 This research explored the evolution of trust between public and private sector partners in the context of Project Last Mile, PLM. Trust was seen as essential to the success of the project, which seeks to translate the business acumen of the Coca-Cola company to strengthen public health systems in Africa. Through qualitative analysis of interviews with key stakeholders, the authors identified five domains that were foundational to building trust, reputational context, team composition, tangible outputs, shared values, and effective communication. These findings suggest that trust can be fostered through careful consideration of these factors when designing and implementing global health partnerships. This article was authored by Sarah Christie, Teresa Shaheen, Leslie A. Curry, and others.