Funder Collaboration in the Volatile Global Health and Development Environment
By Gayle Martin and Ntefeleng Nene, The Bridgespan Group
With the sharp decline in official development assistance (ODA) funding, global health and development systems face a period of profound volatility. The impacts have reverberated in communities across the Global South. The old model of international aid may be over, as many have pointed out (for example, here, here, and here).
Major donor countries, including the United Kingdom, Germany, France, and the United States, have each substantially reduced aid. The US alone slashed aid disbursements by more than half in 2025. While the US Congress recently passed a $50 billon foreign affairs spending bill (including $9.4 billion for global health programmes), questions remain about how and if it will be spent.
The Organisation for Economic Co-operation and Development expects the global aid slump to continue in 2026 and beyond. The consequences are severe: clinics have closed, health systems are stretched, and vaccination and nutrition programmes are decimated. Already hundreds of thousands of lives have been lost, most of them children. One study projects that global aid cuts could lead to at least 9.4 million additional deaths by 2030.
In the face of this crisis, leaders remain deeply committed to the communities they serve. Many are even asking: Could this moment create an inflection point, a chance to rebuild systems to be more just, resilient, locally rooted, sustainable, and self-reliant? What will it take to realise this vision?
For decades, ODA funding has helped drive progress across global health and development – supporting immunisation efforts, reducing child mortality, and strengthening essential systems. But increasingly uncertain ODA flows and shifting geopolitical dynamics are placing growing pressure on existing models of aid delivery – while also surfacing long-standing questions about their effectiveness.
This moment also highlights the importance of philanthropy infrastructure – the networks, intermediaries, and support organisations that enable resources, knowledge, and relationships to move more effectively across the system.
In contrast to traditional models that have often been shaped by donor priorities and top-down decision-making, many leaders say it’s time to lean into local ownership and leadership. “What if funding enabled locally-led organisations to work without restriction, delivering fully locally led solutions?” asks Nadia Kist, executive director of Blood: Water, which funds and strengthens African-led community organisations on the frontlines of ending health disparities. “What if we were able to build a more long-lasting approach that invests in sustainable community resilience? There would no longer be an indefinite need for bilateral assistance.”
In our recent publications, Why Funding African Collaboratives Matters Now More Than Ever and The Power of Collaboration at a Time of Volatility in Global Health and Development, Bridgespan examined the specific role philanthropic collaboration can play in this period of volatility. Our client work and research consistently demonstrate that broad collaboration – among funders, civil society organisations, governments, and the private sector – is essential for lasting social change. More than ever, given the scale of challenges facing the global health and development sector, collaboration is critical.
While philanthropy cannot replace the scale of ODA, it can play a catalytic role – helping to bridge funding gaps, support innovation, and invest in more equitable and resilient systems. Philanthropic collaboratives, vehicles that align and direct funders’ resources and expertise, are a critical part of the evolving architecture for global health and development in this moment of great disruption. By aligning resources across funders toward shared goals, they can mobilise more capital and shared expertise than any single private donor or foundation can alone. Collaborative funds can move funding more quickly, share risk, and flexibly support local organisations and leaders navigating uncertainty. In many cases, collaboratives are helping to sustain critical services and prevent further erosion of health systems.
Because many collaboratives have deep connections to organisations and leaders on the ground, they can help shift resources and decision-making closer to the communities most affected. This includes directing funding to proximate leaders, supporting locally rooted institutions, and investing in systems that can endure beyond short-term funding cycles.
Data from a 2025 survey of over 50 collaboratives leaders working in global health and development underscored the unique position of philanthropic collaboratives. Most surveyed collaboratives aren’t dependent on aid flows: nearly 75 per cent of collaboratives that responded to our survey reported receiving less than 10 per cent of their funding from ODA. In fact, 80 per cent still planned to grant out the same amount or more money compared to the prior year.
At the same time, collaboratives are experiencing surging demand from grantees without a corresponding increase in their own funding. Nearly 90 per cent of our survey respondents reported an increase in requests from potential grantees compared to this time last year. But over three-quarters of respondents expected their own 2025 funding to decrease or remain flat.
Collaborative funds – an underutilised catalyst for system transformation
With sufficient support, philanthropic collaboratives, and collaboration writ large can help turn this period of volatility into an opportunity to advance local ownership, strengthen local leadership, and build the infrastructure needed for more sustainable and resilient systems.
Through private conversations with donors and our research, we know there is a real desire to meet this moment and to use their capital to help in a time of unprecedented need. An awareness of the scale of need to rebuild systems has some donors fearful that their funding may be too small to matter, or that they lack the knowledge to direct funding toward the right leverage points for sustainable change.
Our research shows the immense potential of collaborative funds at this moment. For funders and ecosystem actors seeking to engage in new geographies or issue areas, or those who feel they lack the time to fully source and research more bespoke giving options, collaboratives can offer ready-made avenues for learning while giving. Collaboratives can even identify organisations to fund directly in the future. For donors worried about being ‘a drop in the bucket,’ giving together with other donors to support systems-level change can offer a chance to meet the problem at a scale they couldn’t achieve alone.
We’re at a critical juncture for global health and development. “If the moment the [ODA funding] tap is closed and everything crumbles, that should raise a red flag,” says Kist. “We need to rebuild the system with this in mind.”
This moment presents both risk and possibility. The question is not only how to respond to immediate gaps, but how to build systems that are more resilient, locally rooted, and capable of sustaining change over time. Collaboration will be central to that effort – not as a strategy of convenience, but as a core feature of how philanthropy operates moving forward.
Gayle Martin is a principal in Bridgespan’s New York office. Since joining the organisation in 2020, Gayle has supported a range of nonprofit and philanthropic clients across global development, climate change, gender equity, global health, democracy, and advocacy. Gayle holds a Master’s degree in Global Human Development from Georgetown University’s School of Foreign Service and a BA in Political Science and Spanish.
Ntefeleng Nene is a partner and head of Bridgespan’s Africa office. She serves both philanthropy and nonprofit sectors with a keen interest in organisations that are driving Africa’s development agenda. She has expertise across a number of development areas and industries with a particular interest in the intersection of public health, sexual reproductive health rights and gender equity. She graduated from the University of Durban-Westville with a BA in Social Work and from the University of KwaZulu-Natal with a Master’s in Public Health Law.
