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The State of Civil Society Working in Global Health in 2026
Civil society is navigating a profound transformation in global health. Development assistance is declining, civic space is narrowing, and the global health financing architecture is shifting toward greater country ownership and domestic financing. At the same time, civil society organizations (CSOs) are being asked to take on greater responsibility while many are losing the resources and operating space they need to do their work. The State of Civil Society Working in Global Health in 2026 provides a global view of how CSOs are experiencing and responding to these changes, as well as what they need to remain resilient and effective.
Developed by PAI in partnership with the IBP Network and the Community of Practitioners on Accountability and Social Action in Health (COPASAH), the report draws on responses from 461 organizations across 73 countries, supplemented by focus group discussions and key informant interviews.
The report was launched September 24, 2026, on the sidelines of the 81st session of the United Nations General Assembly (UNGA 81) in New York.
The State of Civil Society Working in Global Health 2026 Report: Resilient, Relentless, and Ready
Civil society is navigating a profound transformation in global health. Development assistance is declining, civic space is narrowing, and the global health financing architecture is shifting toward greater country ownership and domestic financing. At the same time, civil society organizations (CSOs) are being asked to take on greater responsibility while many are losing the resources and operating space they need to do their work. The State of Civil Society Working in Global Health in 2026 provides a global view of how CSOs are experiencing and responding to these changes, as well as what they need to remain resilient and effective.
Developed by PAI in partnership with the IBP Network and the Community of Practitioners on Accountability and Social Action in Health (COPASAH), the report draws on responses from 461 organizations across 73 countries, supplemented by focus group discussions and key informant interviews.
The report was launched September 24, 2026, on the sidelines of the 81st session of the United Nations General Assembly (UNGA 81) in New York.
In a special video message for the launch, UNFPA Executive Director Diene Keita affirmed UNFPA’s solidarity with civil society and emphasized the community trust, technical expertise, and strong coalitions CSOs bring to advancing women’s health and opportunities. She called for stronger partnerships grounded in trust, accountability, and meaningful listening to those closest to communities.
Report Findings
The findings reveal a sector under extraordinary pressure, but also one with deep expertise, trusted relationships, extensive networks, and a determination to adapt.
- 52% of respondents are not confident in their organization’s financial stability over the next two years.
- Nearly 90% reported that their ability to monitor services or engage in advocacy had been reduced.
- 84% reported receiving no to moderate benefits from localization, despite expectations that it would bring greater resources, decision-making, and leadership to local organizations.
- 72% engage with U.N. entities, and 68% work with global financing mechanisms, yet participation in decision-making and accountability spaces remains uneven.
- Civil society’s reach also extends far beyond SRHR. Two-thirds of CSOs working in SRHR work across three or more additional sectors, including gender equality, education, human rights, economic empowerment, climate change, and humanitarian response.
Special Briefings
Accompanying special briefings translate the implications and opportunities for action for audiences across the global health and development ecosystem.
- For donors and philanthropy, Protecting Progress: Why Donor Investment in and Partnership with Civil Society Are Essential to Sustaining Gains describes why sustained investment in civil society is critical to protecting hard-won health gains and ensuring country ownership includes meaningful community participation, accountability, and locally led solutions.
- For multilateral institutions and global financing mechanisms, Why Continued Support for Civil Society Is Existential for Multilateral Global Health and Development Goals explains the gap between civil society participation and influence and describes the need for funded, formal opportunities for CSOs to shape priorities, investments, and accountability.
- For the private sector, From Private-Sector Innovation to Impact on Lives: Civil Society Closes the Gap examines how civil society’s community trust, technical and contextual knowledge, advocacy, and accountability can complement private-sector innovation, technology, investment, and scale to help ensure products and services reach communities and deliver impact.
- For civil society, Navigating Crisis and Leading Change: Civil Society Action for Resilience and Advocacy uses report’s findings to offer strategies CSOs can use to strengthen their resilience and collective influence, including diversifying financing, strengthening coalitions, countering misinformation and anti-rights movements, advancing meaningful localization, and securing a stronger voice in national and multilateral decision-making.
The findings point to an urgent need to protect what civil society has built while investing in what comes next. Ensuring CSOs have the resources, partnerships, and influence to lead will be essential to building a global health and development system that is locally rooted, accountable, and responsive to the communities it is intended to serve.
