How Long Can Health Systems Afford to Sideline the Private Sector?

When money is tight, how do trust and control shift in partnerships?

As traditional funding streams become less reliable, organizations can no longer rely on familiar, comfortable partnership patterns. Health systems, governments, non-governmental organizations (NGOs), and community groups may need to reconsider who they work with and on what terms. Organizations that once kept industry at arm’s length may now be rethinking those boundaries and raising difficult questions about trust, control, and aligned motives. When a private partner brings both funding and implementation expertise, how should roles and decision rights be structured so that local communities and governments retain autonomy while still benefiting from the industry’s capacity to deliver results at scale? This type of question calls for more deliberate thinking about cross‑sector strategy and public–private collaboration in health care.

What unique value does industry bring beyond the money?

Many companies excel in implementation, operations, data systems, and scaling complex interventions, areas where public and nonprofit organizations may struggle. These capabilities can significantly enhance the impact of health initiatives, particularly as resources tighten in domains such as global health and women’s health. Yet most companies expect a say in how their investments are used, which can reveal concerns about influence and control when roles are not clearly defined. Navigating this tension requires deliberate approaches to responsible engagement: clarifying decision‑making authority, agreeing on shared outcomes, and building transparency mechanisms to leverage industry expertise without compromising public health priorities.

How can we build health innovation ecosystems that foster collaboration among competitors?

Complex health challenges rarely fall within the remit of a single organization or sector. Assuming that competitors cannot or will not work together constrains what health systems believe is possible. In reality, no single organization can provide all the technologies, services, or innovation pathways needed to address complex, system-level challenges. An ecosystem mindset starts from a different premise: multiple private firms, public institutions, and civil society organizations each fill well‑defined roles, contributing their strengths and acknowledging their limitations. In these environments, companies can be explicit about where they add value and where others may be better positioned to lead. Thoughtful and intentional orchestration of these relationships is important to how cross-sector collaborations function across different health systems.

Key question to take forward:

As you watch the video and consider your own setting, you might reflect on: 

How could you and your organization rethink your partnerships to achieve a more sustainable health impact?

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