Real Collaboration: What It Takes for Global Health to Succeed

By Mark L.Rosenberg, Elisabeth S.Hayes, Margaret H.McIntyre, and NancyNeill . Published by University of California Press , Berkeley and Los Angeles , 2010 . Hardcover 280 pages , ISBN 9780520259508 ; rrp A$40.95 .

Reviewed by Priscilla Pyett

Department of Health Social Science, School of Public Health and Preventive Medicine, Monash University, Victoria

I confess that as a sociologist and public health researcher my interest in this book lies primarily in the first part of the title –Real Collaboration– and less in the extravagant claims of the subtitle What it takes for global health to succeed. I was also, selfishly, disappointed that it does not include research collaboration but focuses on collaborations for implementing programs for disease prevention. However, there are many lessons for researchers and practitioners to be gained from this valuable book which brings together the wisdom and experience of some great leaders and innovators in the global health field. At times one feels almost as if one is eavesdropping on the conversations of some of these giants of successful global immunisation and disease eradication programs (think smallpox and polio, for example). With a Foreword by Daniel Fox and a Preface by William Foege, the authors include eminent public health practitioners Mark Rosenberg, CEO of the Task Force for Global Health, and Elisabeth Hayes who is Associate Director of the Center for Global Health Collaboration at The Task Force for Global Health.

The case studies include dramatic examples of problem-solving in local partnerships in India, for instance, as part of the global struggle to eradicate smallpox, or in Africa, during a campaign to control onchocerciasis or river blindness. Partners in this book include WHO, UNICEF, the Gates Foundation, the World Bank, and an example of advocacy cites a project that built social capital among ambassadors at the UN! Most of us will never participate in such high-profile programs but it is a privilege to share the experiences and insights that are so generously and honestly imparted throughout this book.

The book is based on an analysis of seven international projects selected because they provided rich lessons and because the partners were willing to reflect on the weaknesses as well as the strengths of their efforts. Consultation and analysis were conducted by a highly qualified research team supported by an even more experienced advisory team. The chapters are organised around a Partnership Pathway with a practical toolkit in the appendix to guide leaders and partners through the four stages: Genesis, the First Mile, the Journey and the Last Mile. The book also comes with a DVD and online resources, providing the toolkit in PDF format. I found some of the forms rather wordy and technical for use by community participants, but no doubt experienced collaborators could modify relevant forms for the local context.

What the authors mean by ‘real collaboration’ is not expected to be the norm for global health partnerships but is regarded as ‘the most powerful form of collaboration’ and as ‘absolutely necessary to accomplish certain goals’. They recognise the complexity of ‘real collaboration’, particularly in the international context, due to the severity of the health problems, the lack of infrastructure, the diversity of cultures and expectations when different countries are involved, and the ever-changing political challenges. Real collaboration is a challenge for public health researchers and practitioners in an Australian context as well, and particularly in the highly political and complex area of Aboriginal health. Some of the key elements identified in ‘real collaboration’ are identifying and including all the key stakeholders from the outset; building trust; demonstrating flexibility; ensuring good communication, good governance and project management; sharing power and building skills in the local organisations; and the ‘willingness of partners to set aside business-as-usual and consider new possibilities together’. I humbly suggest that many of these have been identified as key characteristics of ethical and effective collaborative research with Aboriginal communities.1,2

I was encouraged to read that the authors believe that effective collaboration can be taught, but that they also recognise that ‘it cannot be taught in a single lecture or even through one very well written paper or book’ (presumably a cheeky reference to this book!). Through their case studies the authors address issues such as governance, project management and sustainability, including the importance of transferring skills and power to the local organisations before exiting the field. The authors recognise the more obvious need to ensure members of the partnership bring relevant knowledge, resources, skills, agendas, shared vision and buy-in, but also the less well recognised value of optimism and emotional intelligence. This is a very accessible book that could be useful to a wide range of students and practitioners in public health, community development and international health.