Philanthropy has long faced the challenge of ensuring that investments create lasting change rather than short-term results. This issue has become especially urgent in global health, where funding pressures and deep cuts make it critical for donors to support programs that local governments can sustain independently. Ensuring long-term impact requires strategies that promote local ownership and meaningful engagement throughout project lifecycles.
The Global Grants Program, part of the Bloomberg Philanthropies Data for Health Initiative, recently conducted a qualitative assessment of sustainability to understand what drives long-term impact in strengthening public health data systems. The study involved in-depth interviews with project leads from 17 teams across Africa and Latin America, uncovering lessons that are broadly applicable to funders seeking to maximize local ownership and sustainable outcomes.
One of the key findings is that engaging stakeholders early is essential for sustainability. Projects that secured senior-level government buy-in and prioritized stakeholder involvement from the outset were more likely to maintain momentum and achieve lasting impact. Early engagement allows decision-makers to invest in project outcomes, and it builds champions across multiple levels of government who can support continuity during staff transitions. Examples from Malawi and Argentina show that involving key government leaders and maintaining open dialogue with stakeholders ensures that programs remain relevant and adopted over time.
Timeframes also play a critical role in sustainability. The Global Grants Program provides up to $100,000 for 12- to 15-month projects, which can deliver short-term results but is often insufficient for institutionalization. Many pilot projects struggled to embed innovations into government systems within this period. Lessons from Nigeria and Côte d’Ivoire illustrate that longer or more flexible timelines allow governments to adopt processes, integrate costs, and ensure continuity, highlighting the importance of planning for project longevity beyond initial funding periods.
Tangible outcomes are another major driver of sustained impact. Projects that produced visible, user-friendly outputs—such as dashboards, integrated registration systems, or digitized tools—were more likely to gain support and remain in use over time. In Paraguay, a burden of disease study influenced national health insurance policies, while in Gombe State, Nigeria, digitized birth registration increased efficiency and engagement among registrars. Demonstrating clear value helps maintain buy-in, particularly during leadership transitions, and reinforces the importance of projects to decision-makers.
The assessment underscores that sustainability in global health is achievable when funders combine trust-based grantmaking, adequate timelines, and investments in locally relevant, tangible solutions. These lessons are crucial in an era of shrinking global health budgets, ensuring that country ownership translates into lasting improvements. By prioritizing early stakeholder engagement, realistic timeframes, and visible outcomes, funders can maximize the long-term impact of their investments in global health and beyond.
The insights from the Sustainability Assessment Report aim to equip funders with practical guidance to strengthen sustainability efforts, turning current disruptions in funding into opportunities for securing long-lasting improvements in public health systems.
