Introduction

Global health and development finance is in a period of profound change, with significant reductions by bilateral public finance providers shaking the system’s foundation. In early 2025, the United States, the world’s largest provider of Official Development Assistance (ODA), announced a massive reduction in its foreign aid, cancelling more than 80 percent of USAID’s contracts and moving remaining development operations and functions to the U.S. State Department. Facing domestic political pressures, fiscal realities, and external security imperatives, other major ODA providers have also cut their ODA substantially from 2024 to 2025: Germany by eight percent, France by 39 percent, and the UK by six to seven percent as of the writing of this report.[1] Altogether, OECD-DAC expects 9-17 percent cuts across all sectors and all members.[2] ODA is complemented by other finance flows, including international and domestic private capital, concessional finance from the Multilateral Development Banks (MDBs), and domestic revenues. Countering the ODA trend, in 2024, MDBs pledged to mobilize between $300 billion and $400 billion in new and additional lending within 10 years[3], while pledging more efficient and effective coordination within the wider public development bank system.

The current environment presents both a challenge and an opportunity for the Gates Foundation to think and work differently. The unfolding crisis not only threatens decades of development progress but also means the Gates Foundation will need to look beyond alignment with traditional donors and concessional finance to sustain momentum. The crisis presents opportunities to address challenges within the prevailing model: short-lived, single-donor, project-based approaches that are not fit-for-purpose, by accelerating the mainstreaming of scaling to meet the financing pressures and gaps left by retreating donors. Given the announcement in May 2025 by Bill Gates that the foundation will give away $200 billion over the next 20 years and wind down operations by 2045[4], scaling has taken on even greater importance within the foundation as teams look to identify effective pathways to sustainably scale their impact beyond the life of the foundation.

In light of these major developments, the Gates Foundation participated in a study of how a few of its teams have approached scaling. This study includes documenting and synthesizing distinct experiences, good practices, successes, and lessons learned. The study illuminates instructive scaling experiences for potential application by other funder organizations and contributes to a broader learning agenda on how various development stakeholders can improve the sector’s efficiencies and effectiveness, drive down delivery costs and timelines, and maximize impact.

Study scope

The study draws lessons from the Gates Foundation’s experience with scaling across a range of Program Strategy Teams (PSTs) and initiatives. It examines the foundation’s approach to scaling, draws case-based insights across several PSTs, and makes suggestions for future focus areas. The study captures lessons from how PSTs conceptualize impact, define scaling in relation to their strategic objectives, structure partnerships, and address sustainability considerations. Overall, this paper intends to advance wider learning on scaling impact and contribute to the Scaling Community of Practice’s initiative on mainstreaming scaling in funder organizations.

Importantly, this study is not an evaluation of the foundation’s approaches or impact. Nor is it fully representative of all foundation initiatives or teams. Instead, it offers illustrative insights based on a close examination of a sample of teams, products, and innovations.

The study is authored by a consultant, Simon Winter, under the guidance of Matt Eldridge and Caroline Kuritzkes (DPAF) and Nicole Golden (FSO).

Defining “scale” and “scaling”

For the foundation, successful scaling is achieving substantial and lasting impact on critical development challenges for the poor and underserved, where target populations vary by program strategy and country context. Individual solutions are seen as a means to achieve impact at scale, rather than ends in themselves. Lasting impact is supported by changes in key enablers: institutions, understandings, and systems.^[5] The study distinguishes between “transformational scaling,” which is defined by various experts^[6] as building realistic pathways to scale through the design of projects and innovations; investing in systems change and strengthening to create the enabling conditions – policies, institutions, value chains,  financing –  that relieve constraints to scale and sustainability; and, as needed, funding longer-term interventions, albeit often with multiple phases. This is contrasted with “transactional scaling,” which refers to larger programs and impacts achieved within shorter timeframes, with the application of additional resources (human and financial), but typically without systemic changes in institutional frameworks^.[7] This is not to imply that transformational scaling is necessarily superior to transactional scaling, but for most very difficult and complex development challenges, at least some element of transformational scaling is required.

A brief history of scaling at the Gates Foundation

Scaling has long been a strategic priority across the foundation, which has made considerable progress in multiple program areas. The foundation’s approach to key development challenges has mostly focused on identifying innovative solutions (products and approaches) that can solve tough development challenges, such as new vaccines, delivery of health services, seed varieties, and digital and data tools. The development, adaptation, and introduction of solutions to meet the needs of specific low-income and vulnerable communities, followed by adoption at scale by optimizing their affordability, design suitability, and delivery pathways, sits at the core of the foundation’s approach.

Two reviews prior to this case study examined the foundation’s earlier scaling efforts.

In 2010-2011, a health-centric review concluded that the foundation is a “catalytic” organization focused on the sustainability of supported changes, continuous improvement, and “impact at scale” through collective action (not scale per se). The review suggested strengthening diagnostics of users’ needs (i.e. “pull” vs “push” approaches to innovation), a strong orientation towards taking actions to deliver impact, and learning by doing, especially by engaging with effective intermediary organizations and learning from private sector scaling efforts.

Takeaways from a 2018 review included the foundation affirming its unique selling position strategically as built around: (a) pursuing bigger bet philanthropy, (b) leveraging its capabilities as convenor and creative partner, and (c) deepening its technical depth and analytical rigor.  This exercise highlighted that the Global Alliance on Vaccines and Immunization (Gavi) was seen across the foundation as a successful example of scaling.

 

Box 1 – Gavi Since its founding in 2000, Gavi helped immunize more than 1.2 billion children, and is estimated to have prevented more than 20.6 million future deaths. By 2022, 19 countries had graduated from Gavi support. Keys to its success in scaling included the use of Advanced Market Commitments that lowered costs, the International Financing Facility for Immunization that used innovative bonds to secure predictable upfront cashflows, and local health system strengthening. While Gavi has been very successful, it has encountered barriers to sustainable scale, including risks related to “aid dependence,” insufficient domestic attention to budgeting for transitions, and under-investment in demand generation in many countries.a a https://www.gavi.org/sites/default/files/programmes-impact/our-impact/apr/Gavi-Progress-Report-2024.pdf

 

The review encouraged engaging the private sector to produce or distribute developed innovations, and, while noting the importance of suitable enabling environments, suggested that others would mostly lead on the structural or institutional factors conducive to scaling, often through intermediaries. The 2018 review concluded by suggesting scaling pathways could:

• Develop new solutions that enable weak systems to be complemented by approaches to achieve scale quickly.
• Strengthen the ecosystem for scaling, including launching/strengthening intermediaries, building human capacity, and catalyzing complementary funding.
• Leverage existing systems and scale by lowering cost/prices to improve affordability, while maintaining the quality of the innovation.

We can think of the first two as forms of transformational scaling. The third is notionally quicker by plugging into an existing system, but often not possible given the weakness of existing systems in contexts where the foundation operates.

What is clear from these two reviews and reflected in feedback provided by this study’s interviewees is that the goal of achieving impact at scale is universal across foundation teams. However, the foundation encourages PSTs to develop their own bespoke scaling approaches tailored to the diversity of contexts, experiences, and solutions to be pursued. Teams have not been expected to adopt centrally articulated specific scaling pathways or methods.

Methodology

This review bases its insights on examination of the scaling experiences of four PSTs: Agricultural Development (AgDev), Family Planning (FP), HIV, and Digital Public Infrastructure (DPI). These four PSTs were selected to showcase a sample of scaling approaches and pathways from across the many foundation teams. Staff on other teams, including Development Policy and Finance, the Foundation Strategy Office, and the Africa Regional Office, were also consulted with a total of 24 staff engaged through semi-structured interviews.

Questions included interviewees’ evolving understanding and experience of scaling; approaches, tools and methods used to mainstream scaling across their portfolios; strategies to secure co-financing for scaling; challenges they experienced; and ways they tracked, measured, and learned about scaling. Interviewees were asked to share key documents that illustrate their evolving scaling approaches and relevant external reviews. The insights they provided, combined with review of relevant internal documents, inform the study’s findings.

Overview of the case study PSTs

The following table summarizes the strategic focus areas for the four PSTs.

Program Strategy Team	Focus Areas	Scaling case examples
Agricultural Development	Crops research and development Agricultural delivery systems Climate, gender and nutritional food Livestock	CGIAR[8] innovations’ use by small scale producers Dual-purpose poultry
Family planning	Reducing unwanted pregnancies through behaviour change, and Increased use of innovative products to prevent pregnancies	Intra-Uterine Devices Contraceptive Implants Demand generation
HIV	(Early on) direct catalytic funding for prevention and treatment (e.g., Global Fund) Support learning networks to enable national scaling.	Prevention awareness Treatment demand creation Treatment therapies
Digital Public Infrastructure (DPI)	Reusable, interoperable, open-source digital tools	Digital IDs Digital payments Digital data sharing

 

The foundation’s approach to scaling

Aligned with its mission, financial resources, and staff expertise, the foundation views itself as an innovation and catalytic partner, not a scaling partner per se. The primary focus of the foundation has been on high risk and high ambition challenges that it is uniquely suited to pursue. This includes initiating and perfecting adoption of needed products at scale in a limited number of focus geographies. Once progress is clear, and a critical tipping point is reached in terms of co-financing or co-investment, the foundation backs off direct scaling support in target countries and its role evolves to foster replication and adaptation of the solutions at scale in other geographies. For example, in addressing HIV, interventions have progressed from direct catalytic funding through vertical funds and, in target countries, to support for learning networks that enable actors to do national scaling in a broader array of geographies. The networks help countries identify best practices and challenges, stimulate progress through friendly rivalry, and provide technical assistance where needed. They include the CQUIN, the LabCoP, and the South-South prevention learning network.[9] The learning networks have spawned further networks at sub-national and local levels, generating scaling multipliers without any direct foundation involvement. The learning networks provide the basis for further exploration of comparative, cross-country scaling experiences.

While different teams at the foundation have developed a range of scaling strategies, it is possible to discern some overall patterns to the approaches they pursue. The rough cycle of the foundation’s work on scaling includes several common workstreams as laid out in the following sub-sections. While data and evidence building is typically first, other workstreams often function in parallel. Even with data and evidence, it is critical to update this from time to time as needs evolve, technologies advance, and contexts and circumstances change.

1. Understand the challenge through data and evidence building: This involves research and diagnostics on the size of the target populations and/or addressable market, their needs, and gaps they experience in addressing those needs. If the data does not yet exist, then the foundation invests in generating it and looks to make the data public.

This includes understanding target user perspectives. In DPI, for example, teams ask who from the private (especially financial) sector will be able to leverage DPI for economic benefits, to grow their markets and reduce costs? Foundation teams realize that people having needs may be different than those people actively demanding they be met, especially for populations who do not yet realise there are products that can help meet their needs. This leads to a realization that the foundation should support demand activation and support providers of such services to respond to such challenges (for example, in family planning, and HIV testing).

Diagnostics are followed by developing a theory of change, key outcome metrics, and targets.

2. Identify and/or develop solutions: Teams scan the availability of innovative products and services that can meet the assessed demand/needs in the focus strategic sectors. In general, there is a slight preference toward identifying and scaling products that already exist but are not already affordable or accessible to target populations in their local contexts. In addition to working with manufacturers to lower product costs so they are more affordable to users and funders, maintaining quality and efficacy is a priority.  In the livestock team of AgDev, for example, such products include new varieties of dual-purpose poultry (DPP), sex-sorted semen, and livestock vaccines. Teams are encouraged to work closely with scaling partners across production and delivery as early as possible in the program design phase to ensure they have time to prepare to scale. This includes the direct scaling partners, such as companies that own the intellectual property and/or will be critical for private sector delivery of innovations.

Where private sector solutions are not available, the foundation may support the public sector or support public-private partnerships to undertake research and development (R&D). In AgDev, the Crop R&D team supports the Consultative Group on International Agricultural Research (CGIAR) to conduct frontier research and develop new products and technologies, such as significantly more productive and/or resilient seed varieties. The foundation also supports the selection and scaling of innovations developed by others and backed by robust evidence of their impact and cost-effectiveness, for example, through AIM4Scale.^[10]

The DPI case is unique, with the foundation supporting it to create a cross-cutting infrastructure that could enable other teams to more efficiently and affordably achieve their objectives. For example, by improving market players’ viability to engage with underserved customers in agriculture through the establishment of farm registries. The DPI team does not typically develop new products but supports roll outs to scale what is already developed and proven. The foundation, nonetheless, funds high risk development efforts that other funders will not, and in rare cases may support product development, when a needed quality product is not available. Three principles guide the DPI team: scale, sustainability, and speed.[11] Speed is a major differentiator of the DPI work, with the team testing new ideas and either failing fast or finding rapid ways to scale. This is based in part on “Societal Thinking,”[12] a systemic approach developed through many “Do-Think-Do” cycles with change leaders across the globe. The “Do” cycles involve co-exploring, designing, and building missions that create impact at population scale. The “Think” cycles help distil the learning into core values, design principles, and open frameworks. A primary pillar of the DPI scaling and sustainability principles is the more minimal the design, the lower the unit costs, and the more DPI can be re-used, then the wider will be adoption.[13]

3. Develop and implement the scaling pathway: Pathways to adoption at scale vary. Given its nature, DPI looks at delivery at the scale of the whole system from the onset. Several other PSTs take a more stepwise approach that typically involves pilots for proof of concept on both technical efficacy as well as affordability / investability grounds, with early attention to and involvement from those who will take the lessons and pilot products. Box 2 includes more specifics about the DPI example.

 

Box 2 – Example of successful scaling – The roll out of Digital IDs in India India’s national Aadhaar introduced in 2009 gave citizens access to a digital ID system. This meant that people no longer had to rely on intermediaries. The original use case for digital IDs was government-to-person benefit transfers (India is projected to have saved more than $40 billion USD in its direct benefits transfer programs by removing ghost beneficiaries and plugging leakages through strong identity assuranceb); however, the systems were designed for multiple use cases (for example, opening a bank or mutual fund account, securing a SIM card, or receiving government payments). India’s financial inclusion jumped from less than 20 percent to more than 80 percent in less than 10 years.c Bank account ownership in India more than doubled to 78 percent in 2021, which brought millions of Indians, especially women, into the formal economy. The system has broadened the reach of social safety net programs, reduced waste, and made the government more responsive during times of crisis. The foundation focused initially on higher capacity states like Maharastra and then shared the lessons to others including the foundation’s priority states like Uttar Pradesh and Bihar. The biggest challenge in the weaker states remains weak procurement and payment capacity/systems. b https://www.pib.gov.in/PressReleasePage.aspx?PRID=2123192 c See BIS study here https://www.bis.org/publ/bppdf/bispap106.htm

 

The choice of whether to pursue a private or public scaling pathway is primarily driven by what it will take to reach and have impact on a target population. To decide, teams examine the relative strengths of the public and private sector channels and services.  For example, in health, simpler products might be distributed by pharmacies, while more sophisticated interventions may need highly trained health professionals operating through public clinics. With DPI being public in nature, the government is the main scaling partner. In AgDev, with the focus on products to be used by small scale producers, the private sector is the generally preferred manufacturer, supplier, and distributor of these products at scale.

A distinctive positive feature of the foundation’s work is a willingness to invest in growing demand for needed innovations. Target populations may have needs but lack awareness of solutions that can help address those needs and, therefore, may not express demand for those solutions. Ensuring potential demand is generated and expressed by target populations reduces the risk that great innovations are “pushed” at target populations and not adopted.

1. Catalyzing private markets for innovations.

Private sector engagement must balance development outcomes (i.e., helping small-scale producers who the private sector usually avoids due to their limited resources and high-risk perceptions) with financial sustainability (i.e., ensuring the private sector can engage commercially, competitively, and profitably over time).

For private sector scaling, a key question is: what data do private investors need to make investment decisions to engage with target populations at scale? This has led the foundation to support data collection to better understand, for example, price elasticities and business opportunities. Such data helps farmers and businesses understand the value opportunity and risks/returns. The foundation offers grants, blended finance tools, and/or technical assistance to businesses to help them achieve the economies of scale that can enable access by target populations to affordable innovations.

The foundation works, for example, with private partners to put in place advanced market commitments or other volume guarantees to assure manufacturers of sales volumes to lower costs and prices. While a range of innovative financial instruments and tools have helped attract private capital to enterprises that can supply and/or support target populations, a single best practice is unlikely to be broadly applicable. Foundation finance instruments include: grants, recoverable grants, quasi-concessional debt and equity investments (Program Related Investments),[14] and financial guarantees (which address risk perception).

One example of private sector enabled scaling is the dual-purpose poultry work supported by AgDev, as described in Box 3.

 

Box 3 – Example of successful scaling – The introduction of dual purpose poultry (DPP). The introduction of DPP started with the identification of suitable poultry breeds to increase productivity in a resilient way in Sub-Saharan Africa. The first project in Ethiopia introduced higher productivity chicks in a model that supplied day old chicks to mid-size brooders who then supplied older chicks to small-scale producers. The local government was very enthusiastic about embracing the innovation. An interested private sector partner, Ethiochicken (now Hatch Africa), was excited to expand the local production of DPP day old chicks. The first scaling out effort — from Ethiopia to Nigeria and Tanzania — was funded by the foundation in partnership with the World Poultry Foundation and private sector businesses in each country. The foundation awarded a 10-year recoverable grant at 0% interest to help a scaling partner poultry company raise additional private capital. As evidence of positive poultry productivity impacts was generated, the foundation’s role in scaling changed. It went from demonstrating and adapting the model to improve viability, to helping establish it in new, more nascent markets. Further scaling to 10 countries is being developed without foundation support, led by the key international companies.

 

2. Partnering with governments to facilitate broad up-take.

Governments are the focus for offering public goods or assets, for example, to provide complementary weather, soils, and other data or DPI and services. For DPI, it is only the public sector that could achieve universal digital inclusion, as it is hard to establish a private business case for inclusion of the poorest and most vulnerable.

Governments are also looked at to provide support and enabling for private sector scaling. The foundation’s grants to AGRA, for example, help provide access to and support for country governments as well as regional organizations (such as regional economic communities) to support such activity.

Across multiple teams, the foundation helps governments play roles in supporting innovation and regulatory enforcement by building alliances, including with public actors (such as senior public officials), farmer representatives, and businesses, and steering committees to address pre-competitive issues.

3. A note about policy

Regardless of whether scaling paths are public or private, the foundation is aware that sometimes policy and regulatory reform is needed to support scaling. It offers support for data and advisory services (non-lobbying), especially aimed at local government support for scaling solutions. For example, for DPI, having a regulatory environment that supports data privacy and confidentiality is critical; for health products, regulations may need to change to allow private pharmacies to distribute publicly procured innovations.

 

Box 4 – Example of successful scaling – Modular Open-Source Identity Platform (MOSIP)d Building from the learnings from the creation, deployment, and usage of the Indian Aadhaar example in Box 2, the MOSIP initiative’s primary goals include: ·         Developing an ID platform: an open-source public good digital identity system; ·         Enabling early adopters: at least two countries adopting the platform to build a robust, secure and privacy-preserving foundational ID system; ·         Creating a commercial ecosystem: a vibrant community of a vendors, system integrators and innovators to support platform adopting countries. MOSIP has made significant progress against all three performance objectives, including: 980+ million people living in countries piloting or deploying MOSIP – Philippines, Ethiopia, Nigeria, Morocco, Togo, Senegal, Sri Lanka, Burkina Faso, Niger, Uganda, and many others, with 150+ million people registered in the Philippines, Ethiopia, and Morocco as part of national deployments; 19 out 28 MOSIP countries in Africa; and, 100+ commercial partners onboarded including biometric device vendors, Automated Biometric ID System providers and system-integrators, as a result of MOSIP training programs, marketplaces, and certification processes. The foundation’s investment in setting up MOSIP has supported scaling out by being highly leveraged, with only US $20 million of foundation investment being used to mobilize US$2.5 billion of World Bank funding. Looking forward, the intention is to reach more than 300 million new digital IDs by 2030. d see https://www.mosip.io/

 

The table below illustrates the four illustrative scaling pathways used by the foundation. The choice is partly dependent on what is being scaled.

What Is to be Scaled?	Scaling Pathways	Catalytic Actions	Types of co-funder engagement
Public infrastructure	Public sector, national and/or local government agencies	Generate data/evidence and engage users; Research best technologies/solutions Establish platform (e.g., MOSIP) to accelerate scaling Engage governments to re-orient public spend and policy Engage co-funders and partners to fill gaps, derisk etc.	MDBs and bilaterals GF can build co-funder capacity Host governments for infrastructure
Innovations that need public delivery and funding	Public sector, national and/or local government agencies	Assess demand and delivery system strength Identify proven demand and supply solutions, engage system partners Catalyze manufacturers/suppliers to provide solutions Engage co-funders for scaling	Global Fund, WHO, Gavi Other foundations National governments
Population-wide innovations that can be privately delivered	Private or non-profit sector delivery, supported by policy and other enablers	As above, AND assess private delivery gaps Catalyze improved service response May need regulatory changes	Global Fund and others for incentives Development finance institutions (DFIs), foundations and private investors for private scaling
Community or individual specific innovations for private production and delivery	Private sector; supported and enabled by public co-funding for policy, de-risking financing, and infrastructure	Data on demand and solution costs for investors, delivery companies Prioritize innovations if GF supported, step change impact Incentivize private actors for solution adaptation and delivery Engage co-funders to support catalytic intermediaries[15]	MDBs, e.g., TAAT with AfDB Bi-laterals and other Foundations Private companies

 

4. Co-Funding. A core principle across all PSTs is that the foundation should not look to achieve scale unilaterally. Instead, it actively seeks co-funders – public or private – depending on the scaling pathway, especially for innovation delivery at scale.

The foundation regularly partners with multilateral co-financiers (especially MDBs like the World Bank, IFC, and African Development Bank) to co-finance both scaling efforts and complementary investments (such as policy, and system capacity building). For instance, AgDev’s modest annual investment in the TAAT Clearing House helped create a digital catalogue of scale-ready CGIAR innovations, enabling their integration into African Development Bank and other programs.[16]

Co-funding also enables scale-up in geographies beyond the foundation’s deep engagement focus. Complementary schemes can also support scaling out by incentivizing private sector engagement in underserved or high-risk communities, such as remotely located smallholder farmers.

An emerging focus is supporting country and state government agencies in mobilizing and deploying their own public resources for scaling.

5. Monitor, Evaluate, and Learn (MEL): An effective MEL system is vital to track and compare scaling progress across programs. While individual teams document results and lessons, cross-team comparative learning remains limited. Current MEL practices include tracking innovations across stages (e.g., early innovation, scale-up, exit), but more analysis is needed on what happens after innovations transition out of direct support.

Where an innovation’s outcomes are well-established, teams assume adoption leads to impact and focus on measuring cost, efficiency, and behavior/supply-side effectiveness—starting with baseline mapping and large-scale surveys to track change.

Learning networks use self-assessment tools and qualitative cross-country comparisons to evaluate progress. The foundation also tracks two leverage indicators: (1) additional funding mobilized, and (2) influence on policy change through its advocacy efforts.

One team has applied a Scaling Readiness Framework that that assesses technical readiness,[17] impact potential, delivery models, financing (public vs. private), and enabling environments.

The DPI team uses activity-based indicators—such as number of pilots, user adoption, solution quality, and speed of deployment—to measure progress. Though macroeconomic impacts of digital IDs are of interest, DPI’s MEL emphasizes inclusion and quality of access for the underserved. An ongoing study in India is assessing the impact of digital ID systems on low-income populations.

Finally, teams like AgDev are developing streamlined results frameworks that link innovation adoption to economic outcomes across the value chain. There is growing interest in using advanced data tools to prioritize scale-ready innovations and improve learning across the foundation.

Overall Findings

In addition to documenting evolving approaches, this study surfaced key insights from the foundation’s scaling experience—particularly related to scaling pathways, systems, strategic partnerships and the enabling role of regional offices. In this section, we highlight the positive take-aways from across the four PSTs that were examined closely. In the next section, we make recommendations for consideration by Gates Foundation teams, as well as others looking to strengthen their scaling approaches.

Pathways and systems

• The diversity of the development challenges the foundation works on reinforces that scaling approaches are not easily standardized. At the Foundation, form (pathway) typically follows function (the nature of the product or solution to be scaled).
• Prioritisation helps with maximizing returns on resource use. Most teams focus on relatively few critical innovations – rather than a wide portfolio. This reinforces aiming at transformative scaling, bringing in a range of public, private, and community partners for complementary work in most scaling ecosystems.
• The foundation is willing to embrace longer term programming. The expected duration varies according to the status of product proof (i.e., is it a complete innovation, or is it already produced somewhere, but not available to the target populations), and whether commercial players are already producing the product, or whether new institutions need to invest in production facilities.
• Taking a system strengths-based approach to selecting between private and public sectors for demand creation and product delivery is a pragmatic approach. In the cases where systems are too weak for either public or private strengthening, the foundation supports hiring staff to assist with delivery. The expanded talent pool can be taken on within the system after the intervention ends.
• Teams that primarily utilize private sector-led scaling also recognize the essential role of government in expanding access to transformative products. Effective private sector engagement has been supported by tools such as market opportunity data, demand aggregation strategies, and catalytic financing (e.g., grants and risk-sharing instruments) to de-risk early-stage scale-up and improve investment viability.
• The DPI team emphasizes rapid iteration, testing new approaches, and scaling successful models quickly. The Indian experience with digital IDs informed the creation of initiatives like the Modular Open-Source Identity Platform, designed to support the rollout of digital ID systems in other countries. These efforts have also helped mobilize significant co-funding. Public sector-led scaling is central to ensuring that the poorest populations benefit. The value of DPI is reinforced by its multiple use cases—including improving financial transfers to the underserved, tax collection, public financial management, and data access and exchange. The emphasis on speed and failing fast (if that happens) also supports optimal foundation resource use.
• Successful transformational scaling is not primarily about mobilizing resources for a specific product or solution but about strengthening system capacity and ensuring conditions are primed for impact that is both at the addressable population level and sustainable. The foundation invests in system strengthening to optimise the functioning of systems and to address technical, financial, and (small p) political barriers to impact. In health, for example, this means recognizing foundation support is temporary, and engaging ministries of finance and policy alongside health ministry counterparts and adapting strategies to meet institutional and market realities.

The role of partnerships

• For solutions with commercial applications, strategic partnerships with MDBs (like the African Development Bank), DFIs like IFC, or venture philanthropies, are useful as part of a long innovate-to-scale, multi-phase, runway where the patient capital of MDBs/DFIs[18] helps bridge the “valley of death” financing gap between pilots/proofs of concept and full commercial sustainability.
• While innovative financing tools like advance market commitments or purchase guarantees have successfully mobilized critical investment and product innovation in areas like vaccines, this progress could be temporary if the program period is not used to demonstrate market demand, develop lower cost products and delivery models, reduce key risks, or otherwise strengthen the financial feasibility.
• The foundation often looks to partners to address persistent, systemic challenges that obstruct scaling. In countries where government capacity is weak, partners fund and/or support complementary activities on the policy or regulatory environment. In larger countries like Nigeria, the foundation has focused pioneering efforts on states that offer early traction potential, and collaborates with partners to strengthen government capabilities in others.
• Productive partnerships with governments and other stakeholders—particularly in health systems—have been effective in attracting co-funding and supporting scale-up across countries. For DPI, the foundation looks to mobilise other funders to support state capacity building and to advance DPI solutions for public financial management. The foundation’s critical roles include: (1) Creating a “center of gravity” to attract other public donors. (2) Co-creating solutions with the teams from World Bank and others, for example, through the ID4D grant.[19] This helps the World Bank build internal capacity to better understand IDs/DPI and advise governments effectively, improve the efficiency and effectiveness of the use of World Bank resources, and support country capability building. (3) Raising the importance of DPI, including through blogs, speeches, conferences, and advocacy to other agencies by foundation leadership.

The role of regional offices

While this brief section relates to the cross-cutting potential of the foundation’s Africa regional office (ARO), the opportunity highlighted is for scaling funders to engage locally to foster long-term capacity building of regional economic communities and continental bodies. The ARO has worked with and through the African Union, Africa Centers for Disease Control, ECOWAS, the African Development Bank, and others to help them have capabilities to support scaling beyond the foundation’s priority countries, across the region.

• Part of the ARO’s work on scaling is to support African institutions to mobilize resources from other funders and support public financial management, budgeting, and domestic revenue mobilization. In the future, the ARO will work more closely on program design with PSTs, align with PST staff on the continent, and emphasize greater empowerment, adaptation to local contexts and leadership opportunities for regional staff.
• The ARO is also a gateway to understand continental and national government priorities, social contexts, and the development ecosystem to support African goals to deepen regional engagement, trust, and partnership. Regional priorities include job creation, workforce development, industrialization, youth engagement, as well as unlocking economic opportunities over the longer term. A deeper inquiry could link to the foundation’s interest in transformational scaling.

Suggestions for the future

Following the flow of major scaling activity areas, some suggestions surfaced during the internal discussions and are complemented by insights from the author. They build on the strengths laid out above. Many of these relate to what could be components in a foundation-wide standardized guide for teams. Such a guide could underpin a continuous improvement culture, potentially anchored in an internal Scaling Community of Practice.

• Strategy and overall approach. A definition and guide to the institution’s strategic focus on scale and scaling would be a good foundational statement from foundation leadership. This should be explicit about the commitment to mainstreaming scaling across the foundation. The pronouncements should flow into organizational processes, for example, emphasising the need to develop team or solution scaling strategies upfront before any data collection is done. This would carefully focus initial data collection as well as enable the development of early hypotheses around the selection or development of innovations, delivery pathways, and much earlier engagement with external co-financiers.
• Data and Evidence. Initial data analytics could include: sizing needs/addressable markets/developing denominators; how to engage communities and segment demand to ensure the most disadvantaged are included; looking at the comparative costs and qualities of alternative innovations; and, assessing the extent to which incentives and risk underwriting should be provided to the private sector.
• Innovation and solution development. Guidance should include how to think about public vs. private R&D, selection and adaptation of existing solutions vs. more research, and commercialization and investments in production capacity to capture economies of scope and scale. The guide should preferably have a strong bias towards production and manufacturing in the Global South, locally where possible and economic to do so, including supporting the development and strengthening of local entrepreneurs and subject matter experts, in line with existing and potential target countries strategies and capabilities. The guide should include how to manage innovation portfolios, including decisions to exit when scaling is no longer feasible.
• Scaling pathways. Guidance should include how to select the most appropriate pathway, how to catalyze public and private sector delivery, and how to conduct standard capability assessments of existing systems, whether public, community, or private. As per the innovations point above, a positive bias should be made towards local or at least Global South organizations as partners for any capacity building or system strengthening needed, balancing this with the need for speed and quality. Use of learning networks to diffuse innovations across non-priority countries for the foundation should be highlighted.
• Co-funding and financial innovation. Demand is growing ahead of supply in the face of the ODA crisis. The foundation can work closely with others looking to “do more with less,” including: MDBs and interested philanthropies, as well as national and state governments, and public development banks, looking to re-orient their public spending. MDBs/DFIs and others will have their own procedures, requirements, and preferences. Opportunities to scale through them could be missed if philanthropy isn’t sufficiently flexible and the engagement process isn’t started early enough. The guide could include when and how to approach co-funders and investors, including how to align early in the program scoping/development process, how to use debt swaps and other innovative finance tools, and how to link (for example) family planning into health insurance services. Success factors for partner engagement include active listening and developing relationships at leadership-level, taking a long-term perspective, complementary output and impact expectations, and being open to working in different countries of interest to the co-funders. The guide could also include how to scale and systematize innovative financing schemes that pay for outcomes, including: social or environmental/climate impact bonds, pay for performance/results, and recyclable first loss and guarantee facilities. It could also lay out the best uses of alternative kinds of innovative, blended and/or systemic financing solutions in support of scaling.
• Monitoring, evaluation, and learning. More standardized tools should be developed and rolled out related to the MEL of mainstreaming scaling, as well as to keep track of and compare individual PSTs efforts in this regard. This should explicitly talk about the relationship between scaling MEL and adaptive management approaches for foundation investments. It should also include support for a “beyond project cycle” set of activities, including cross-portfolio and ex-post evaluations, with specific focus on scaling questions and insights.[20]

The foundation may wish to explore the following areas to strengthen its scaling efforts across teams and geographies:

• Strengthening the learning agenda. While strong progress has been made in early-stage research and in measuring and monitoring scale, the foundation could benefit from tools that compare the cost-efficiency and effectiveness of different demand-generation strategies. In addition, frameworks for identifying and addressing barriers in the transition from proof of concept to late-stage scaling could support adaptive management—particularly for reaching marginalized populations who are most vulnerable to being left behind. This could help with internal learning as well as provide the content for more frequent and intentional exchanges with external partner organizations.
• Prioritizing systems strengthening alongside speed. While private- or non-profit-led approaches can enable rapid scale-up, long-term sustainability often depends on robust public systems. Guidance is needed on how to assess system strength collaboratively with other funders and actors, and how to coordinate complementary system-building activities. For functions like DPI, more clarity is also needed on the respective roles of the foundation and its partners in building government capacity.
• Fostering country-level coordination. Scaling could be accelerated through greater coordination among governments, funders, businesses, and civil society. Country-level platforms focused on specific sectors or innovations could serve as convening spaces for alignment and joint action.
• Expanding access to financial services for scaling through markets. In areas like agriculture, scaling often depends on improving access to finance for farmers and agricultural small and medium enterprises. While social enterprises like One Acre Fund and Babban Gona offer promising models, their reach remains limited. The foundation may wish to consider whether and how it can help expand these models—or foster others—to serve the broader population of small-scale producers.
• Fostering country level financial sustainability: While collectively supported vertical funding mechanisms, such as the Global Fund, PEPFAR and Gavi, have supported millions of people, reliance on them has, at times, fostered dependence on donor-driven structures rather than integrating costs into already stretched domestic public budgets. The closure of PEPFAR and broader cuts in ODA in early 2025 raise two critical questions: (1) How can the funding burden be shifted toward regional and national public resources, other philanthropies, and the private sector?; (2) How can remaining resources be used more efficiently without compromising quality or overburdening national health workforces? This is an area that needs further sector and location specific solution building.
• Improving MEL for scaling and system capacity. Further work is needed to assess improvements in state capability and systems, as well as to track how scaling practices are mainstreamed across the foundation. MEL efforts could incorporate a stronger focus on equity—specifically ensuring that benefits are reaching the most vulnerable—before declaring a scaling initiative successful.

[1] Various online 2025 news reports.

[2] See https://www.oecd.org/content/dam/oecd/en/publications/reports/2025/06/cuts-in-official-development-assistance_e161f0c5/8c530629-en.pdf

[3] See https://www.iadb.org/en/news/multilateral-development-banks-deepen-collaboration-deliver-system#:~:text=Scaling%20up%20MDB%20financing%20capacity,Review%20recommendations%20and%20related%20reforms.

[4] https://www.gatesfoundation.org/ideas/articles/next-chapter.

[5]See for example: https://academic.oup.com/tbm/article/15/1/ibae063/8008690, https://www.socialfinance.org.uk/what-we-do/what-does-it-take-to-make-impact-at-scale#:~:text=Our%20definition%20is%20deliberately%20broad,shifts%20in%20culture%20and%20mindsets.

[6] It has various synonyms including “transformative scaling” or “transformational change.”  See for example: https://link.springer.com/chapter/10.1007/978-3-030-78853-7_3#:~:text=Scaling%2Dup%20is%20one%20mechanism,%2C%20linking%2C%20or%20catalytic%20effects., https://www.bridgespan.org/insights/transformative-scale-resource-center, https://scalingcommunityofpractice.com/wp-content/uploads/2024/05/Scaling-Fundamentals.pdf

[7] Scaling Community of Practice, ibid.

[8] Consultative Group on International Agricultural Research

[9] See: https://cquin.icap.columbia.edu; https://globalhealthlaboratories.tghn.org/categorised_resources/aslm/LabCoP/, and https://www.hivinterchange.com  

[10] https://www.myjoyonline.com/innovative-aim4scale-mechanism-unveiled-at-cop28-for-advancing-resilient-and-low-emission-food-systems/#google_vignette

[11] A guiding book for DPI is Think Scale. The DPI team interacts with the book’s authors.

[12] https://societalthinking.org/ is a resource for looking at how to link scale thinking to social change.

[13] Take the internet for example: TCP/IP, the fundamental and minimal set of protocols, governs how data is transmitted over the internet, is very simple, and can be adapted to numerous browsers, undersea, and ethernet cables, providing a standardized way for devices to communicate.

[14] PRIs are finance tools used by some philanthropies (such as loans, equity investments, and guarantees) with the primary purpose of furthering philanthropic objectives and an incidental potential to generate a financial return. PRIs on their own or paired with grants can be used to de-risk and demonstrate proof of concept at commercial scale for innovative solutions.

[15] For example, the foundation has asked others to co-support AGRA, TAAT, AIM4Scale and complementary areas.

[16] https://taat-africa.org/about-us/; The African Development Bank is also conducting a mainstreaming scaling case study.

[17] The technical dimension is based on NASA’s nine stages of Technology Readiness Levels.

[18] Depending on the MDB/DFI/venture philanthropy partner, the capital could be provided on terms that are concessional, semi-concessional, or commercial (but patient and more risk tolerant).

[19] See https://id4d.worldbank.org/

[20] Reference could be made to and use made of the draft Mainstreaming Tracking Tool of the SCoP.