Mitigating health policy fragmentation through interlocks. The networks between American and Swiss public-private partnerships

Abstract

The boards of health partnerships such as the Roll Back Malaria Partnership (RBM) and Medicines for Malaria Venture (MMV) create networks through cross-board membership (interlocks). While these networks bear the risk of cooptation and collusion in corporate governance, in public-private partnerships they may facilitate cooperation and responsiveness to health policy. This is feasible only through networks with specific characteristics discussed in this article. The analysis shows one whole network connecting 10 health partnerships established in Canada, Switzerland and United Sates, and belonging to two different subsectors (Product Development and Coordination and Financing). However, confluence on a few central interlocks makes the behavior of interlock individuals and organizations crucial for the effectiveness of the network, rendering good governance practices all the more important. At the same time, network clustering opens the possibility of tackling interdependencies at sub-level where expertise can be critically brought to bear. The article shows that, whether considered as a vector of collusion or as a bridge for coordination, the practice of overlooking partnership interlocks hinders both health policy oversight and strategic operation.