Global Health Partnerships (GHPs) need humility to embrace the aid modalities of the Paris agenda (national ownership, alignment and harmonization) so as to integrate their efforts with national planning processes and to minimise transaction costs for recipients.

For reasons of justice and efficacy, GHPs need to strive for more balanced representation of stakeholders on their governing bodies which will often involve more sophisticated constituency management arrangements.

Notwithstanding the reality that public and private interaction of some form is required to meet many global health challenges, GHPs need to reassess the prevailing paradigm, which presupposes that market-based approaches are necessarily more efficient than public sector ones. More systematic costing of alternative approaches is called for.

A number of standard operating procedures should be adopted by GHPs so as to improve performance and mutual accountability. These include articulating ‘SMART’ objectives, defining roles, responsibilities and decision rights, and regularly undertaking consolidated partnership wide planning.

GHPs require improved oversight. This involves, among other things, applying standards for the selection of partners, be they corporate, civil society or public, establishing systems for managing conflict of interest, and ensuring that basic elements of transparency are observed.

Partnerships must be adequately resourced to prosper. Financing gaps can be minimized through setting more realistic targets and/or ensuring that plans identify specific partners to plug gaps. Partners must also acknowledge the real costs of alliance management and agree on how to finance them.

For too long GHPs have focused on product-oriented interventions and communicable diseases. It is time to use similarly innovative public–private (and civic) interactions to address non-communicable diseases and life-style risk factors, which arise partially as a result of core corporate activities. Needless to say, NCD partnerships should learn from the communicable disease arena and leapfrog to a next generation of better-governed partnerships.

A simple assessment mechanism should be devised to score GHPs on a biennial basis on their performance across a range of indicators. The resulting assessment might aid investors (particularly donors and foundations) make decisions on supporting GHPs. It might also provide reform-oriented partners ammunition in dealing with recalcitrant partners, secretariats or hosts.