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May 3, 2021

The Importance of Public-Private Partnerships and Preparing for the Next Pandemic: A Conversation with Natasha Bilimoria

By Kayla Zamanian (SFS'23)

On April 20, 2021, Georgetown’s Conversations in Global Health class was fortunate enough to engage in conversation with Ms. Natasha Bilimoria, the current deputy assistant administrator in the Bureau of Global Health at the United States Agency for International Development (USAID). To say the least, Ms. Bilimoria has had an impressive and diverse career in global health. In 2013, she became the director of U.S. strategy for Gavi, the Vaccine Alliance, where she focused on garnering public and private sector support in the United States to advance Gavi’s mission of increasing childhood immunization in low-income countries. Prior to her work at Gavi and USAID, Ms. Bilimoria spent several years at Friends of the Global Fight against AIDS, Tuberculosis, and Malaria, which advocates for U.S. support for the Global Fund (a public-private partnership which aims to end the AIDS, tuberculosis, and malaria epidemics). Ms. Bilimoria’s experience working in multilateral institutions, non-profit organizations, and the federal government brought a unique and refreshing perspective to our discussion on how we can inspire Americans to recognize the power and importance of global health in an era where the health of individuals and nations is more connected than ever before.

Public-private partnerships (PPPs) have become a buzzword in global health; however, Ms. Bilimoria believes, for a number of reasons, that they deserve the praise. Speaking from her personal experience at Gavi and her work in support of the Global Fund, Ms. Bilimoria emphasized that the success of both these PPPs was tied to their willingness to “bring every stakeholder to the table.” Furthermore, she highlighted the nuance of the private sector’s contributions, stating that although “everyone thought of the private sector as just another donor,” over time, the global health community has come to realize that the private sector can offer apt expertise to help organizations like Gavi fill in any management or planning gaps.

Another important theme that came up in our discussion with Ms. Bilimoria was the concept of health system strengthening, such that as we work to overcome the current pandemic, we must also keep the possibility of future pandemics in mind. Ms. Bilimoria stated that although the term “health system strengthening” has been used for a long time, we are just now starting to see what happens when a country has weak systems in place—strong health systems are a necessary condition for strong pandemic preparedness plans. Moreover, Ms. Bilimoria drew on the Democratic Republic of Congo and Guinea as examples of countries that have endured serious public health crises but used their experiences to establish systems that could hold through in the case of a future pandemic. The adjustments that the DRC and Guinea made to their health systems as a result of the 2014 Ebola outbreaks have been extremely helpful in mitigating the impacts of COVID-19 on their populations. The COVID-19 pandemic revealed cracks in even the wealthiest countries’ health care systems and showed how important prevention, preparedness, and early investments are to our ability to respond to emerging global health threats.

Finally, we ended our conversation on the influence that the United States’ actions have on other countries within the global community. Ms. Bilimoria reminded us that when the United States shows leadership, it is noticeable, and the world often looks to the U.S. for guidance. She stated that “when the U.S. starts giving more money to GAVI or the Global Fund, it puts pressure on other countries to do the same,” which can create a sort of “friendly competition” and actually improves overall international contributions to global health efforts. She noted that the arrival of the new administration ushered in comments like “we’re so happy the U.S. is back,” and it’s true—the United States has not only brought funding to the table, with regards to COVID-19 relief and vaccination efforts around the world but also the expertise to create effective multilateral solutions to solve pressing global health challenges and inequities.

Even more inspirational than her outstanding professional accomplishments and career history is Ms. Bilimoria’s commitment to equity, advocacy, and the improvement of every individual’s health around the world. Her reflections reminded us that cooperation is key to improving global health. Whether between different nations, the private and public sector, or different governmental bodies, we must work together to ensure that every individual can attain the highest standard of health possible. As we strive to bring an end to the current stage of the COVID-19 pandemic, we must keep the values of equity and justice in mind and ensure that our efforts go toward ensuring everybody has equitable access to the vaccine, regardless of their national identity. The road towards global health justice is a long one; however, with multilateral cooperation, health system strengthening, and a common aim of establishing equity, we can be certain that we will leave this pandemic more prepared for future crises and more cognizant of just how interconnected our health is to geographically distant populations.

Kayla Zamanian (SFS'23) is a sophomore at Georgetown University studying science, technology, and international affairs and a student in the Conversations in Global Health course.