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  • Real Collaboration: What it Takes for Global Health to Succeed
  • Michael L. Rowland, PhD (bio)
Real Collaboration: What it Takes for Global Health to Succeed, by Mark L. Rosenberg, Elisabeth S. Hayes, Margaret H. McIntyre, and Nancy Neill. Berkeley and Los Angeles, CA: University of California Press, 2010. 280 pp. with DVD.

Health-related human suffering abounds world-wide, whether because of disease outbreaks, such as the recent cholera outbreak in Haiti, or illnesses and injuries from natural disasters or other calamities. Given the ease and rapid increase of transfer of germs, viruses, and bacteria across borders, there is a growing need to better understand how to address global health concerns and needs of the world population, and (just as importantly) how individuals, corporations, organizations, and countries can work together to eradicate global health threats.

The authors of Real Collaboration sought to address the research question, "How can global health leaders achieve close collaboration and have a bigger impact?"[p.9] The book is full of insights from some of the most influential world leaders in global health. It is based on over a hundred interviews. In addition, the findings were triangulated with [End Page 390] insights from an advisory panel and by a 2006 symposium at the Carter Center that was used to explore further the findings and conclusions on close collaborations.

Readers should certainly read the foreword and preface, which lay much of the foundation for what follows in the book. In the preface, William H. Foege clearly illuminates the possibilities of collaborative partnerships. As he states, "Collaboration requires leadership through persuasion and relationship building because the real coalition skills are interpersonal."[p.xii]

The book is part of the series by California/Milbank Books on Health and the Public. It has 11 chapters and is divided into two parts. Part One of the book begins by examining "partnerships pursuing a single, shared goal performed better when they became an integrated team—the end of the spectrum called 'close collaboration'"[p.9] Some of the questions that the book answers are How can competing organizations, private companies, and other leaders in global health learn to share institutional resources and funds to eradicate disease threats? How do we develop new models of leaderships that are needed to lead diverse and evolving global health entities?

Chapter Two focuses on the changes that the global health landscape has generated, including different expectations due to changes in available funding opportunities for global health, greater participation from local people in the process, and new expectations from local governments. Chapter Three allows readers to see some of the difficulties inherent in partnerships that have responded to diseases and threats of disease.

While global health partnerships and initiatives are the primary focus of the book, only one chapter is devoted to special cross-cultural issues and challenges in working in partnerships on a global level. Chapter Four delves into the challenges brought about by cultural and social differences. The chapter begins with Bill Foege, an advisor to the Bill & Melinda Gates Foundation, as he recalls some of the cultural issues and approaches encountered as Merck and the Special Program for Research and Training in Tropical Diseases (TDR) in Africa to combat river blindness and the ensuing struggles that eventually led to the destruction of the partnership. The authors state, "While differences in culture complicate partnerships everywhere, we found they are more pronounced in global health partnerships because of the broad diversity of organizations and individuals involved."[p.54] They identify and illuminate three specific differences: 1) cultural differences among countries and regions, 2) cultural differences in organizations; and 3) differences among individuals. This chapter, while brief, is one of the most interesting and relevant for understanding global health disparities.

Part Two encompasses Chapters Five through Ten, which take readers through each mile of the journey in collaborations. Chapter Eleven refocuses the attention on the importance of collaborations and the tragic consequences of the lack of real close collaboration in global health initiatives.

The DVD accompanying the book offers readers an opportunity to see and hear some of the exchanges that took place at the 2006 Carter Center symposium, including comments from former President...

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