Today the inclusion of private stakeholders in providing access to health is proving to be a sustainable approach. To achieve developmental impact the public sector is no longer the key source or actor. Although increased support by the government - both financial and political - may be required in the future it is not fundamental for the implementation stage. The VDP can continue to grow and be sustainable through the work of private organisations and funders. The state can later step in and expand the system nationwide when it is fully demonstrated. Private partnerships are changing how health-care is provided and its sustainability.