Resonance sat down with Gary Cohen, Executive Vice President of Global Health at Becton, Dickinson and Company (BD) and Steve Schmida, Founder and Chief Innovation Officer at Resonance, for our second episode of the Inclusive Innovation Exchange to examine global health partnerships.
Drawing on rich real-world examples and decades of practical experience, Cohen and Schmida reflected on the "secret sauce" that makes great partnerships and how these partnerships can advance inclusive innovation in health to yield world-changing results. Below, we share the top six takeaways from their discussion.
6 Steps for World-Class Global Health Partnerships
1. Use Data to Identify Health Problems and Form Partnerships
Just like any complex project, partnerships are sharper, more effective, and more efficient when they’re rooted in actionable data. Cohen founded Together for Girls, a global, multi-sector effort to reduce violence against children and youth, in 2009 after visiting Sub-Saharan Africa for HIV-related research and prevention. He heard a consistent theme throughout 30 trips in 12 countries: A significant proportion of new HIV infections were among girls and young women, and many of these infections were the result of sexual assault. To Cohen, the data were clear: addressing HIV transmission demanded that we also address sexual violence.
Cohen leveraged his network to discuss the issue with several agencies and was eventually able to attract the attention of UNICEF, the United Nations Population Fund (UNFDA), the President's Emergency Plan for AIDS Relief (PEPFAR), and several others. Together with the support of Swaziland's government, the partners used in-person home surveys to understand the scope of the problem and then designed interventions to address root causes. This work has since expanded to 23 countries across Africa, Asia, Central Europe, and Central America.
In addition to using data to establish the nature, drivers, and extent of a given problem, a partnership must also measure its outcomes to make sure it’s on the right track. Schmida cited the Partnership Results Chain Framework as a resource to help partners use data and metrics to assess achievements and stakeholder value. He emphasized that collaborators should tie partnership metrics back to each partner's motivations to incentivize everyone to meet shared goals.
2. Use Transparency to Align Partnerships Around a Shared Goal
At Resonance, we often talk about the importance of aligning partners around a shared goal. But one webinar participant wanted to know how to tell if partners were aligned. Cohen and Schmida both stressed the importance of transparency.
"A conflict of interest isn't a problem," said Cohen. "It's a problem if it's hidden." All partners must be willing to get explicit about their motives. An agribusiness may wish to increase the volume and reliability of supply, while a donor hopes to raise farmers' incomes. A partner may need to show results to her boss, and another may have a deeply personal connection to the project's goal.
Schmida stressed that partners can and will have different motivators and incentives. However, in a well-designed partnership, those interests should mutually reinforce—not detract from—the partnership’s core objectives. For example, a company's efforts to profit in a new market can also create jobs in the local community or expand access to needed products or services. "Partners usually have different motivations, but they should reinforce each other," he said. "It's part of getting to know your partners and what they are trying to achieve."
3. Stay Focused on Health Objectives with Right-Sized Governance
Governance is an integral part of any partnership. But just as partnerships can be large and complicated or small and streamlined, governance structures are not one-size-fits-all. Schmida advised designing a "fit-for-purpose" governance model to keep partnerships on track. He also suggested tiering governance so that smaller groups oversee different elements of the partnership, such as finance or communications, and mapping out internal stakeholders to confirm who will need to sign off on priority deliverables.
Cohen cautioned that complicated governance schemes can also become a crutch if partners aren't careful—masking a lack of leadership or clarity around how to turn intent into action. "Some partners can spend years circling around governance feeling like they're accomplishing something when they're not," he said. "It's important to tailor governance to your circumstance." A good governance structure should enable the partnership to move efficiently and successfully, always keeping the partnership’s real-world objectives at heart.
4. Scale the Partnership by Starting Small, with Big Vision
Cohen advises partners to start by trying to do something really well in just one place. While it's valuable to have a grand vision at the outset of your partnership, it's just as important to start with an attainable scope that can help you prove the methodology that will eventually enable scale.
Schmida outlined three financial pathways to scale: (1) through public sector funding or service provision, (2) through the private sector, harnessing the market, or (3) with a hybrid approach (for example, private sector provision paired with public-sector subsidies). Read more about these different pathways in Resonance's guide to cross-sector collaboration.
Cohen added that if the partnership has a business model that generates a financial return, it is already on the path to scale. While initiatives reliant on philanthropic or donor funding may eventually hit a ceiling; those with a financially self-sustaining business model are “replicable and really there’s no limit to the [potential] scale.”
5. Nail the Basics of a Global Health Partnership
"At the end of the day, a partnership needs to make a change in the world, and that process needs to be managed effectively and transparently," said Schmida. Both he and Cohen touched on the importance of project management at several points in their conversation.
"It's where the skills of the business sector come into play: Efficiency and the ability to get beyond broad expressions of intent," added Cohen. "Applying that skill to humanitarian need can be very powerful."
The major initial step of a partnership, Cohen said, is to do the rigorous work of defining the partnership—its purpose, goals, measures, etc.—even if it takes a year or more. "Doing that pre-work greatly reduces risk later down the line," he said.
It also helps ensure that a bad match is terminated quickly. Cohen described working with one past partner so bound by rules and protocols that the partnership objective morphed into something that no longer reflected or fulfilled the collaboration’s original stated vision. The partner also wasn't able to put resources behind the implementation and seemed more interested in framing and announcing the partnership than in realizing its stated goals.
"Life is short; time is precious," Cohen said. "Where partnerships can be framed, it's a fantastic experience. But if it's not going to work, it's time to redirect or abandon the collaboration. There are too many important things to work on; if partners are at odds, it's just not worth it. Best to root out that stuff early."
6. Assign the Right People
The most critical factor in a partnership's success? The right people. Cohen said that great partners exhibit specific characteristics and attributes that make them well-suited to participate in a partnership. We need "people who enjoy taking on a challenge and are comfortable working in an unstructured manner; people who judge their success based on something other than making money or climbing the career ladder; people who drive professional and personal fulfillment from solving big problems;" and those who are naturally collaborative, diplomatic, and facile at working across cultures and sectors.
Schmida agreed. Those who possess strong soft skills and empathy tend to excel at cross-sector collaboration. "When you are in a long-term partnership, you're going to hit bumps in the road" based on the ups and downs of each organization, he said. "Having empathy and helping each other navigate these is incredibly important."
Cross-Sector Collaboration for Meaningful Outcomes
As COVID-19 awakens the world to the importance of global health investment and collaboration, practitioners are increasingly turning to partnerships to achieve meaningful outcomes. When partners take the time to define a sound methodology, employ empathy and inclusivity, and align on vision and goals, they are far more likely to overcome challenges and scale their successes. While the path is rarely easy or straightforward, great partnerships can and do deliver unprecedented results for patients, communities, and practitioners in countries around the world.
Solving today’s global health challenges demands creativity and collaboration. To fight infectious diseases such as COVID-19 and noncommunicable diseases like diabetes and hypertension, we need partnerships that span sectors and continents and partners who leverage the influence and resources of governments, companies, and NGOs to address cross-cutting health challenges that no one organization can solve alone.