Recent cuts to official development assistance (ODA) from the UK, US, and several European countries—including the Netherlands, Belgium, and France—have sent shockwaves through the global health and development sector. These reductions have disrupted the international aid architecture, leaving affected countries with little time to develop sustainable financing alternatives. While such cuts pose immediate challenges for lifesaving interventions across nutrition, water, sanitation, hygiene, and other essential services, they may also catalyze a shift toward empowering local organisations and country-led solutions in global health.
The current funding disruption highlights the need for more equitable partnerships in global health. Locally led action goes beyond meeting financial targets; it is about transformation and innovation, creating space for communities and civil society to design, lead, and implement their own solutions. This shift requires establishing locally driven funding streams and ensuring national governments provide supportive policies and frameworks. With traditional top-down approaches being increasingly scrutinized, the moment presents an opportunity for local actors, regional philanthropists, and businesses in ODA-recipient countries to assume greater ownership of their health priorities.
Global health challenges today are complex and interconnected, including pandemics, climate change, antimicrobial resistance, migration pressures, and urbanization. Addressing these issues demands interdisciplinary partnerships that integrate public health, economics, environmental science, anthropology, clinical medicine, and community expertise. Yet, evidence shows that equitable collaboration remains limited. For instance, only a small fraction of research from low- and middle-income countries (LMICs) has first or last authors affiliated with local institutions, revealing structural inequities in research authorship, funding, and international exposure. These imbalances often persist even within collaborations between LMICs, undermining shared goals in global health.
To build effective and equitable partnerships, knowledge, resources, and expertise must flow in all directions, with every partner recognised as contributing essential pieces of the global health puzzle. The current funding disruption offers a unique opportunity to reset partnerships on this foundation, moving beyond reliance on traditional donors and embracing local leadership. Global health solutions must be tailored to regional contexts, socio-political realities, and cultural landscapes, with traditional experts adopting a learning mindset and local actors recognised as knowledge holders. Valuing non-financial contributions—such as community trust, lived experience, and historical knowledge—is increasingly critical as traditional funding sources decline.
As international aid evolves, six principles can guide the development of more equitable global health partnerships. First, co-creating solutions ensures local actors shape priorities, program design, implementation, and evaluation. Second, cultivating trust through transparency acknowledges power dynamics and competing agendas while maintaining open dialogue. Third, equitable authorship and recognition establish fair credit across research outputs, policy briefs, and media. Fourth, knowledge should be shared inclusively, creating cycles of learning with feedback from affected communities. Fifth, local expertise should be centred, adapting approaches to contextual realities. Finally, investing in future leadership—particularly for young scientists and women—ensures that the next generation of global health leaders reflects the communities most impacted by urgent health challenges.
Transforming global health partnerships requires humility and boldness. By building collaborations grounded in mutual respect and country-led decision-making, the sector can address immediate health threats while laying the foundation for a future where health is a global good, equitable and accessible to all.
