The office helps implementing agencies in the field recognize the value of public-private partnerships, and trains people in ways to approach the private sector. OGAC staff view public-private partnerships to be more effective when they can match initiatives to existing programs, rather than creating new ones. According to PEPFARs annual report (OGAC 2008), the initiative helped facilitate numerous in-country public-private partnerships and seven large-scale, multi-country, public-private partnerships in 2007.
Operationally, a public-private partnership is structured through a one-to-one funding match between the private sector and government, but multiple private sector partners can join together to meet the matching requirement. Ideally, as public-private partnerships grow, private sector funds will exceed U.S. government resources. Most public-private partnerships are financed through funds allocated in the country operational plans. In addition to in-country partnerships, OGAC staff also broker larger, regional partnerships, such as one with a large multinational medical technology company to strengthen laboratory practices and provide training to laboratory staff in multiple countries.
The effort to foster public-private partnerships brings with it a number of challenges for implementation and expansion. For instance, according to interview respondents, OGAC staff members often face resistance from U.S. field staff who may feel distrust toward the motives of the private sector. Another challenge is the funding mechanism. Establishing public-private partnerships can be a cumbersome and time-consuming process. Moving money and developing contracts for each specific public-private partnership within a government bureaucracy can take much longer than it would at a large corporation. This can cause frustration among private sector partners.
The planning process for public-private partnerships currently uses a more passive rather than a proactive approach, according to OGAC staff. The U.S. government and focus countries respond to opportunities brought to OGAC by businesses or foundations interested in partnerships, rather than systematically looking at a countrys needs and finding private sector solutions to meet them. However, OGAC is working on shifting the emphasis to the latter approach and private sector partners have been flexible and open to these changes. According to OGAC staff, implementing agency staff may find public-private partnerships more appealing if they can see how they could fill a specific gap for their country.