An honest insider’s critique
In global health, we love to talk about partnerships. Public-private. Cross-sector. Multi-stakeholder. Community-based. They dominate strategy decks, RFPs, panels, and press releases.
I’ve worked on these partnerships from both sides: advising private sector clients trying to engage responsibly, and working from within multilateral institutions tasked with managing that engagement.
Here’s the uncomfortable truth:
Cross-sector partnerships are hard. But the reason they’re failing is because we’ve designed them to be safe, siloed, and performative.
What I saw advising the private sector
When companies try to engage in global health, they want to contribute core capabilities — capital, technology, logistics, data, distribution — in ways that align with how their businesses actually operate.
What they’re usually offered instead is a tightly controlled engagement lane:
- A single “approved” entry point
- Minimal connection to core strategy or operations
- Impact framed almost entirely as reputational or philanthropic
In other words: be helpful, but don’t be embedded; be engaged, but not influential.
Companies often reinforce this dynamic themselves. Global health engagement is frequently parked inside CSR, sustainability, or “impact” teams, structurally separated from commercial, operations, product, and market leadership where real leverage sits. These teams are expected to speak the language of public institutions, prove social value, and avoid anything that looks “too commercial.”
The result is a parallel track of engagement that feels safe, but disconnected from how the company actually creates value. When partnerships stall (i.e., slowed by unclear decision-making, limited authority, or constraints on scale) companies disengage quietly. Not because they don’t care, but because the partnership was never designed to meet both public and private realities.
What I observed inside multilateral institutions
Inside global health organizations, I saw the mirror image.
Many institutions now have dedicated private sector teams. But those teams are frequently structurally siloed from real decision-making power. Why?
Because private sector engagement is still treated as something that must be:
- Carefully contained
- Heavily governed
- Designed to remain at an arms length away
So we say partnership is core to how these organizations operate, and then follow it with a rulebook.
Yes, partnership is embedded in who we are. But here is how, when, where, and with whom we partner…and mostly why we don’t.
The result is partnerships that sit alongside strategy, not inside it.
What no one likes to admit
Five hard truths sit beneath most partnership failures:
1. We align on language, not incentives.
We agree on mission statements and principles, but we almost never align on what actually drives behavior.
Public institutions are rewarded for the number of people reached and procedural correctness. Companies are rewarded for speed, scale, and return. Philanthropies are rewarded for attribution.
Then, we’re surprised when decision-making stalls.
If incentives aren’t aligned, no amount of goodwill will save the partnership.
2. Power is uneven, but we pretend it isn’t.
We talk about co-creation, but partnership governance often tells a different story. Who controls budgets? Timelines? Final decisions?
How and when is the community involved?
If decision rights aren’t explicit and transparent, the partnership becomes performative.
3. We confuse caution with integrity.
Fear of influence, conflicts of interest, and bad optics leads us to distance instead of design.
We want private-sector efficiency, innovation, and capital, but we flinch at profit, incentives, or commercial logic. So we design partnerships that ask corporations to act unlike corporations.
4. We underinvest in the work of partnership design and infrastructure development.
We fund programs. We fund innovations. We rarely fund the operating muscle required to hold complex partnerships together.
Partnerships don’t fail because the idea was wrong. They fail because there is no neutral entity owning the design, development and management of the partnership.
5. We say we want impact, but we define it so narrowly that partnerships lose viability.
We ask partners to bring their strongest capabilities, while counting only a fraction of what those capabilities produce.
What counts:
- People reached, doses delivered, or services provided
- Short-term program outputs
- Attribution-friendly metrics that fit donor reporting cycles
- Pilots that demonstrate “proof of concept”
What doesn’t count – often because the measurement systems aren’t funded to track it or don’t exist long enough to measure it:
- Long-term system performance or cost reduction
- Market creation and sustained demand beyond donor funding
- The business value that keeps private partners engaged over time
A final provocation
Cross-sector partnerships are broken because we’ve prioritized optics over outcomes, control over capability, and comfort over effectiveness.
If we’re serious about partnerships, we have to stop asking:
How do we engage the private sector safely?
And start asking:
What would it take for this to actually work, given how institutions really behave?
That’s a harder question. But avoiding it is exactly why we’ve been stuck for the last decade.
Why I built The Partnership Lab
I want to be clear about one thing: I’ve been part of these dynamics too.
I’ve helped design partnerships that were careful, well-intentioned, and ultimately constrained by the same systems they were meant to change. We optimized for alignment, process, and risk management…and too often paid for it with slow speed, lack of clarity, and sub-optimal delivery.
Seeing that pattern repeatedly — and recognizing my own role in it — is what led me to build The Partnership Lab .
The Partnership Lab was created to change how cross-sector partnerships are designed in practice. To build partnerships that can actually launch, scale, and endure.
If we want different results, we need to design for them.