Building authentic partnerships to overcome global health threats

The 40% cut in UK official development assistance (ODA), following an almost complete termination of US foreign assistance and similar cuts across Europe – including The Netherlands (30%), Belgium (25%) and France (37%) in the past year – has sent shockwaves through the global health and wider development sector.

These decisions have fundamentally altered the international aid architecture with little time for affected countries to develop sustainable financing alternatives.

While these cuts create immediate challenges for lifesaving interventions serving hundreds of millions of people, weakening systems that provide essential interventions across nutrition, water, sanitation and hygiene and many others, they may accelerate a long-overdue transformation in how global health partnerships develop and function. This moment may be remembered as one with devastating impacts but also as one that shifted power to local organisations and country-led solutions.

Towards more equitable partnerships

For years, the narrative has been shifting away from traditional top-down development approaches that, even when well-intentioned, undermine power dynamics.

Movements like #ShiftThePower and the increasing focus on the localisation agenda have gained traction as genuine attempts to address historical imbalances. However, progress has been incremental. The current disruption to traditional funding models could accelerate this transformation, propelling local organisations, regional philanthropists and businesses in ODA-recipient countries to fill gaps and claim greater ownership of their health futures.

As international actors navigate this changing landscape, we must be proactive rather than reactive. Instead of merely adapting to reduced ODA budgets, we have an opportunity to fundamentally reimagine partnerships to address shared global challenges.

Interdisciplinary partnerships for an interconnected world

Our current global challenges show how interconnected we have become. Conflict and instability have wide-ranging impacts across countries and regions and almost always affect the health of populations often disproportionately the most marginalised communities worldwide.

The complexity of challenges, such as pandemics, climate change, antimicrobial resistance, migration pressure and urbanisation, demands responses that draw on diverse disciplines, sectors and regional perspectives. We need collaborations that blend public health with economics, environmental science with anthropology, and clinical medicine with community expertise to create truly interdisciplinary partnerships where mutual benefit becomes a reality.

Evidence suggests, however, that equitable partnership remains aspirational in many areas of global health. A recent National Cancer Institute analysis found that only 15% of research from low and middle-income countries (LMICs) has first authors from LMICs and just 10% has LMIC-affiliated last authors.

This under-representation reveals structural inequities in who controls research narratives and whose contributions are recognised. Barriers include restrictive authorship criteria which privilege intellectual contributions over data collection, alongside English-language dominance in publications, funding disparities, unequal opportunities for international exposure and visa restrictions.

Global health partnerships, while often presented as inherently beneficial, require critical reassessment. Even when designed to support the countries affected by the health issue in question, they frequently reinforce inequitable power dynamics – sometimes even within collaborations between LMICs. These imbalances in decision-making authority, resource control and knowledge production undermine our collective goals.

The solutions we seek will emerge only from spaces where knowledge, resources and expertise flow equitably in all directions, recognising that each partner holds essential pieces of the global health puzzle. The current disruption offers a rare opportunity to rebuild these partnerships on an equitable foundation.

Embracing a new mindset for lasting change

For global health solutions to achieve lasting positive impact, they must be tailored to specific regional contexts, socio-political realities and cultural landscapes. This requires a willingness for traditional ‘experts’ to become learners and for those previously treated as ‘aid recipients’ to be recognised as knowledge holders.

This moment of transition demands we broaden our understanding of what constitutes a valuable contribution. Too often, partnerships are evaluated primarily through financial metrics, overlooking how expertise, historical knowledge, community trust and lived experience are equally critical for successful outcomes. As traditional funding sources recede, recognising and elevating these non-financial resources becomes not just ethically important but strategically essential.

Six principles for transforming global health partnerships

As the international ODA architecture evolves, these six principles can guide the development of more equitable partnerships:

1. Build solutions together
   True partnerships elevate all voices – especially local expertise from community leaders, health workers and citizens. In this new landscape, co-creation means ensuring these partners play central roles in shaping priorities, designing approaches, implementing programmes and evaluating outcomes. The ODA cuts create space for local leadership to assert greater influence over health priorities.
2. Cultivate trust through transparency
   Building trust requires power dynamics and competing agendas, which may not be visible to all partners, to be acknowledged. As funding patterns shift, open dialogue about resources, constraints and expectations becomes even more important for sustaining collaboration through the uncertainty.
3. Establish equitable authorship and recognition
   The current moment offers an opportunity to reset expectations around credit and attribution. As research collaborations adapt to changing funding environments, establishing clear guidelines for equitable authorship across all outputs – academic publications, policy briefs and media – becomes essential for shared ownership.
4. Share knowledge inclusively
   Research findings must be accessible to all contributing communities, especially those most affected by the health challenges being studied. Knowledge dissemination should initiate dialogue, gather feedback and adapt approaches, creating cycles of learning even as funding sources change.
5. Centre local expertise
   In resource-constrained environments, the insights of local experts – researchers, practitioners, community leaders and citizens –become even more valuable. Listening means being willing to adapt approaches based on contextual understanding which external partners may lack.
6. Invest in future leadership
   Young scientists, particularly women, face significant barriers in balancing professional development, family responsibilities and academic advancement. Despite funding constraints, we must prioritise mentorship and leadership development, ensuring the next generation of global health leaders reflects the communities most affected by our world’s most urgent health challenges.

This transformation requires both humility and boldness – recognising that successful solutions emerge from collaboration rather than imposition. By building partnerships grounded in mutual respect and country-led decision-making authority, we can address immediate health threats while laying the foundation for a future where health is truly a global good, accessible to all.