by Martin Edlund, CEO, BillionScale Health

The old model for global health is over, and the new one hasn’t fully taken shape. But one thing is clear: the role of donors will be smaller – but more catalytic. Today, we can’t just stretch aid dollars, we need to multiply them. With every precious grant dollar unlocking five or ten more.

At BillionScale Health, we are working to find and finance five breakthrough solutions in the next decade. We think the new “capital stack” will be defined by “5Cs:”

• Country Spending
• Concessional Debt
• Consumer Spending
• Catalytic Grant Capital
• Commercial Investment

In the old days, donor funding dominated. What’s different now is that the first 3 C’s are all forms of country spending. That puts countries in the driver’s seat. They decide what problems to focus on. They decide what solutions scale.

BillionScale Health is pursuing this approach in Indonesia, supporting the government to scale Wolbachia, a nature-based tool to fight dengue that Indonesia first demonstrated in 2020. Working with the ministry of health, local universities, local foundations, and business leaders, we are pursuing a plan to scale Wolbachia to 100 cities and 100 million people.  

It will make Indonesia a launching pad for the region: a center of excellence, a driver of lower costs, a manufacturing hub for Wolbachia technology, and an easy example for neighbors to learn from and follow.

That’s the blueprint. Work with first movers to demonstrate a path to scale. Work with regional funders (like the Asian and Inter-American Development Banks) to ensure the capital and learnings are there to support other countries when they’re ready. Then expand across the region.

When you 10x capital, you 100x impact. That’s the multiplier effect of scale.

-Martin