Exploring the Role of Public-Private Partnerships in Advancing the Development of Health Technology in a Global Market: A Case Study of Gavi, the Vaccine Alliance

Public-private partnership (PPP) is an innovative collaboration among multi-sectoral organization actors in health technology development and often constitutes various forms of governance arrangements driven by socio-economic mechanisms. In this case study, I used a naturalistic and observational approach to collect data on organization actors involved in developing childhood vaccines for the resource-limited countries. The organization networks were reconstructed to examine the PPP governance structure and the nature of actors’ relations. Social network methods were applied to analyze the roles and positions of these organization actors in a complex governance structure based on their relational contracts to promote accelerated introduction of pneumococcal and rotavirus vaccines supported by Gavi, the vaccine alliance (Gavi). My study results showed that, overall, UNICEF and Gavi were the influential and popular actors in the advice, vaccine procurement and financing networks and had control over financial and information flow. The two whole networks for Advance Market Commitment (AMC) and International finance facility for immunization (IFFIm) were loosely connected and highly fragmented. The composition of organization actors for both networks were fairly similar, but more recipient governments and enabling government organizations-affiliated actors participated in the AMC network. Most non-profit organizations involved in this partnership were research institutions and health services organizations. Simple hierarchical and efficient structure were observed in most of the networks, except collaboration network, which showed horizontal integration with more balanced relationships between organization actors. UNICEF, Gavi, and London School of Hygiene and Tropical Medicine were the top organization actors brokering relationships and connecting other organization actors across sectors. No difference was observed between the immunization coverage for both vaccines and among countries grouped by AMC and IFFIm and income categories determined by Gavi eligibility policy. In general, there was a significant improvement in vaccine coverage before and after the accelerated introduction of pneumococcal and rotavirus vaccines. My study results suggested a new approach to analyze global health PPP structure and assess organization actors’ network relationships. When an alliance is properly formed, it offers valuable opportunities for participants to gain access to resources, expert knowledge, and needed support