Building What’s Next: Global Development When the Model Breaks

Reflections from BNID’s Global Changemakers Salon

On September 29, about 100 grad students, nonprofit leaders, and academics filled The Foundry in Cambridge for an evening built around one question. The debate over whether the development model is breaking has largely been settled. What matters now is what gets built next.

Cecilia Wallen, Executive Director, opened the evening with that framing. Facilitator Fuzieh Jallow, founder and CEO of Terra40, and BNID board member, then guided a conversation between two leaders who approach the problem from complementary directions: Dr. Sheila Davis, CEO of Partners In Health, and Lisa Corsetto-Poon, Policy Lead at J-PAL.

Smaller footprint, or deeper roots?

With funding shrinking, the sector is being told to do less: narrower mandates, smaller footprints, fewer risks. Sheila offered a different answer: “go deeper.”, when other organizations leave, we stay”

She traced that conviction to the 2013 Ebola outbreak in Sierra Leone. The epidemic exposed a health system that had never been built, and Partners In Health chose to stay and build it rather than leave when the emergency passed. Health, she said, is a human right, and everyone deserves equitable care. Her approach is to work with governments rather than set up parallel systems. She sees structural gaps in who gets care, such as the contrast between breast cancer outcomes in Boston and in Malawi, as the thing crisis response alone can’t fix.

Fuzieh Jallow moderates the discussion with Lisa Corsetto-Poon and Sheila Davis.

Evidence as a compass when money is tight

Lisa described what rigorous evidence can offer leaders deciding where to invest. Randomized evaluations are one methodology among several for measuring the causal impact of social programs. When resources are scarce, they add rigor and confidence. Unconditional cash transfers were one example: research showed they work, and that evidence helped sustain support for them.

She also argued for starting with the problem rather than the program. On youth unemployment, for instance, training is not always the missing piece. Sometimes the barrier is networks, connections, or subsidies, and evidence helps show what works in which context. She also described the long-run evidence on the graduation approach pioneered by BRAC, which supports women in moving from insecure to more secure livelihoods. Ten years on, results remained positive.

When cost-effectiveness meets the moral question

The speakers were candid about the limits of the numbers. When there is no health care at all, cost-effectiveness is hard to claim, because you are starting from scratch. Sheila put the question differently: what is the moral case for staying in places like Haiti and Lesotho, and what happens if we leave?

Both agreed that funding cuts are pushing organizations such as Mercy Corps and CARE to streamline their collaboration. New funders are stepping in to fill some of the gaps. The call is to focus on outcomes rather than inputs. Both speakers saw targeted interventions and system-building as complementary. The same goes for evidence-minded funders and system-change funders: there is a role for both.

Who gets to decide?

The conversation turned to who sets the agenda. Both speakers stressed that evidence should be produced in partnership with local decision-makers and communities. That means embedding evaluation skills and curricula in local institutions, so the people closest to the work lead the studies. Sheila pressed the point about decentralizing and decolonizing the sector, and noted that donors need to change too.

She also flagged the risk that new approaches to routing aid, including directly through national governments, may not deliver the genuine localization the sector has long promised. She was clear that the old system had deep flaws of its own. Strengthening civil society so it can hold governments accountable, and encouraging private-sector investment, were among the paths discussed.

An audience member asked what those of us who don’t run large organizations can do to adjust. Three threads from the evening stood out:

• Commit long-term. Multi-year and unrestricted funding, often from major donors rather than grants, sustains the platforms that make depth possible.
• Build transferable skills. Operations, logistics, and supply chain skills carry across sectors and contexts.
• Look locally. Community-based work with vulnerable people, and real investment in local knowledge and local researchers, remain the foundation.

Five years from now

Closing the evening, both speakers described a future in which global development is driven by countries themselves rather than by aid, with a shift toward structural systems and a focus on outcomes that improve lives.

Thank you to Cecilia for organizing, Sheila, Lisa, Fuzieh, and everyone who joined us at The Foundry. To attend other BNID events, please visit BNID’s event calendar.