The fullest and most formal approach to partnership is illustrated by the Global Alliance for Vaccines and Immunization (GAVI), a public-private partnership created in 2000 and currently being restructured as a foundation based in Switzerland. GAVI brings together stakeholders committed to improving access to immunization in poor countries, and centralizes the processes of setting goals, developing strategies, guiding implementation, and allocating partners donated resources in its independent administrative structure. The founding members of the Alliance include the World Health Organization, UNICEF, the Gates Foundation, and the World Bank Group. The partnership includes many other players: developed and developing country governments, research and technical institutes, the vaccine industry in both the developed and developing world, and civil society organizations. GAVI follows a full partnership model. Donors pool resources, and the Alliance itself governs the project and allocates funds. The U.S. is one of the original six donor countries and currently is represented by the Assistant Administrator for the Bureau of Global Health at USAID, who presently holds a seat on the GAVI board.
Such full and formal partnerships appear to be an option when a problem is well defined and interventions are fairly well-understood, stakeholders view each other as equals in addressing the problem or program area, and resources are adequate for supporting the partnership function. Collaboration can create an effort that is greater than the sum of its parts. However, it requires a high level of commitment from participants and that participants cede a substantial degree of control over the resources they commit. While such partnerships can be very effective in leveraging resources, they require large up-front investments to function properly. In some cases, the potential benefits may be outweighed by the substantial transaction costs incurred in the process of identifying partners, seeking common ground, establishing formalized structures and agreements, and maintaining governance. It appears to be difficult to quantify such costs, but their significance was emphasized in both the literature (Sandfort 2008; U.N. Foundation n.d.) and interviews conducted as part of the case studies.