As aid flows decline, more countries are articulating a new vision in which health financing would build on national resources, answer to domestic priorities, and remain accountable to their own citizens. Such a change is long overdue, and it can be achieved by pursuing reforms in three areas.
In 2004, Aceh was hardest hit by the Indian Ocean tsunami. In 2025, Indonesia’s most disaster-aware province was among the worst hit by floods. The failure was not forecasting, but what happened – or didn’t – after the alarms were raised.
Trump’s dismantling of USAID and deep foreign aid cuts are forcing international NGOs to shrink, localise and seek new funding models – with profound consequences for global health and humanitarian work.