The Power of Funder Collaboratives to Advance Global Health

(Illustration by Peter Grant)

Global health challenges call for solutions that are national, regional, or continent-wide in scope. This makes partnership with national and subnational governments essential, as government leadership, resources, and policies undergird sustained change. But what does that look like in practice, and what can funder collaboratives do to set their collaborative efforts up for success?

The Beginnings Fund, a global health collaborative launched today that brings together donors from the Middle East, Global North, and Global South, offers one example. The fund is already working with Ministries of Health, researchers, and health workers to tackle all preventable maternal and newborn deaths in countries in Africa, where a death occurs every 14 seconds from complications in pregnancy, birth, or after birth.

Advancing the Impact of Collaborative Funds

The social sector has seen an explosion in collaborative funds over the last 15 years, representing a significant shift in the philanthropic sector. This article series, sponsored by The Gates Foundation, invites practitioners, donors, and advisors to reflect on the impact of collaborative funds—what has worked well? What could work better? And how can the field advance even greater positive change?



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Another example is a donor collaboration that worked with government to help Niger become the first African country to eliminate transmission of river blindness, a parasitic health scourge that affects nearly a quarter of a billion people globally. Niger’s stunning achievement, 45 years in the making, demonstrates the power of government effort amplified by collaborative funding—in this case, from the Reaching the Last Mile Fund (RLMF), a coalition of countries and donors established by Sheikh Mohamed bin Zayed Al Nahyan, president of the United Arab Emirates, in partnership with the Gates Foundation.

These collaboratives offer valuable insights—including how to hone in on the right problem, assemble the right groups to identify and implement a solution, and build a strong coalition—for any philanthropist looking to make a difference in global health.

Identifying the Right Problem

Philanthropy can never replace the depth and reach of government resources and institutions, but there are sweet spots where collaborative funds can make a significant difference. Specifically, funders should determine whether the social problem they want to address is preventable, whether there are existing solutions they can adapt and scale, and whether there is opportunity to pool resources to that end.

Despite strides in reducing maternal mortality, about 260,000 women die annually in pregnancy and childbirth from preventable causes such as eclampsia, sepsis, or post-partem hemorrhage. Meanwhile, 2.3 million newborns die mostly from preventable issues such as fluid in their airways or infection—complications that modern medicine routinely treats.

While the problem is global, and children dying in the first month of life has halved since 1990, 70 percent of global maternal deaths occur in Sub-Saharan Africa. The region bore the highest burden of neonatal mortality at 26 deaths per 1000 live births, and progress toward prevention has slowed. With both a preventable problem and scalable solution in hand, the fund aims to support government initiatives to make well-trained health care workers and low-cost equipment innovations the norm in African countries building on the political will to strengthen health systems and talent pipelines to sustain improvement.

The RLMF collaborative took a similar approach. In Niger, for example, thanks to collaboration between government, industry, and philanthropic donors, the prevalence rate of river blindness dropped from approximately 70 percent in the 1970s to 0.02 percent in 2002. In 2018, RLMF joined this effort, with an aim to support countries like Niger in getting river blindness elimination across the finish line. RLMF supported Niger’s Neglected Tropical Diseases program to develop and update technical guidelines for stopping treatment and assessing ongoing transmission, and to scale up a national surveillance system.

The collaborative also worked with local partners and community health workers. Some acted as historians, combing through old maps and records to identify every village that ever reported a case; others volunteered as human bait, sitting for hours on riverbeds with their skin exposed to lure and catch tiny flies before they bite to allow scientists to track the spread of disease. As a result of this work, the World Health Organization officially certified Niger as transmission-free
this year.

Building on these successes, and in partnership with countries now Senegal, Mali, Benin, and Togo are all close to achieving the river blindness breakthrough as well. And with support from other funders, RLMF has expanded its sights and is now looking to mobilize $500 million to accelerate the elimination of both river blindness and lymphatic filariasis, a condition caused by parasitic worms that can lead to organ damage and disfigurement, in partnership with countries across Africa and Yemen.

Implementing the Solution

Successfully implementing a solution requires breaking down the problem and building a solution that includes both the “hardware” (tools and technologies) and “software” (people and systems) needed to power change.

On the one hand, then, Beginnings Fund is putting “hardware” in place, including:

• Antibiotics and point-of-care ultrasounds to minimize the risk of infections and other pregnancy complications
• Adapted continuous positive airway pressure machines, oxygen, and Kangaroo Mother Care protocols to address common newborn complications such as respiratory distress, asphyxia, and hypothermia
• Obstetric drapes (which cost less than $1) and drugs to prevent, detect, and treat postpartum hemorrhage in real time

On the “software” side, it is working with governments and national partners, including academic institutions, to strengthen data systems for decision-making and quality improvement. It is partnering with colleges to increase the number of trained midwives and other maternal and newborn health workers, and with specialists at leading hospitals on the continent to equip health workers with lower-cost, life-saving interventions.

Building a Coalition of Will and Skill

Collaborative funding can not only build financial support at the scale of need but also allow willing funders to learn from each other as they go and develop know-how about both the problem and what works to address it.

Building the Beginnings Fund network, for example, began in 2023, with a couple of funders committed to improving health outcomes on the African continent. Data on maternal and newborn mortality revealed a particularly vast and achievable opportunity for improvement. The network invited funders with similar missions to discuss collaboration, and reached out to health experts and African policy makers about what kinds of support would help governments in lower-income countries create consistent, quality maternity care.

These conversations led to strategy-building on how best to target investments—which products, people, and systems were necessary to improve maternal and newborn care at scale. Willing funders coalesced, combining not only their funds but also their respective expertise in innovating health care products, strengthening the health care workforce, and partnering with African governments on systems change. So far, philanthropic donors have contributed nearly $600 million toward advancing maternal-newborn health care solutions in alignment with government plans and priorities. Out of this, $450 million went to launch the Beginnings Fund, with plans to raise a full $500 million by year end 2025. The latter will accelerate plans for maternal-newborn survival in up to 10 countries, including Ethiopia, Rwanda, Tanzania, Malawi, Kenya, Uganda, Zimbabwe, Lesotho, Nigeria, and Ghana.

Over the years, I’ve seen philanthropy, working with government, make an immense difference to the success of health programs across more than 40 countries in Africa, Asia, and Latin America. Whether the target is ending neglected tropical diseases, reducing malnutrition, or eliminating preventable deaths in pregnancy and birth, collaborative funds are in a unique position to help solutions considered routine in many parts of the world become a reality in the countries that still need them. As Niger’s elimination of river blindness demonstrates, and as Beginning Fund hopes to show in the coming decade, there is enormous power when government resources, will and skill, and philanthropy unite to tackle a problem.

Read more stories by Alice Kang’ethe.