Submission to the UK International Development Committee

Inquiry: Future of UK International Aid - November 2025

Introduction

The UK’s role in international development has long been a strategic tool for advancing global health, development and soft power. However, the planned reduction in Official Development Assistance (ODA) from 0.5% to 0.3% of Gross National Income risks further undermining the UK’s global leadership and its ability to deliver impact, following years of prior cuts.

Major shifts in the global health and aid systems present a unique opportunity for the UK to shape a reformed system. Countries and communities most affected by health challenges - particularly in low- and middle-income countries - must be at the heart of this reform.

This will mean moving beyond fragmented projects to long-term architecture strengthening and shared governance. With the right reforms, and political will, UK ODA can use its contribution to global health research and development (R&D) as a strategic asset for health security, economic growth and soft power.

About Wellcome

Wellcome is a global charitable foundation based in the UK. Its mission is to improve health for everyone by supporting science to solve urgent health challenges. With a planned investment of £16 billion between 2022 and 2032 and total active grant funding for UK organisations of £3.9 billion,[1] Wellcome funds research across disciplines to understand life, health, and wellbeing, and to deliver equitable health solutions. Its work spans discovery science and targeted programmes in climate and health, infectious disease, and mental health. Beyond funding, Wellcome influences policy, engages communities, and promotes inclusive practices to ensure that scientific advances benefit society globally. Wellcome is actively involved in efforts to reform global health architecture, including our role in developing the Lusaka Agenda.

Responses to Inquiry Questions

How should the Government be prioritising UK Official Development Assistance (ODA) in the coming years?

The UK should prioritise ODA that strengthens global health research and development (R&D) as a strategic asset for health security, economic growth, and soft power. Due to successive reductions in ODA, the scale of ODA funds for R&D has been severely depleted and is now set to halve between 2026 and 2029 as a result of the latest Spending Review.[2] The distributed approach to ODA R&D funding across five UK departments has also made coordination and focus difficult to achieve.

In this context, ODA R&D should be carefully targeted to address a set of significant development challenges, where there are gaps in evidence, important opportunities to develop transformational technologies, and where UK investment is needed.

ODA will continue to be important, especially for those countries and communities with the greatest needs, but it should not drive dependence. By committing to equitable research partnerships, the UK can ensure that ODA is as efficient and effective as possible, while positioning itself as a credible partner. 

ODA-funded R&D delivers global public goods: vaccines, diagnostics, and treatments that protect lives everywhere. There is no zero-sum trade-off between global and national interest in research - scientific breakthroughs benefit the UK and our partners. The UK’s global role in ODA has historically positioned the country as an innovation leader with economic and soft power, exemplified by CEPI’s vaccine portfolio and the UK’s role in COVAX.

The UK’s leading science and research base provides a distinct point of difference compared to other donors. As attitudes to international development roles shift, the UK must root its new approach to international development in its existing advantages, and research should be at the heart of this.

Given the reduced commitment to ODA, Government should prioritise the following:

•         Set a clear pathway back to increase UK ODA, and ring-fence global health R&D as a priority

•         Invest in equitable research partnerships that build capacity in low- and middle-income countries (LMICs), ensuring local needs drive research decisions.

•         Use the refreshed Science and Technology Network (STN) to identify relationships where the UK can invest with partners at scale and with impact to address global health challenges. The UK must not retreat from the multilateral institutions that protect global health and science.

•         Support end-to-end innovation from discovery science to product development and regional manufacturing through partnerships with Global Health Initiatives (GHIs) and Product Development Partnerships.

What needs to change to realise the goal of moving from paternalistic models and relationships to partnerships?

Seismic shifts have upended global health this year, giving the world a unique opportunity to work together to transform the global health system. The only way to secure health for everyone is to create a sustainable, equitable system that meets everyone’s needs in a changing world.

Countries and communities most affected by health challenges – particularly in low- and middle-income countries - must be at the heart of global health reform. The UK should champion a shift from donor-driven models to country-led, equitable partnerships, as set out in the Lusaka Agenda. This means moving beyond fragmented projects to long-term architecture strengthening and shared governance.

To realise this shift from paternalism to partnership, the UK should align itself with the Lusaka Agenda’s key reforms:

1. Strengthen primary health care and resilient health systems: Align investments behind one national plan and integrate services to build sustainable systems, including at the community level.
2. Enable sustainable, domestically financed health services: Support countries to increase domestic health spending and plan coherent transitions from external to domestic financing.
3. Advance equity: Coordinate approaches to reach vulnerable and marginalised populations through integrated, community-led programming.
4. Improve strategic and operational coherence: Harmonise governance and processes to reduce burden on countries, increase efficiency, and respond to local priorities.
5. Coordinate innovation: Align R&D, product development, and regional manufacturing to ensure affordable, fit-for-purpose health products for underserved regions.

Where is reform needed in multilateral agencies and development banks the UK is a member of, and funds?

Reform should focus on making multilateral health and development financing more coherent, country-led, and fit for future challenges. The UK is uniquely positioned to encourage these changes given its global influence as a funder and its soft power.

However, it is the countries and communities most affected by health challenges that should drive decisions about what a transformed global health system should look like. The Lusaka Agenda’s five shifts for GHIs are equally relevant to wider multilateral reform.

Wellcome recommendations:

•         UK institutions and representatives should use their influence on GHI boards, the World Health Organisation and multilateral development banks (MDBs) to push for implementation of the Lusaka Agenda – including joint workplans, harmonised frameworks, and shared accountability mechanisms.

•         Advocate for reforms that integrate climate and health resilience into core mandates, including adaptation finance and health system strengthening.

•         Support mechanisms for joint oversight and learning across GHIs, MDBs, and bilateral donors to accelerate progress on the Lusaka Agenda five shifts.