By Jamie Hansen, Global Health Communications Manager

Two new publications co-authored by our executive director, Amanda Marr Chung, and her Zimbabwean and British colleagues offer timely insights on effective strategies for ensuring the sustainability and local ownership of global health programs at a time of declining donor support.

The first, published in PLOS Global Public Health, describes how the research team empowered frontline workers in Zimbabwe to sustainably integrate an HIV prevention program into the national healthcare system. Their efforts included equipping frontline workers with the agency and leadership skills to identify priorities, co-create solutions to challenges, and maximize limited resources while sustainably integrating health services amid decreasing donor funding.

“This approach is particularly relevant in light of declining development assistance for health,” says Dr. Marr Chung. “As we work to reimagine global health and cultivate equitable partnerships, it is essential to center local voices in health programs, as these individuals are closest to the problems, with the contextual knowledge and lived experiences to resolve them.”

A second publication in BMJ Global Health offers recommendations for the successful transition of a donor-funded HIV prevention program (voluntary medical male circumcision) to an integrated model led by the government of Zimbabwe. To understand barriers and facilitators of this transition, the study team interviewed a wide range of stakeholders, including: local and national government leaders, managers, healthcare providers, village health workers, community members, donors, and implementing partners.

“Our research revealed that power imbalances between donors and the government limit local ownership and integration of the Voluntary Medical Male Circumcision program in Zimbabwe,” says Dr. Marr Chung. “To reduce dependency on donor funding and ensure long-term sustainability, governments and policymakers must prioritize domestic resource mobilization and increase allocations for HIV prevention within national health budgets.”

Additionally, they found that systematic involvement of subnational stakeholders in program planning and governance is essential for fostering local ownership, aligning programs with community needs, and achieving effective program integration and sustainability.