Jessica Fanzo - The Nitze School of Advanced International Studies, Johns Hopkins University, Baltimore, MD, USA
Yusra Ribhi Shawar - The Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
Tara Shyam - Independent Consultant, Singapore, Singapore
Shreya Das - Independent Consultant, New Delhi, India
Jeremy Shiffman - The Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

BackgroundEvery country is affected by some form of malnutrition. Some governments and nutrition experts look to public-private partnerships (PPPs) to address the burden of malnutrition. However, nutrition-related PPPs face opposition, are difficult to form, and there is limited evidence of their effectiveness. MethodsWe conducted a literature review and ۳۰ semi-structured interviews with individuals involved in or researching nutrition-related PPPs to identify the factors that shape their creation and effectiveness in food systems. ResultsSeveral factors make it difficult to establish nutrition-related PPPs in food systems: a lack of understanding of the causal pathways behind many nutrition problems; a weak architecture for the global governance of nutrition; power imbalances between public and private sector nutrition actors; and disagreements in the nutrition community on the advisability of engaging the private sector. These complexities in turn make it difficult for PPPs to be effective once established due to goal ambiguity and misalignment, resource imbalances, and weak accountability. ConclusionIf effective nutrition-related PPPs are to be established, private sector conflicts of interest must be addressed, trust deficits between private and public sector actors must be surmounted, and evidence must be assessed as to whether PPPs can achieve more for public health nutrition than private and public sector actors working separately.

Public-Private Partnerships, Food Systems, Nutrition, Accountability, Trust, Transparency