Global survey finds civil society faces mounting funding threats and rising anti-rights pressure

More than half of surveyed civil society organizations working across global health and development lack confidence they will remain financially viable over the next two years, according to a new global report from PAI and partners. The State of Civil Society Working in Global Health in 2026: Resilient, Relentless, and Ready, draws on responses from 461 organizations across 73 countries and documents financial pressures, shrinking civic space and an increasingly organized anti-rights movement.

The report was developed by PAI with the IBP Network and the Community of Practitioners on Accountability and Social Action in Health (COPASAH). Among the findings:

• 52% of responding organizations lack confidence they will remain financially viable over the next two years. Four in 10 report budget reductions exceeding 50% and nearly one-third have reduced their workforce by more than half.
• 68% report severe disruptions to or discontinuation of at least one sexual and reproductive health service.
• 89% report a reduced ability to monitor government commitments and advocate for accountability.
• 90% report threats to sexual and reproductive health and rights policies, while 46% identify misinformation as a challenge.

“The findings should concern anyone who cares about global health,” said Nabeeha Kazi Hutchins, president and CEO of PAI. “Civil society organizations have irreplaceable value: deep community relationships, trusted voices and firsthand knowledge of what people need. They are essential to how countries advance and sustain progress. The need now is to protect and enhance the expertise and presence of civil society at a time when the external pressures and demands are extraordinary.”

Despite commitments to locally led development, funding, meaningful participation and institutional support for local civil society have fallen short of expectations.

“Civil society is not a luxury to be ‘afforded’ by countries when times are good but dispensed with when times are tough. It is the very how and why of societies— how they take shape, express themselves, defend human rights, respond to crises and hold institutions accountable. When civil society voices are silenced or pushed aside, we all lose, but it is women, young people and the most excluded who pay the highest price. As the world struggles to confront enormous challenges, weakening civil society is not just short-sighted – it is the very last thing we can afford to do,” said Kate Gilmore, former United Nations deputy high commissioner for human rights.

The report calls for sustained, flexible funding, meaningful participation in policy and financing decisions, and support for coalitions.

Read The State of Civil Society Working in Global Health in 2026: https://pai.org/resources/state-of-civil-society

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About PAI

For more than 60 years, PAI has advocated for policies and funding that advance sexual and reproductive health and rights. PAI works with a network of more than 1,700 local organizations across 67 countries to support evidence-based and locally led advocacy. pai.org

About the IBP Network

The Implementing Best Practices (IBP) Network brings together more than 25,000 practitioners, researchers and civil society partners worldwide to advance sexual and reproductive health and rights and improve health for mothers, newborns, children and adolescents. It draws on local evidence and community experience to inform global research, policy and programs. ibpnetwork.org

About COPASAH

The Community of Practitioners on Accountability and Social Action in Health (COPASAH) is a coalition founded and led in the Global South that includes more than 650 organizations and networks through six regional hubs. Its members share tools and evidence that help communities monitor health services, hold institutions accountable and shape health priorities. copasah.net