Global public–private partnerships (PPPs) have become prominent in efforts to address global challenges, particularly in the health field. In the scholarly literature, global PPPs have been conceptualized as arenas for voluntary public–private cooperation rather than agents of global governance. This paper challenges this approach, arguing that a sub-class of highly institutionalized partnerships have developed into transnational bureaucracies that, much like international organizations, can draw from their administrative capacities to exercise agency and gain and consolidate authority over time. To substantiate this argument, I present an in-depth analysis of five global health partnerships that played a leading role in the Access to Covid-19 Tools Accelerator (ACT-A), the initiative that sought to coordinate the global response to covid-19. Based on extensive document review and analysis of the ACT-A PPPs —Gavi, the Vaccine Alliance, The Global Fund to Fight AIDS, Tuberculosis and Malaria, The Coalition for Epidemic Preparedness Innovation, Unitaid, and The Foundation for Innovative New Diagnostics — I show how these partnerships’ leadership role during the pandemic emerged from a decade long build-up of PPP agency. These organizations gained administrative capacities that enabled them to increase their authority vis-à-vis their donors, boards, and other external actors through three interlinked strategies: (a) developing greater financial autonomy; (b) expanding their mandates (including toward pandemic preparedness and response); and (c) establishing inter-partnership cooperation and mutual representation to other forums. My analysis suggests the need for future research to consider highly institutionalized PPPs as agents of global governance and to explore empirically and theoretically the consequences of their rising authority.

中文翻译：

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全球卫生治理中公私伙伴关系的权威和机构不断上升

全球公私伙伴关系（PPP）在应对全球挑战（特别是在卫生领域）的努力中发挥着重要作用。在学术文献中，全球公私合作被概念化为自愿公私合作的场所，而不是全球治理的代理人。本文对这种方法提出了挑战，认为高度制度化的伙伴关系的一个子类已经发展成为跨国官僚机构，它们很像国际组织，可以利用其行政能力来行使代理权，并随着时间的推移获得和巩固权威。为了证实这一论点，我对五个全球卫生伙伴关系进行了深入分析，这些伙伴关系在获取 Covid-19 工具加速器 (ACT-A) 中发挥了主导作用，该计划旨在协调全球对 covid-19 的应对措施。基于对 ACT-A PPP 的广泛文件审查和分析——全球疫苗免疫联盟、疫苗联盟、全球抗击艾滋病、结核病和疟疾基金、流行病防备创新联盟、国际药品采购机制和创新诊断基金会——我展示了这些合作伙伴关系如何在大流行期间通过长达十年的 PPP 机构建设发挥领导作用。这些组织获得了行政能力，使它们能够通过三项相互关联的战略增强其相对于捐助者、董事会和其他外部行为者的权威：(a) 发展更大的财务自主权；(b) 扩大其任务授权（包括大流行病防备和应对）；(c) 建立伙伴关系间合作并在其他论坛上相互代表。我的分析表明，未来的研究需要将高度制度化的 PPP 视为全球治理的代理人，并从经验和理论上探讨其权威不断上升的后果。