Donor governments have long expressed commitments to “country ownership,” but now the Biden administration and the U.S. Agency for International Development (USAID) are putting “localisation” at the heart of their new vision for sustainable global health and development.

USAID Administrator Samantha Power has led the charge around localisation, championing the need for locally led and inclusive development. “To engage authentically with local partners and to move toward a more locally led development approach is staff, time, and resource intensive -- but it is also vital to our long-term success to sustainable development,” she noted recently.

With lessons from nearly seven years, Palladium’s Health Policy Plus Project (HP+) has a new report out, one that outlines six key components for transforming how global health programming is designed, delivered, and monitored, to catalyse inclusive localisation.

The commentary, authored by HP+ consultant and a prominent voice on women’s global health and rights, gender, HIV/AIDS, and U.S. policy, Janet Fleischman, notes that most discussion around localisation in USAID’s global health programs centres on transitioning service delivery and procurement to local partners, which are easier to measure than transitioning support to strengthen the policy environment.

“This gap in translating localisation to the policy arena requires a different kind of engagement with national and subnational governments and local actors,” notes Fleischman. “This will foster an enabling environment where governments and local actors truly lead, and where civil society is involved in ensuring accountability, identifying needs, and defining priorities.”

From focusing on technical assistance and capacity strengthening, supporting local professionals, ensuring equity of marginalised groups, to improving data use, the report offers actionable best practices for not only global health organisations but USAID at large for ensuring that localisation can be successfully implemented in the countries in which they work.

Fleischman underscores that when taken together, these components form the foundation for health policy development, advocacy, decision-making, civil society engagement, and domestic financing. “USAID’s success with localisation will hinge on how capacities and leadership of initiatives to support policy, advocacy, financing, and governance are strengthened and transitioned to local organisations and teams on the ground,” she adds.

“This historic moment of global reckoning demands concerted action to revamp the way USAID and its implementing partners operate, geared toward joining with local partners to design, collaborate, and innovate new approaches to drive health improvements,” Fleischman concludes. Ultimately, the hope is that the learnings from long-running programs such as HP+ can help to push forward this critical agenda for the development sector.

Read Fleischman’s commentary, “A Pivotal Moment: How to Achieve Localisation in Global Health,” based on new brief from Health Policy Plus, “Catalyzing Localisation in Policy, Advocacy, Financing, and Governance”.