Philanthropic foundations and the governance of global health: the Rockefeller Foundation and Product Development Partnerships

This paper explores the influence of private philanthropic foundations in the governance of global health. Such foundations, including Rockefeller and Ford, have historically played an important role in infectious disease control, providing seed finance to develop vaccines (e.g. yellow fever) and subsidies for the eradication of certain parasites (e.g. hookworm). More recently these actors have utilised their material resources to facilitate and broker strategic coalitions between civil society groups, transnational corporations, international organisations (IOs) and states in innovative policy arrangements variously known in the literature as public-private, multi-sectoral and multi-stakeholder partnerships. Partnerships, such as the GAVI Alliance, the Institute for OneWorld Health and the Global Fund to Fight AIDS, Malaria and Tuberculosis, to name but a few high-profile cases, have been identified as appropriate policy responses to complex, and seemingly intractable, global health threats. However while theorists and practitioners have devoted considerable attention to the implications of these instruments for health governance, focussing their attention on the quality of health outcomes as well as the normative desirability of multi-actor collaboration, there remains a relative paucity of empirical research on the role played by private philanthropic foundations in both financing partnerships and influencing global health policy. While some researchers recognise the central importance of these actors to the development of the partnership model there is a continued perception that they remain benign agents, rather than actors with considerable leverage to achieve both desirable and undesirable outcomes. This paper attempts to address this vacuum by undertaking a case study analysis of the Rockefeller Foundation’s support for Product Development Partnerships (PDPs) throughout the 1990s and early 2000s. Particular attention is paid to the International AIDS Vaccine Initiative (IAVI), a PDP initiated by the Foundation which played an important role in the emergence of the model as a norm in global health governance. It is suggested that the Rockefeller Foundation’s instrumental role in establishing a blueprint for PDPs, as well as convening meetings that led to the development of financing partnerships like the GAVI Alliance, enabled the Foundation to retain influence in the health sphere, despite its relative decline in assets and diminished importance in the philanthropic sector more generally.