BMC Public Health 2006, 6:285 http://www.biomedcentral.com/1471-2458/6/285 The partnership arose and flourished because BENS leadership was strategic in its outreach to government officials and because government officials were willing to entertain a new type of relationship with businesses BENS is a non-profit entity whose members include peo- ple and companies from the for-profit sector. As such, BENS has carefully defined its mission and methods in ways that are sensitive to the historical reticence of their business colleagues and government officials to engage with one another. This approach has facilitated a focus on shared objectives and a process that has enabled partici- pants to overcome obstacles to collaboration. The partnership readily garnered support from people in business and public health because mass SNS dispensing represents a clear example of the potential benefits of government-business collaboration Rapid, mass dispensing of post-exposure prophylactic medications to the residents of a large urban area is obvi- ously a task that government alone would be unable to manage successfully, and it is equally obvious that the consequences of failure could be devastating. Even if busi- nesses were able to provide prophylactic medications to their employees, businesses could not survive if customers and those who maintain necessary infrastructures were unprotected because governments were overwhelmed. At the same time, it is evident that public health agencies and businesses have complementary skills and assets that, if combined, would increase opportunities for successful mass dispensing. There are multiple and complex challenges to collaboration, including some that can be managed but probably not eliminated and others that may be resolved through ongoing efforts While our investigation identified multiple challenges to collaboration, the business and public health leaders responsible for forging the partnership in Georgia viewed their ability to recognize and confront these challenges as an important accomplishment and not as a deterrent to advancing the partnership. In particular, the cultural divide between people in business and government has been narrowed, and personal trust and respect have grown through collaboration. This achievement, however, can- not be taken for granted as the partnership grows and new participants from businesses and governments become engaged. Many of the challenges we identified emerged as the partnership addressed progressively more complex tasks, from preparing an informational pamphlet to designing and testing an SNS dispensing model, extend- ing that model to new sites, and adding pandemic influ- enza planning to the partnership agenda. This process surfaced concerns about the limits of volunteer engage- ment and the danger of complacency, which will require ongoing attention, and about liability and confidentiality of sensitive information, which may be amenable to legis- lation. For example, most state Good Samaritan laws pro- vide liability protection to individuals but do not extend that protection to businesses or non-profit organizations that assist in an emergency response; moreover, these laws typically come into play once disasters occur but do not apply during pre-event drills or exercises (personal com- munication, November 8, 2006, Gene Matthews, JD, former CDC General Counsel and Senior Fellow, Univer- sity of North Carolina School of Public Health). These limits of Good Samaritan laws may discourage some busi- nesses from engaging in public health emergency plan- ning and exercises, and efforts to describe and characterize their limits can provide the foundation for efforts to seek legislative or policy changes. The BENS partnership model resonated with business and public health colleagues alike This model is based on identifying shared objectives, identifying respective assets and liabilities, and imple- menting manageable and measurable projects that fit within both government and business missions. While this may sound elementary, maintaining this focus has required ongoing effort. The concept of community continuity links principles of business continuity and public health The importance of business continuity planning is widely accepted among business leaders. Public health officials are accustomed to taking a community-level perspective in seeking to protect and promote health. The link between these concepts is that a healthy population (e.g., healthy employees, customers, suppliers) is essential to business survival during and following a public health cri- sis, and viable businesses are essential to provide jobs, essential goods and services, and a sense of economic well-being necessary to support health[17]. Calls for a comprehensive approach to disaster planning, response, and recovery emphasize the importance of the economic impacts of disasters on physical and mental health [18,19]. Businesses can also play a key role in supporting the recovery of communities from an epidemic or disaster. This was illustrated in 2003 following the SARS epidemic in Toronto. Conventions and tourism – two of the city's key industries – suffered when organizations cancelled conventions and tourists turned away. Responding to this threat to the economic health of Toronto, businesses that would normally be competitors, such as airline, rail, and bus companies, collaborated to foster the return of con- ventions and tourists [20]. Both domestically and internationally, there is growing interest in partnerships between business and govern- ments for addressing a spectrum of public health threats, including obesity, tobacco use, bioterrorism [21], pan- Page 10 of 13 (page number not for citation purposes)