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Abstract
Public–private partnerships (PPPs) are perhaps the key emergent theme in the delivery of what the socio-economic literature terms global public goods. In light of the problems relating to the distribution of health services and products in developing countries, partnerships between public and private institutions are often proposed as an innovative mechanism to reconnect and reorient supply and demand. In this area, the International Aids Vaccine Initiative (IAVI), which is driving the development of candidate HIV/AIDS vaccines through injections of capital into the research process, represents a significant case study. IAVI seeks to form partnerships between key public and private interests committing them to sharing the risks, costs and benefits of research into an effective and affordable vaccine against HIV. Our empirical work covers partnerships based in several countries including Kenya, Uganda, Rwanda and India. Our early findings highlight IAVI's ability as a learning institution as it adapts its institutional arrangements to various local contexts. An offshoot of this appears to be the building of real local capacity.
Notes
1. We would like to thank the UK Economic and Social Research Council for funding this research, the useful comments of two anonymous referees, and the informants in IAVI in India and East Africa who gave of their time and insight.
2. There are several reasons for this fragmentation. These include: the relative decline of the largest pharmaceuticals due to the lack of new blockbuster drugs and other drugs coming off licence; the impacts of intellectual property and patenting; the costs associated with meeting regulations; the enormous expense of clinical trials; tiered pricing systems; and fragmented markets.
3. For one thing no one has developed an immune response strong enough to clear the HIV virus from their body, meaning there is no tangible immune response to model a vaccine on.
4. Fact sheet: IAVI's intellectual property agreements for AIDS vaccine development, New York, IAVI.
5. Interviews conducted with IAVI field staff in Kenya, April 2004.
6. Interview conducted with IAVI field staff in Uganda, May 2004.
7. Interview conducted with IAVI field staff in Uganda, May 2004.
8. Interviews conducted with IAVI field staff in Kenya, Uganda and Rwanda, April 2004.
9. According to Nelson and Winter (Citation1982), the main goal of the evolutionary approach is to explain how agents’ behaviour affects systemic change in different structural conditions, the focus being on the observable role of the economic environment, ‘in defining mistakes and suppressing the mistakes it defines’ (Winter Citation1988, p. 492).
10. That is, transaction-specific investments.
11. Interview with IAVI manager, Nairobi, April 2004.
12. Interview with IAVI Uganda Project Manager, April 2004.
13. Interview with IAVI Rwanda Project Manager, April 2004.
14. Interview with IAVI Rwanda Project Manager, April 2004.
15. Indeed, several new medicine trial initiatives are beginning to build on this nascent trialling capacity in Africa, including a recently announced multimillion euro European Union initiative.
17. Interviews with the Rockefeller Foundation, December 2003.