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The IBP Memorandum of Understanding (MOU) supporting the formation of the IBP Initiative was originally approved and signed by WHO/RHR, USAID, UNFPA and 13 international agencies, in September 2003. Since 2003 the partnership has grown at a steady rate and now in 2012, has a membership of 37 international organizations.

The MOU covered an initial period of two years, with an option of extending the agreement at two-year intervals. The MOU is supported by Operational Guidelines that describe the governance, policies and guiding operational principles of the IBP Initiative. The Operational Guidelines are reviewed and updated on a regular basis by members of the IBP Steering Committee in response to the changing needs, growth and development of the partnership. All partners review and agree on any amendments to the IBP Initiative Operational Guidelines.

In September 2005, all partners signed an "Agreement to Extend the MOU" supporting the IBP Initiative for a further two years.  

At the IBP Initiative Meeting on June 2007 the partners unanimously agreed that the next extension of the MOU should be for an indefinite period, with the provision that any partner can leave the IBP Initiative by providing three months' notice in writing. It was also agreed that the IBP Operating Guidelines would be amended to reflect this decision.

An indefinite extension of the MOU was prepared for partners to sign and is used for all new partners joining the IBP Initiative. 

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