PPPs, especially in their early stages, tend to be fragile constructions. Disputes over governance and financing are common. Governments, pushed to work across ministries and perpendicular to conventional bureaucratic structures, may have difficulty delivering results quickly or efficiently enough for the private sector. Support for a PPP might wax and wane depending on political circumstances beyond either partner's control. Governmental support of a given PPP might even be contingent on the outcome of a yet-undecided election.
On the other hand, companies unaccustomed to working with governments or constricted by rigid quarterly earnings reports may find the public-sector approach to public health to be insufficiently profit-focused. Private-sector partners are similarly not immune to executive turnover and may also be weighing long-term results against short-term liabilities. Both partners may hold pre-existing biases against the other.
Without executives in the public and private sectors who are both invested in success and authorized to enact changes quickly and efficiently, PPPs will struggle to get off the ground. As we've noted earlier, in choosing partners, it is important to partner not just with reputable corporations, but with qualified and effective individuals within those companies. Each partner must be clear-eyed about the perspective of the other up front-and recognize the limits set forth by those perspectives, which will often differ. Partners must have both the motivation and the capacity to deliver on projects. Partners that lack the credibility or authority necessary to meet expectations will find it hard to engage in successful partnerships.