Stronger partnerships include shared goals and coordinated decision making and, hence, some level of alignment in strategies and resources. Coordination appears fruitful where problems are defined clearly and donors have already developed interventions that they implement on their own. This type of partnership can help to avoid redundancies and enable donors to build consciously on the efforts of others. Strategies can be revised or funds reallocated by partners in response to one anothers efforts, yet decisions are still autonomous.
The Presidents Malaria Initiative (PMI; Loewenburg 2007), led by USAID and implemented with the U.S. Centers for Disease Control and Prevention, illustrates coordination in philanthropic efforts. PMI includes partnerships both within and external to USG. Partners not only communicate with each other but also adjust their strategies, use of resources, and implementation efforts based on what other partners are doing. The importance of coordination within PMI is indicated by the title given to the Initiatives head: U.S. Malaria Coordinator. This position oversees both PMI and USAIDs non-PMI malaria programs.
PMI coordinates the anti-malaria efforts of various federal agencies and its own anti-malaria program. Within USG, the U.S. Malaria Coordinator has decision-making authority over all federal anti-malaria efforts and resources. Outside of PMI, the Coordinator provides USGs lead representation at all international malaria prevention and treatment meetings, including those sponsored by non- and quasi-governmental groups, such as Roll Back Malaria, the World Bank, the World Health Organization, and UNICEF. PMI leadership thus participates in shared decision making with these and other entities, such as the Global Fund to fight AIDS, Tuberculosis, and Malaria, and the Bill & Melinda Gates Foundation. Through these efforts, partners design and adjust their strategies and interventions to maximize the effectiveness of their efforts. For example, the Global Fund procured more than 8.7 million anti-malaria treatments in Uganda, while PMI resources were used to support the distribution of these treatments to local health facilities and community drug distributors. In Zambia, PMI partnered with PEPFAR and the Global Business Coalition to distribute more than 500,000 nets to persons living with HIV. PMI focuses on four well-developed interventions, centering on malaria prevention and treatment via insecticides or netting and existing medicines, respectively. These efforts are coordinated but have minimal overlap, with the Gates Foundation, the major foundation stakeholder working on malaria, focusing heavily on vaccine development and distribution.