Much could be learned from more in-depth examination of cases where USG-foundation interactions have developed over time and are seen by informed parties as positive models. The present study relied primarily on a document review and interviews with select high-level decision makers. Interviews with multiple individuals at different levels of the organization, ideally, would shed more light on the processes at work across the lifecycle of the initiatives. Such an approach could reveal how USG-foundation relationships are developed and how decisions are made at different levels of the organizations; how one type of interaction may evolve into another; what challenges were encountered across the lifecycle of the initiative; and how challenges were addressed.
It would also be useful to expand the in-depth examination to include other stakeholders. This could provide the perspectives of foreign governments, NGOs, international corporations, local businesses, researchers, and members of the target populations for philanthropic interventions. In nearly all the cases studied here, such organizations and individuals appeared to play an important role in the development and implementation of health and social service initiatives, but their roles and reactions were not studied.
Finally, the methodology of the present study is not appropriate for assessing the efficiency, effectiveness, or value added by any kind of USG-foundation interaction, or the relative usefulness of the different types of interaction. While it would be difficult to arrive at a definitive assessment of these issues, a more systematic examination of the various types of interactionsperhaps through surveys of key USG and foundation stakeholderscould reveal the prevalence of the different types of interaction, the successes and challenges associated with each, and the perceptions of informed stakeholders about their relative utility.
 See, for instance, Philanthropies Working Together: Myths and Realities, by Robert Hughes (2005), of RWJF, or the work of philanthropic affiliations, such as the Council on Foundations, the Philanthropy Roundtable, and Grantmakers for Effective Organizations.