As foreign aid budgets shrink across Western nations, the global health and development sectors are confronting a moment of reckoning. In this episode of DevelopmentAid Dialogues podcast, host Hisham Allam speaks with Katri Bertram, a global health and development expert with two decades of experience spanning international organizations, NGOs, and government institutions. She is currently the International Director of Impact and Advocacy at Light for the World, focusing on disability inclusion and eye health. Her experience at the World Bank, Save the Children, and the German Federal Ministry of Health informs the critical analysis she shares in this interview, examining how these historic aid cuts are reshaping global development—and what that means for accountability, power, and the future of international cooperation.
Download the transcript of this episode.
Drawing on her experience, Bertram makes one thing clear: this is not just a funding crisis—it’s a systemic shift.
“We’re not talking about minor adjustments,” she said. “These are real cuts — billions of dollars. Entire aid programs are being shut down. This is a cliff, not a dip.”
The warning signs, Bertram noted, have been building for years, especially since 2015 when anti-migration politics began dominating the discourse in many European countries.
“What started as rhetoric about refugees being a threat has seeped into how politicians view aid recipients,” she said. “The sector didn’t pay enough attention. Now the political narratives have overtaken the development agenda.”
These shifts aren’t just ideological—they’re having tangible consequences. In health, where Bertram has focused much of her career, the data is devastating.
“Recent figures show people die every day from HIV/AIDS due to U.S. aid cuts. Humanitarian services are reporting deaths as well. This isn’t theoretical. This is happening now.”
See also: U.S. foreign aid freeze threatens critical programs in Africa
Beyond the loss of life, she sees the chaos exposing a deeper dependency problem.
“One donor pulling out should not collapse an entire health system. But it does. That tells you something’s fundamentally broken.”
Bertram argues this moment could be a turning point—but only if the aid model is reimagined with intention.
“This isn’t the power shift we wanted,” she said. “We’ve talked for years about localization, about shifting leadership and resources to local communities. But what we’re seeing now isn’t a transfer of power. It’s abandonment.”
She believes the development community must confront this crisis honestly.
“We can’t just keep trying to patch up the old system. It’s over. Budgets aren’t coming back. We need to build something more resilient—and rooted in local ownership from the start.”
That means asking difficult questions about the sector’s own structures.
“We’ve become too focused on growth. But what if our impact was measured not by how big we get, but by how well local systems can function without us?”
For the full conversation with Katri Bertram, listen to the latest episode of DevelopmentAid Dialogues. Follow us for more honest, in-depth conversations on the future of development cooperation.
