The dance of power and trust-exploring micro-foundational dimensions in the development of global health partnership

The global health system has significantly evolved over the last 30 years, particularly since the UN Millennium Declaration in 2000. The transformation in global healthcare partnerships has been most visible in the area of neglected tropical diseases, where technological innovation is directly linked to social change. Numerous strategic partnerships between different actors, including pharmaceutical companies, global and national health institutions and philanthropic organizations and disease specific foundations populate the landscape of neglected tropical diseases and yet, we know little on relational and structural aspects underpinning the partnerships. Our research uses a rich longitudinal case study – a tripartite public-private partnership formed between a global health organization, a major pharmaceutical company and a research university to develop a new drug for the treatment of malaria in Sub-Saharan Africa. Development of new drugs is central to attain social change in a poverty stricken region. We adopt a micro-foundational perspective in analyzing strategic choices made by the partnership's Product Development Team (PDT) and unravel the dynamic interplay between power–trust relationship in such strategic business partnerships.