Dr Tedros Adhanom Ghebreyesus, director-general of the World Health Organisation, uses this issue of Alliance magazine to urge foundations to take action in response to the challenges of our times.

In his poignant dialogue with Professor Senait Fisseha of the Susan Thompson Buffett Foundation – a leading health funder – he calls on Foundations to do several things:

First, they should redouble their efforts to ensure that all funding and partnerships are in alignment with a country’s priorities. That means listening to the voices of affected communities and countries and putting them in the driver’s seat.

Second, Dr Tedros implores funders to stand up for the values of international cooperation and multilateralism and lend their support to intergovernmental organisations like the WHO. ‘Because it’s the sum of everything which is bigger than any part,’ the WHO’s knowledge and experience make it best placed to respond to today’s health challenges, he argues.

Third, foundations should advocate for investment in public health using their unique position and influence to ‘put pressure on those high-income countries’ who are undermining primary healthcare and public health to urgently change course and prevent more avoidable deaths.

The area of sexual and reproductive health and rights (SRHR) may too be of particular interest to funders. Dr Tedros notes that SRHR was ‘a contentious issue in global health even before this emergency’ but no more. Now it is a central – and visible – part of its strategy. And at only 6 per cent of all health philanthropy, it is also an area where funders are beginning to shift gears.

Another major development is the establishment of the WHO Foundation – a potentially significant development for institutional philanthropy, opening the doors to deeper partnerships between the world of global health and philanthropy while reducing WHO’s dependency on member states. It is encouraging that funders across the political spectrum from the Gates Foundation to the Open Society Foundations are supporting the initiative.

But differences in the philosophies of Bill Gates and George Soros and their respective foundations are also visible in this issue and serve to highlight some of the fault lines in public health debates.

While Gates has brokered market-based solutions to vaccine development through partnerships with pharmaceutical companies, the Open Society Foundations’ Julia Greenberg and Aggrey Aluso, who served as guest editors of this issue, draw attention to some of the problematic elements of these arrangements. Instead, Greenberg and Aluso emphasise efforts to build a more citizen centred global health system infrastructure.

I hope the debates on these pages provide a meaningful and thought-provoking introduction to these and other key issues as you navigate the challenges in your own philanthropic work.

Our sector is well placed to rise to the challenges which a new decade has brought. And following a year dominated by global health let’s hope that 2021 is the year in which philanthropy answers the call from Dr Tedros.

Charles Keidan is the Executive Editor of Alliance magazine.