KIN Global: Health and Wellness Prevention and Partnerships: What ...

1979, it is estimated that 30 million lives have been saved. The program cost $25M for 12 years, but it is estimated that
it has saved an additional $275 in direct costs every year since. Some global public goods should be understood not in
terms of their “cost” but in terms of the social and economic costs of delaying their eradication. 1
Why isn’t prevention a major focus in society today?
Given the aforementioned benefits of preventive efforts, why is it not at the forefront of the global health agenda
today? The success or failure of a prevention effort is inherently difficult to measure. The result of a specific effort either
occurs many years in the future or is based on the avoidance of a negative. Additionally, providing evidence for the
effectiveness of a drug, vaccine or biomedical prevention mechanism is much easier than for a behavioral or structural
prevention program which is usually a combination of several efforts. 2
Since measurement of prevention programs is difficult, governments and funders find it challenging to create a business
case for funding and implementing these initiatives. Governments hesitate to allocate funding to an effort that shows
little benefit to constituents in the near-term. Funders also often fail to provide resources to prevention programs as
they are not always proven, due to inherent measurement issues, to succeed. Additionally, they have thus far failed to
reach consensus on the appropriate mix of behavioral, biomedical and structural preventative efforts. Finally, funders
often fail to partner with the right organizations to achieve maximum results, burdening countries with parallel and
duplicative processes. 3 Both governments and funders fail to recognize the sustained effort necessary to wipe out a
disease or to continue to lower prevalence. Where polio has been eradicated in the developed world for 30 years, it is
now returning in several developing nations due to lack of continued funding. Finally, there is a lack of human and
physical infrastructure in developing countries to implement programs funded by international funders. To address the
aforementioned barriers, we will look to successful models in the treatment and diagnosis areas of health management.
Health Partnerships
Partnerships have become the prevailing model for addressing health problems for low and middle-income countries. 4
The partnership usually includes government, funders, NGOs and possibly the private sector. Collectively, the
partnership provides financial and non-financial resources, increased attention on the issue, increased attention on the
NGO and an opportunity to align the incentives of all stakeholders. There are many examples of partnerships in the
treatment arena and an increasing number of partnerships facilitating R&D for market-neglected diseases. However,
according to Julie Smith, CDC Foundation, little to no literature has been completed on best practices in health
partnerships. 5 Now that they have become the norm in developing world public health efforts, organizations must
decide when partnerships are necessary, choose the correct partners, and set up the most effective structure and
governance for the partnership. Can partnerships help to effectively increase the focus on prevention efforts?
1 Stansfield, Harper, Lamb, Lob-Levyt. “Innovative Financing of International Public Goods for Health,” CMH Working Paper Series,
Commission on Macroeconomics and Health, January, 2002.
2 Bertozzi, Stefano M., Laga, Marie, Baustista-Arredondo, Sergio, and Coutinho, Alex, “HIV Prevention 5: Making HIV prevention
programs work,” Lancet 2008: 372: 831-44.
3 Conway, Michael D., Gupta, Srishti, and Prakash Srividya, “Building Better Partnerships for Global Health,” The McKinsey Quarterly,
December 2006.
4 Ibid.
5 Smith, Julie. CDC Interview, 12 May, 2009.