There is no one-type-fits-all public–private partnership for food and nutrition research or initiatives. The structures and functions of cross-sector collaborations vary, depending on the types of entities partnering, partner intentions and contributions, and the type of project. When describing the range of Foundation for the National Institutes of Health public health partnerships, Andrea Baruchin, director of NIH Relations at FNIH, remarked, “I always say, when we’ve seen one partnership, we’ve seen one partnership, because every one [is] different.” This chapter summarizes the workshop presentations and discussion on model public–private partnerships, including the many public–private biomedical partnerships managed or coordinated by FNIH and the various food and nutrition–related partnerships in which the U.S. Centers for Disease Control and Prevention and U.S. Department of Agriculture participate.
What makes for a successful public–private partnership? Descriptions of existing cross-sectoral initiatives prompted many questions about how existing public–private partnerships manage conflict of interest, intrasectoral competition, and other challenges. Baruchin’s description of the FNIH-managed Biomarkers Consortium, a large-scale public–private partnership with broad participation from a variety of stakeholders, triggered an especially lively question-and-answer period. The question-and-answer periods fed into the broader discussion on key features of successful public–private partnerships. Also included in this chapter is a summary of that discussion.
There was little attempt to categorize the wide range of possible collaborative relationships. However, David Castle offered some general insights on variations in public–private collaboration, with an emphasis on varia-
tion in partner intention and strategic focus. He identified six strategic elements to consider when thinking about the value of potential partnerships. His presentation is summarized at the end of this chapter.
Over the course of the workshop, participants raised many examples of public–private partnerships. Several models that were discussed in more detail are highlighted below. Andrea Baruchin provided an overview of several models of public–private partnerships being coordinated and/or managed by FNIH. William Dietz of CDC and Rob Post of the USDA Center for Nutrition Policy and Promotion also discussed the types of partnerships in which their agencies are engaged.
Foundation for the National Institutes of Health1
The FNIH was created and authorized by the U.S. Congress specifically to develop public–private partnerships in support of the NIH mission. The foundation is a nonprofit NGO with an independent board of directors. The current board of directors is a mix of representatives from academia, philanthropy, and industry; the director of NIH and the commissioner of the U.S. Food and Drug Administration (FDA) are on the board as ex-officio members. Since its formation in 1996, FNIH has raised approximately $590 million in support of more than 400 projects. Because it has no endowment, FNIH depends on both unrestricted and restricted donations. Additionally, because the foundation must raise money to support not only its programs but also its own administrative costs, all partnerships include an administrative fee. At any one time, the organization is managing about 100 projects, ranging in size from very large (e.g., the Biomarkers Consortium; see below) to very small (e.g., the many research projects, fellowships, awards, and other special activities established by individual donors). The foundation works with all 27 NIH institutes and centers and with a range of partners, including corporations, other foundations, academia, federal agencies, and philanthropic individuals. The FNIH has received a 4-star Charity Navigator rating for the past 5 years in recognition of the fact that most of its money, specifically, 94 cents of every dollar, directly supports programs.
Baruchin described the FNIH as a “neutral third party” that brings partners together and as a “facilitator” to ensure that all partners’ voices are heard. She emphasized the “flexible” structure of FNIH partnerships, which come in multiple shapes and sizes, depending on partners’ needs.
1 This section is largely a summary of Andrea Baruchin’s presentation.
The FNIH operates two general types of partnerships: (1) NIH-managed partnerships, whereby funds are raised from private donors and partners to expand ongoing NIH activities and for which FNIH acts as a coordinator of the partnership, following all NIH rules; and (2) FNIH-managed partnerships, such as the Biomarkers Consortium, whereby the partnerships develop or support activities that take advantage of NIH expertise but are not led by NIH and for which FNIH coordinates and manages the partnership. In NIH-managed partnerships, FNIH transfers the donated funds to NIH, which then manages the science and expends the funds as necessary; FNIH sometimes coordinates the partnership through an external, or private partner, scientific board with all partners represented. In FNIH-managed partnerships, the FNIH manages all aspects of the program.
One of the largest and best known FNIH-managed partnerships is the Biomarkers Consortium, a partnership founded by FNIH, NIH, and the FDA, with other partners including the Centers for Medicare & Medicaid Services, the Biotechnology Industry Organization, and the Pharmaceutical Researchers and Manufacturers of America. The consortium was launched in 2006 to identify, develop, and validate biomarkers for use in new drug development, preventive medicine, and medical diagnostics. The partnership has 50 contributing members, including 24 companies and 26 nonprofit organizations, advocacy groups, and trade associations. To date, the consortium has launched 14 projects, 2 of which have been completed, at a total worth of approximately $42 million. The FNIH begins fundraising only after a project proposal has been evaluated by one of four steering committees (cancer, neuroscience, inflammation and immunity, and metabolic disorders) and, if approved, its protocol has been checked by an executive committee.
I-SPY 2, an adaptive breast cancer trial, is another FNIH-managed partnership. The FNIH serves many different roles in the partnership, from fundraising to intellectual property management (e.g., it holds the master Investigational New Drug [IND] application with the FDA). The trial is adaptive in the sense that treatment is based on the individual biology of each participant’s tumor (i.e., biomarker measurements). With respect to intellectual property, while most FNIH-managed partnerships are constructed in the precompetitive space, this one pushes slightly beyond that space. To avoid or handle potential intellectual property problems, the partnership uses policies generated by the Biomarkers Consortium, such that no single company stands to be the sole beneficiary of the I-SPY 2 project. New intellectual property is to be managed by the FNIH, which acts as a trusted third party and ensures the fair licensing of new inventions.
As an example of an NIH-managed partnership, Baruchin highlighted the Alzheimer’s Disease Neuroimaging Initiative (ADNI), a 10-year cooperative agreement grant that NIH launched through the National Institute
of Aging (NIA) in 2004. The initiative has 24 private-company, 1 government, and 2 nonprofit-organization partners. The goal of the study is to define the progression of Alzheimer’s disease by tracking normal, early, and mildly cognitively impaired subjects and Alzheimer’s disease patients and to identify biomarkers that can be used as predictors of the disease. Baruchin emphasized how it was decided early on that the partnership would be “very open,” with industry partners involved “from the get-go” and with data released almost in real time. The grant is administered by NIA and a steering committee, with a separate Scientist Advisory Board and a Private Partner Scientific Board (PPSB) coordinated by FNIH. Members of the PPSB participate in ADNI steering committee meetings, and the chair of the PPSB is a nonvoting member of the steering committee. The PPSB also funds ancillary projects.
During the question-and-answer period, Baruchin identified several key lessons learned from partnership work that the FNIH has been involved with since its origins in the mid-1990s:
• Taking time to develop a public–private partnership. Public–private partnerships, particularly large-scale projects, take time to develop. For example, the Biomarkers Consortium and the ADNI each took more than 2 years to establish.
• Managing conflict-of-interest issues. FNIH manages potential conflict-of-interest challenges, specifically the perceived or actual loss of government credibility as a result of partnering with industry, in several ways. Many projects involve multiple industry partners such that there is no real or perceived quid pro quo to any individual partner. Also, FNIH provides a neutral space with all stakeholders assembled when issues are discussed and maintains open and transparent governance policies.
• Avoiding intrasectoral competition. FNIH avoids potential intrasectoral competition by focusing on the precompetitive space. In cases where potential private industry partners are concerned about competition, those partners do not join.
• Opting out of a partnership. Baruchin could not recall any instance where an FNIH partner opted out of a partnership after the partnership was under way, probably because of the extensive up-front discussion that takes place around rules, governance, and other issues. However, she observed that a growing number of commitments are conditional (i.e., continued funding depends on the deliverables produced at the end of a specific time period).
Public–Private Partnerships at the CDC2
Most of the food and nutrition public–private partnerships with which the CDC is engaged are not research partnerships. Rather, their focus is on how to improve the diet. Nonetheless, they serve as a valuable model and source of lessons learned. Dietz described two CDC food and nutrition partnerships: the National Fruit and Vegetable Alliance (NFVA) and the Flour Fortification Initiative (FFI). The NFVA is a national alliance of public and private partners working collaboratively to increase nationwide access to and demand for all forms of fruits and vegetables. The alliance involves both federal and state government agencies, industry partners, and a number of NGOs or civic organizations. The FFI is a 10-year-old network that builds alliances between governments and international agencies, the wheat and flour industries, and consumer and civic organizations to promote wheat and maize flour fortification with vitamins and minerals. Dietz attributed the success of both partnerships to several factors:
• relatively narrow targets;
• common agendas that benefit all partners (with partners benefiting for different reasons);
• complementary skills, contacts, and perspectives that the different partners bring; and
• real incentives for industry partners to collaborate with each other, with no or limited financial disincentives (e.g., in the case of FFI, regulation around fortification provides incentive for flour millers to spend the money to fortify without putting themselves at a competitive disadvantage).
Partnering by the USDA Center for Nutrition Policy and Promotion3
The USDA Center for Nutrition Policy and Promotion maintains three types of partnerships, all of which involve collaboration with public and private organizations of different types:
1. Policy development partnerships. Post pointed to the 2010 Dietary Guidelines for Americans as an example of a policy development partnership. He maintained that an important phase of policy development partnerships is the solicitation of public input and comments. Development of the 2010 Dietary Guidelines for Americans,
2 This section summarizes information presented by William Dietz.
3 This section summarizes information presented by Robert Post.
for example, was a 4-year process, much of which involved public input and the collection of information from partners.
2. Systematic review partnerships. Systematic review partnerships inform federal nutrition policies and programs. Post explained how CNPP created a Nutrition Evidence Library (NEL) to conduct the systematic reviews; NEL staff collaborates with a Technical Expert Collaborative (TEC) to guide the systematic review process. Typically, six to eight experts outside the public sector are involved with each review.
3. Nutrition promotion partnerships (i.e., the Nutrition Communicators Network). Post opined that there is a paradigm shift in USDA’s approach to communicating and conducting outreach for the 2010 Dietary Guidelines for Americans. One of the pillars of the new multicomponent, multiyear, and sustained MyPlate4 communications initiative is using partnerships with each sector to magnify the reach of Dietary Guidelines messages. These nutrition promotion partnerships are where CNPP has really excelled in harnessing the power of partnership. The Nutrition Communicators Network, a commitment to promoting healthy eating in accordance with the 2010 Dietary Guidelines for Americans, builds on experience gained through the MyPyramid Alliance. The goals of the Nutrition Communicators Network are to go beyond communicating information by also affecting behavior, which means “giving people the “how-tos,” and to effectively harness partners’ expertise and networks in order to reach as many audiences as possible. The vision is to embody the socioecological framework in Chapter 5 of the Dietary Guidelines and answer the call-to-action in Chapter 6, where all sectors and levels of society have a role to play. The network extends across more than 6,000 community-based partners (e.g., dietitians, educators, community programs, doctors, schools) and 90 national strategic partners (e.g., health care corporations, media outlets, grocery retailers, health professional associations, restaurant chains, food manufacturers), with the aim to reach as many consumers as possible and at all of the places where consumers are making food decisions. These relationships leverage resources in novel ways to reach the consumer and are all established through agreements with no financial remuneration.
What makes for a successful public–private partnership? Workshop participants broached the subject at various times during the course of the workshop. This chapter draws from the many presentations and conversations that addressed the key features of successful public–private partnerships.5 Seven features are highlighted: (1) a sense of authentic trust; (2) mutuality (working toward a common goal, with the benefits of achieving that goal being different for different partners); (3) the feasibility of achieving the desired outcome; (4) joint planning; (5) the formulation of clear procedural steps for risk mitigation; (6) the establishment of general project management processes; and (7) complementarity (all partners contributing unique but complementary resources). The order of features listed here does not necessarily reflect the perceived importance of the different features, but rather the amount of time spent addressing each topic.
Several workshop participants identified trust as one feature, if not the most important, of successful public–private partnerships. For example, Woteki noted that trust was the single most important feature of a sampling of successful public–private partnerships surveyed across the United States, Europe, and Australia (Woteki, unpublished data). Individual participants from a third session breakout group identified trust as one of the most important factors to consider when deciding whether to form a new partnership, mostly because of the important role that trust plays in risk mitigation (a more detailed description of the report-backs from that breakout session is provided later in this report).
What Kind of Trust?
Trust is not black and white. Rather, as Finegood explained, it is a spectrum. She reviewed Solomon and Flores’ (2001) work on trust, noting that on one end is blind trust, which is trust in an individual or institution that, if betrayed, nonetheless persists. Blind trust requires a certain amount of self-deception. Next on the spectrum is simple trust, which is very difficult to recover if betrayed. Simple trust is devoid of suspicion and taken for granted. At the other end of the spectrum is cordial hypocrisy: a façade of good will and congeniality that hides distrust. Cordial hypocrisy can be
5 Many of the attributed remarks in this section were raised during the panel moderated by David Castle. Panelists included Richard Black, William Dietz, Jonathon Marks, Robert Post, and Catherine Woteki.
6 Some of the information in this section summarizes material presented by Diane Finegood.
very destructive to teamwork and makes honest communication impossible. In the middle of the spectrum, between simple trust and cordial hypocrisy, is authentic trust. Authentic trust is not trust that can be taken for granted. Rather, it is based on recognition of the possibility of betrayal and disappointment and the need for continuous cultivation. Authentic trust is mature, articulated, and carefully considered (Solomon and Flores, 2001). It is, Finegood said, “what we have to strive for.”
Authentic trust is important because it reduces complexity. Finegood explained that worrying about trust adds a level of complexity to a situation and that building trust reduces that complexity and enables cooperation. Authentic trust is less important in hierarchical systems, where top levels of the hierarchy dictate what happens at the lower levels. Yet, as systems become more network-based, the need for collaboration—and the need for authentic trust—becomes more important.
Black emphasized two types of trust: individual and institutional. Even if an individual trusts another individual on a personal level, if the first individual does not trust that the organization to which the second individual belongs is “going to do the right thing,” there is no potential for success. He said, “Not only does the [partnership] need to be based on trust at the personal but also at the organizational level.”
While most of the discussion around trust was focused on intersectoral dynamics, that is, the relationships between individuals and institutions from academia, government, industry, and public-interest NGOs, several workshop participants mentioned the significance of intrasectoral trust. For example, Black observed during the Building Trust workshops what he described as competition and a lack of trust between individuals within sectors. Individuals in academia do not always trust each other, nor do individuals in industry always trust each other, and so on. Finegood expressed a similar sentiment, noting that a major take-home lesson for her from the Building Trust workshops was the “aha!” moment she had when she realized that within-sector trust is more difficult to build than between-sector trust. Up until that moment, she had assumed that working with people from other sectors whose roles she did not understand would be more challenging. She observed that within-sector competition makes collaboration very difficult. This is true not just of the private sector, where different companies are competing for customer dollars, but also within academia, where different institutions or researchers are competing for profile; in the NGO sector, where different organizations are competing for donor dollars or membership; and in government, where different agencies are competing for a fixed set of tax dollars.
How to Build Authentic Trust
Building trust is not a simple task. The Building Trust Initiative developed a cluster map of barriers to building authentic trust that illustrates the magnitude of the challenge. The clusters, or barriers, include self-interest and fear, nonconstructive criticism and closed-mindedness, stereotypes and misrepresentations of other sectors, awareness and manipulation of knowledge, system barriers, competing and conflicting world views, and organizational and individual rigidity.
Nor is there a single best way to build trust. Woteki observed that while partnerships built trust in different ways, most of those ways revolve around “planning up front and getting the right kind of groundwork set.” That includes joint planning (having all partners involved in the planning from the get-go; see below), dealing with intellectual property (IP) issues, and establishing appropriate IP agreements up front (e.g., as FNIH does). Finegood remarked that another key lesson learned from the Building Trust workshops was that trust building requires a safe space. Safe spaces are important for starting conversations and deepening the different sectors’ understanding of each other, celebrating successes, and catalyzing new collaborations before the partnerships are entered into the public sphere. One participant suggested that one way to begin building authentic trust is to “put a fence around” the issue that is going to be addressed by the partnership and agree to trust each other with respect to that one issue and to leave contentious issues off the table.
In a workshop setting, trust can be addressed openly, as it was at the Building Bridges Dialogue meeting, where the entire first half of the day was spent discussing barriers to trust between industry, academia, and government. Alternatively, it can be addressed in a more indirect or secondary way by recognizing the challenge of trust but keeping the focus on other issues. The NCI-USDA meeting took an indirect approach (see Chapter 1 for more detailed information on those meetings). It is not clear which of the two approaches is more effective or more desirable and under what circumstances. One participant remarked that the approach taken by the Building Bridges Dialogue was “extremely productive” because the issue of trust “was on everybody’s mind anyway, so you might as well get it out on the table.” The NCI-USDA meeting, on the other hand, was planned and attended by scientists who wanted to jointly identify potentially collaborative areas of mutual interest. Toner explained that while the intention of the NCI-USDA meeting was to discuss science, not trust, nonetheless there was awareness that trust would have to be discussed at some point. For that meeting, however, the purpose was to start the conversation and lay some groundwork for future in-depth efforts, including discussions of trust.
Mutuality means that all partners are working toward the same goal and that all partners stand to benefit from achievement of that goal, even though they may not benefit in the same way. Many workshop participants noted that mutuality is another important feature of successful partnerships. Dietz mentioned that commonality of interests is an important feature of the National Fruit and Vegetable Alliance, with partners sharing the common goal of increasing fruit and vegetable intake even though their reasons for pursuing that goal differ. Industry partners want to increase sales, while government and NGO partners want to improve the public’s health. In the informal survey that Woteki conducted of public–private partnerships across the United States, Europe, and Australia, respondents identified mutuality as the third most important feature of successful partnerships (after trust and joint planning). According to the results of the survey, academic partners were primarily interested in advancing knowledge and gaining publication; industry partners were primarily interested in getting a particular problem solved and incorporating the solution into their operations or commercial production; and government partners were primarily interested in long-term public good. These results align fairly well with the results from this workshop’s pre-meeting survey (see discussion in Chapter 2).
Commonality of interests does not necessarily mean agreement, one participant explained. Sometimes partners have different wishes for what the ultimate outcome of their partnership will be, in which case it is important for all partners to agree that the approach to achieve the goal will enable all parties to accept the outcome, even if it is not the preferred outcome. That participant pointed to past research on trans fats as an example of an intersectoral collaborative effort characterized by “tolerance for the opposing view,” with the food industry wishing for a different outcome than what was achieved but tolerating the outcome and moving forward accordingly. What all parties had in common in the trans fat example was the need to resolve the issue with a scientific approach that could be accepted by all stakeholders. Another participant pointed out that disagreement is often misinterpreted as disinterest and, as such, creates a perceived barrier to partnership. He suggested that if managed early, dissensus, or friction, could actually become a useful tool for identifying real problems that need to be addressed in order to move forward. Castle mentioned how, in an entirely different context (i.e., industrialized aquaculture), he and his colleagues were able to move beyond contention and give shape to a very contentious set of issues by not presuming that consensus was going to be reached and by identifying and focusing first on areas about which potential partners disagreed the most.
With mutuality, not only is it important that all partners stand to benefit from the partnership, but also that none stand to be put at any sort of disadvantage because of it. Dietz called attention to the need for a “level playing field,” with incentives in place to ensure that no one company is placed at a competitive disadvantage because of its participation in the partnership. For example, the Flour Fortification Initiative relies on government regulation to provide a level playing field and offset the cost of fortification. Finegood observed that some people in the public sector do not realize how important regulation is to leveling the playing field and reducing competition within the private sector.
Feasibility and Achievability
Several workshop participants identified “narrow targets” or, as Black put it, “feasibility of achieving the desired outcome,” as another key feature of successful partnerships. As previously mentioned, Dietz observed that the success of the National Fruit and Vegetable Alliance and the Flour Fortification Initiative can be partly attributed to their narrow targets. Increasing fruit and vegetable consumption is a relatively narrow target compared to, say, reducing obesity.
However, feasibility is a serious challenge. For example, reducing the sugar content of sugar-sweetened beverages, as a narrow-target way to reduce calorie intake, is not as simple as it sounds, according to Black. Black pointed out several problems with recent suggestions that the food industry slowly reduce the amount of sugar in sugar-sweetened beverages, at the same pace across all sugar-sweetened beverages, in order to “wean” people off the sweet taste. First, reducing sugar does not necessarily reduce the sweet taste. There are many ways to create a sweet taste without sugar. So the mandate would have to be to reduce sweetness, not just sugar content. Second, sugar-sweetened beverages are not the only sweet beverages available to consumers. For example, many natural juices are very sweet. So the mandate would have to extend to juices. Third, sweet beverages are not the only sweet products available to consumers. So the mandate would have to extend to all sweet food products. In fact, the entire food industry would have to join the effort and do so at the same time so that no single company is placed at a competitive disadvantage. Fourth, reducing sweetness does not necessarily translate into reduced caloric intake, which is the ultimate goal or reason for trying to wean people off the sweet taste in the first place. If food producers reduce sweetness without reducing calorie content, the effort would be for nil. So the mandate would have to be to reduce sweetness and calorie content.
Some workshop participants stressed the importance of joint planning, with all partners involved in planning activities from the beginning, and of maintaining a space for all partners to have an equal voice throughout the duration of the partnership. In the informal survey of public–private partnerships across the United States, Europe, and Australia that Woteki mentioned, respondents identified joint planning as the second most important feature of a successful partnership (i.e., after trust). That is, all partners were involved in planning projects from the beginning and continued to remain involved as the projects matured. Black pointed to the Keystone Food and Nutrition Roundtable development of a unified front-of-package labeling program as a partnership built on a fully participatory process. The partnership was mediated by an impartial moderator who ensured that all partners had equal voices.
Risk Mitigation Measures
Despite the value of the Keystone participatory process as noted by Black, when it was announced, this multisectoral approach to developing a universal front-of-package labeling system faced high-profile skepticism in the media from some public-interest NGO and academic representatives. Black acknowledged that without giving special consideration to risk mitigation from the outset, partnerships such as the Keystone example can be confronted with public skepticism or unanticipated controversy. Throughout the workshop, several participants similarly stressed the importance of anticipating and managing partnership risk. Some examples of tools that may help minimize risks associated with cross-sector collaboration are featured in Chapter 4.
Mechanics of Partnering
Although the mechanics of partnering, such as who does what when, were not discussed at length, some participants identified certain functional aspects as being key features of a successful partnership. Black stressed that individuals at the table must have the authority or mandate to negotiate on behalf of an organization. He said, “It’s really essential that when you’re participating in a conversation you can actually speak on behalf of your organization.” By “organization,” he was referring broadly to a company, academic organization, or any other type of organization. When individuals meet to discuss partnership ideas or issues but then have to “check back” with their organizations, the dialogue “crashes.” He also pointed to the importance of legal accountability around risk mitigation (i.e., “who owns
what, who has to do what”) and of standard project management concerns. Others stressed the importance of having procedures in place for data and intellectual property management.
Several participants emphasized the importance of each partner’s contributing something unique to the partnership—whether scientific expertise, facilities, food product(s) around which the partnership revolves, money, or other resources. Partnering does not necessarily involve providing actual funds or even in-kind goods or services; there are many ways to contribute.
As illustrated earlier, clearly there is a wide range of collaborative possibility. There are many different types of partnering entities, many different types of projects that partners collaborate on, and many different ways that partners contribute to partnerships. There are also many different strategies behind public–private collaboration. Castle identified six strategic elements to consider when thinking about the value of a potential partnership:
1. nature of the relationship among the partners;
2. management function of the partnership;
3. extent of risk transference from one partner to another;
4. research function of the partnership;
5. type of knowledge created by the partnership; and
6. how the partnership is framed.
Each of these strategic elements is expanded on below. Castle urged people to consider how these six strategic elements could be captured in a decision-making pathway such as the one depicted in Figure 3-1.
Nature of the Relationship
The relational nature of a public–private partnership can be either consultative, whereby the public sector, or state, seeks input from outside organizations or groups; contributory, whereby the state funds a particular cause or organization; operational, whereby the state partners with outside organizations and groups but retains all power; or substantive, whereby risk and reward are correlated with equity and decision-making power. Castle noted that some people consider substantive partnerships to be
7 This section summarizes David Castle’s presentation.
FIGURE 3-1 A benefit-risk decision-making pathway for engaging in publicâ€“private partnerships.
SOURCE: Kraak et al., 2011.
the only “true” partnerships and the norm toward which all partnerships should be striving, implying that the others involve certain compromises. In his opinion, while the other three types of partnerships may involve some compromise, they often work well as short-term tactical collaborations.
Castle explained that partnerships are “not always about the objectives and goals.” Sometimes, the purpose of a partnership is to deal with more proximate issues that need to be worked out. He identified three types of management function:
1. network management, whereby the partnership is built around the need to manage a research, information sharing, public communication, or other network and is focused on the joint development of rules, norms, and incentives;
2. project management, whereby the partnership is built around the need to develop goals and implement resources for a specific project; and
3. process management, whereby the partnership is built around the need to facilitate interaction and cooperation between actors in long-term projects (e.g., academia and industry working together on a problem, with government managing the process and ensuring that it runs smoothly).
Extent of Risk Transference
Many people tend to “tiptoe” around the issue of risk transference, Castle observed, because of the difficult discussions that the issue prompts (e.g., who is most exposed to risk, whether risk is being silently transferred from one partner to another). Partnerships manifest varying levels and types of risk transference, with capital-intensive infrastructure projects typically having different levels and types of risk transference than projects built on existing capital. While risk transference often involves legal liability, it could also involve operational risk. For example, in a jointly developed lab facility, operational risk transference questions that could arise include the following: Who actually takes on the responsibility for thinking about how the lab is going to be designed and built? Who actually takes on the responsibility for financing, leasing or buying, and taking on all of the various other operational tasks?
Although the focus of this meeting was on research partnerships, not all research partnerships are alike. Castle identified three ways that partnerships can function in a research-based collaboration. First, some partnerships create transactional spaces for managing uncertainties and hidden costs. For example, many universities have a difficult time managing the inflating costs of scientific research infrastructure and will partner with industry entities that take on that role. Second, some research partnerships are strategically based on the need to obtain certain scales of economy and scope. Third, the private sector often enters into partnerships from which it can derive the benefits of knowledge generation without taking on all the risks of generating that knowledge. Sometimes long-term research requires public investment because of private-sector need for short-term return on investment. A problem with risk-averse industrial research partnerships, Castle noted, is that the overall rates of in-house industrial research tend to decrease over time.
Type of Knowledge
Castle listed four types of knowledge generated by research partnerships:
1. know-why, whereby partnering with university-based researchers guarantees the formal and collective development of codified knowledge, with peer-reviewed publication;
2. codified know-how, whereby the knowledge generated is the subject of intellectual property rights, mostly in the form of patents but also trade secrets, and which often involves a collaborative licensing agreement;
3. tacit know-how, whereby the knowledge generated is in the form of an intellectual asset that needs to be managed (i.e., knowledge that is not directly fixed in a commodified or licensed product or service), often does not have the potential for licensing, and therefore, tends to involve informal partnering; and
4. know-who, whereby partnerships are based on the identification and location of key individuals, organizations, and networks.
Know-who is arguably the most important strategic element to consider when evaluating whether to enter a new partnership, Castle suggested.
Framing of the Partnership
Finally, Castle emphasized the importance of framing public–private partnerships as “innovation systems,” that is, systems that are able to ac-
commodate the constant reconfiguring of the “triple helix” of industry, academia, and government that our changing public health landscape demands. “The targets are moving,” he said. “For the longest period of time it might have been communicable diseases. Now we’re talking about an era where our principal focus is on non-communicable diseases. In the future, non-communicable diseases will remain a problem, but it might also actually be the case that we get so good at dealing with non-communicable diseases of the body that we find our major struggle will be to cope with people who live longer physical lives but their minds do not stay as healthy.” In response to the triple helix, one participant suggested the metaphor be amplified, perhaps to a “double, double helix,” to include the public, such as through the involvement of public-interest NGOs.