Philanthropy in an era of declining development aid
Philanthropy will never replace public aid, but it can be a powerhouse if we use it right. With global development funding under strain, European aid budgets being redirected towards defence and rearmament; and the United States rethinking foreign assistance altogether, the aid community has been left scrambling.
The reactions so far have been of two kinds: calls for philanthropy to fill the gap and moralising statements shaming governments for stepping back. Unfortunately, the first is unrealistic and the second is ineffective. Private donors cannot solve systemic global challenges alone and telling politicians that they are morally bankrupt generally does not bring them around to your side. Instead, we need to meet policymakers where they are, sharpen our arguments and focus on what actually works.
The hard truth is that most government aid is not even designed for effectiveness, because it prioritises processes over results. Nor has philanthropy been immune to this impulse. In our early years at the Eleanor Crook Foundation, we funded holistic, multisectoral programmes that tried to tackle all causes of malnutrition simultaneously. But the results were underwhelming. The approach looked good on paper, but produced no measurable improvements in malnutrition.
So, we learned from that failure and changed course. Now, we direct our funding where the evidence is strongest and the results most immediate. At the recent Nutrition for Growth (N4G) Summit in Paris, we announced a $50 million commitment, alongside $200 million from other donors, to scale up one of the most cost-effective interventions in global health: prenatal vitamins — known as multiple micronutrient supplements (MMS). This funding will go towards a $1 billion road map to ensure access to MMS for pregnant women no matter where they live.
The science on this issue is unequivocal. MMS replaces the outdated iron and folic acid (IFA) tablets that are still given to many pregnant women in low-income countries. With MMS, women receive 15 nutrients, instead of just two, leading to a dramatic reduction in maternal anemia, stillbirth and low birth weight. The estimated economic returns are substantial — $37 for every $1 invested — and the human returns even more so, with infant mortality reduced by nearly one-third.
The global inequities in maternal health are profound. In London, a pregnant woman routinely has access to comprehensive prenatal vitamins. In Lagos, she might receive IFA, or nothing at all. The difference reflects a gap in will, not knowledge. Ending such disparities does not require a scientific breakthrough, just greater investment in already proven solutions.
More than two decades of research, three Lancet studies and multiple World Bank investment cases have identified roughly ten nutrition interventions that are consistently underfunded despite their proven efficacy. These are not flashy, multisector, utopian initiatives. They are targeted, evidence-based programmes that can be implemented immediately, at scale, to deliver measurable results.
Solutions like breastfeeding support, Vitamin A supplementation, prenatal vitamins and ready-to-use foods for severely malnourished children belong to a package of interventions that could save at least two million lives over five years if scaled up in nine high-burden countries. Such life-changing results would cost just $887 million per year.
Malnutrition is now the leading driver of child mortality globally, contributing to some three million deaths in 2023 alone. These are not mysterious tragedies. They are predictable and in many cases cost little to prevent. In a world that routinely sends tourists to space, we obviously can afford to ensure that all pregnant women have access to a $2 bottle of vitamins.
This year's N4G Summit may be the last of its kind. It was part of a summit series linked to the Olympics, which will next be hosted by the US. With the current US administration already signalling that it will not continue the tradition, the recent commitments made in Paris have gained new urgency. Vague pledges and political posturing will no longer do.
At the Eleanor Crook Foundation, we're not asking governments to spend like they used to. Rather, we are urging them to look at the evidence and use their remaining budgets for official development assistance to scale up proven, cost-effective solutions. A modest investment in MMS — representing less than the cost of one week of G7 countries' defence spending — could save 600,000 lives.
Even with constrained budgets, we have a chance to save millions of lives. But only if we stop trying to do everything and focus instead on what is the right thing to do. @Project Syndicate, 2025
The writer is CEO of the Eleanor Crook Foundation and Chair of Stronger Foundations for Nutrition, is a former chief storyteller for the United Nations Millennium Campaign, a member of the US Global Leadership Coalition, and a board member of the United Nations Foundation's Global Leadership Council
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