When the Funding Stops: How Global Health Can Survive and Thrive
Navigating Budget Cuts with Innovation, Partnerships, and Sustainable Solutions
The emails and WhatsApp text come in daily—friends and colleagues across the global health community expressing deep concern over what the future holds. The recent cuts to USAID funding under the current administration have sent shockwaves through organizations that rely on these resources. Academic researchers are anxious about the ripple effects on their work, their funding, their professional future, and front line workers serving marginalized populations are uncertain if they will still be able to continue their work.
It would be easy—perhaps even justified—to focus on the experience of injustice that many have felt in the way these cuts have occured, to point fingers, to despair at the seemingly relentless cycle of setbacks, and confusion. But history, and those who have shaped it, offer us a different path forward.
I was fortunate to join as a faculty member the Program in Global Surgery and Social Change (PGSSC) at Harvard Medical School in its early years. Founded in 2010 by Drs. John Meara and Paul Farmer, the program emerged in response to the critical gap in surgical care within global health. Soon after joining, The Lancet Commission on Global Surgery was published, bringing worldwide attention to the urgent need for safe and timely surgical access. This effort spurred significant growth in the field of global surgery, bringing about a global network of partnerships and relationships.
Throughout those years, Paul would often sit with us—fellows, colleagues, anyone willing to listen—and remind us of a simple but profound truth: despair is a luxury we cannot afford. He urged us to persist, not in opposition to one another, but in solidarity with those we serve. He constantly emphasized that
health is not just about funding streams or political wins and losses—it is a moral imperative. It demands innovation, commitment, and above all, unity.
Paul’s legacy was not built on waiting for perfect conditions to act. He never allowed bureaucracy or resource limitations to dictate what was possible. Instead, he built health systems in places others had written off as impossible. He redefined what could be achieved by centering his work on the people he served, not on the policies that sought to limit what was possible. His message was clear: healthcare is a fundamental human right, and we must be relentless in ensuring it is upheld.
Over time, PGSSC has evolved to include research and policy-focused fellowships, always striving to meet the changing needs of global surgery. The founding values have not changed—persistence, moral clarity, and an unwavering commitment to justice—continue to shape its work today.
A New Perspective: Social & Economic Development as a Path Forward
What if instead of focusing on the current chaos, we instead focus on a vision of social and economic development that transcends politics and short-term funding cycles?
What if we start to measure progress not only by material gains but by our ability to uplift human dignity, foster self-reliance, and promote collective well-being?
This approach would challenge us to move beyond dependency on traditional funding models and to embrace new ways of working that empower local communities as protagonists of their own development.
Social and economic development, in this context, is not merely about providing aid—it is about nurturing capacity. It is about building resilient health systems and communities that are owned and sustained by the very people they serve. It is about applying principles of unity and consultation to problem-solving, ensuring that solutions are not imposed from the top down but emerge organically from within communities. In this context, the oneness of humanity is not just a spiritual truth; it is a practical foundation for lasting change.
This means that our response to the current moment must be rooted in constructive action, action that is both principled and practical. Emerging technologies, particularly Artificial Intelligence (AI), offer immense potential—but their impact depends on how we engage with them. Rather than viewing AI as a tool to impose external solutions, we must integrate it in ways that enhance local capacity, foster trust, and build transparent, sustainable partnerships. In healthcare, this means using AI not only to improve efficiency but also to create models of care that are responsive to the needs of communities.
When it comes to funding, constructive action means developing financing approaches that reduce dependence on unstable funding and prioritizing long-term resilience over short-term fixes. Most importantly, it requires working alongside (accompanying) those we seek to serve, recognizing that real progress comes not from outside intervention but from strengthening the ability of communities to shape their own futures, strengthening everyone’s ability to navigate challenges with confidence and creativity.
Embracing Innovation and Collaboration
Historically, global health initiatives have been heavily reliant on government grants and philanthropic donations. While these funding sources remain vital, we need to develop parallel strategies that ensure sustainability. This may mean forging stronger partnerships with like minded, values driven, trustworthy partners in the private sector. This may mean leveraging technology, safely and appropriately, in order to drive efficiency, and it may mean exploring alternative financing models. The era of siloed work is over—if we want to survive and thrive, we must unite across sectors and disciplines.
We must also double down on innovation. Technology is not a panacea, but it is a powerful enabler when used appropriately. Artificial intelligence, data analytics, and digital health tools offer unprecedented opportunities to expand access to care, streamline operations, decrease waste and ultimately improve outcomes. If we strategically deploy these technologies, we can not only mitigate the effects of funding cuts but also build more resilient health systems and communities for the future.
The Moral Imperative of Unity
Above all, we must resist the forces of division. In times of crisis, it is all too easy to assign blame—whether to the private sector, government leadership, or those who think differently. Frustration can cloud judgment and, more importantly, obscure our shared purpose. Just days ago, someone asked me, “How can you drive a Tesla?”—a question laden with the kind of knee-jerk judgment that threatens the very partnerships we have worked so hard to build. This level of division is toxic, undermining collaboration when what we need most is unity. History has shown that the greatest victories in global health have not come from discord, but from collective effort. We must continue to build coalitions, uplift voices that are too often unheard, and engage in consultation that seeks truth rather than victory. Our focus must remain on solutions that prioritize the well-being of people over politics.
The road ahead will not be easy. But history has shown us that moments of upheaval often give rise to the most profound transformations. If we choose to meet this moment with courage, creativity, honesty, detachment and collective action, we can turn uncertainty into an opportunity.