BMC Public Health 2006, 6:285 http://www.biomedcentral.com/1471-2458/6/285 expanded and that businesses and governments elsewhere initiate similar partnerships. As one public health official noted: "I see the public health-business relationship as one of the most useful new relationships for public health that has come onto the horizon". In addition to recommendations to attend to the chal- lenges, facilitators, and limits described above, other rec- ommendations included: Make a start Cautions against pushing relationships too quickly were offset by a counter-recommendation against moving too slowly. "You need to make a start, so pick something and get going." Managing growth Obtaining new funding would enable BENS to push beyond the limits of volunteerism, and both the national office and the Metro Atlanta Region of BENS are exploring potential opportunities for additional funding. Several respondents cautioned that such an expansion could present new challenges for the partnership. Given the long-standing context of BENS' role as an organization that offered volunteer services to governments, initiating contractual arrangements with governments would change the dynamics of BENS-government interactions. For example, expanded funding would allow BENS to pay members whose services are needed beyond the limits of what they can offer pro bono. Alternatively, government agencies may be interested in contracting for additional services from BENS members, including those who have previously provided pro bono services and who would likely continue to serve as BENS volunteers. This will require defining the line of propriety for members who are both volunteers as well as potential contractors for BENS-related work. Avoiding complacency and overstatement Despite the achievements to date, substantial work remains to expand the SNS dispensing model to all five metropolitan Atlanta health districts. Beyond Atlanta, where many large companies are based, this model may be less replicable in other, more rural parts of the state. Proponents of the BENS-public health partnership must carefully navigate the boundary between reasonable pro- motion and overstatement. Public health officials are typ- ically grounded in the scientific tradition, which involves carefully qualifying observations. In contrast, business people are more accustomed to the role of marketing in achieving goals. These differences in perspective can lead to discomfort on both sides of the partnership, another example of the inevitable and ongoing differences in the business and public health cultures. Respecting roles No respondent challenged the lead role of government in planning or executing emergency response activities, nor did any recommend that government authorities be trans- ferred to businesses. Nonetheless, concern was expressed by some in government about the ability of public health officials to maintain their leadership role. For example, one official noted: "People in public health tend to have less assertive personalities than people in business. We're dealing with people who run major companies, and they are aggressive and like to take charge. If we're not careful, we could end up handing over con- trol of things that are our responsibility." "We need to keep in mind, public health is the lead. Public health cannot allow others to be the driving force – partners yes, but not lead. Public health should not turn it over to business to manage. I don't see that happening, but..." A related recommendation from some public health offi- cials was to assure that governments maintain an option to work directly with businesses that are BENS members, not having to "go through" BENS, or to work with other business organizations, without feeling obliged to con- sider BENS as the sole conduit for business partnerships. Some business respondents anticipated these concerns by emphasizing that BENS should not aim to usurp govern- ment authorities or position itself as a gatekeeper for busi- ness and public health links, but rather it should continue its role in supporting government programs and facilitat- ing links. As one BENS staff member commented, "We don't have all the answers, there's room for others." Another dimension of respecting government and business roles was expressed by a company executive in the following way: "It is important for all parties involved to understand the 'value proposition' for the other parties. If we are not creating value for other members, the team will not survive. If we can to that, we can sustain our effort." Discussion Collaboration between BENS and public health agencies in Georgia has produced a model for mass dispensing of SNS pharmaceuticals that involves integration of public and private resources and capabilities. The partners have subjected their model to "proof-of-concept" testing and are working to extend it to multiple public health districts in metropolitan Atlanta. Five key lessons arising from our examination of the partnership are: Page 9 of 13 (page number not for citation purposes)