Reflections on Impact: Building what lasts

As we developed this second Impact Report, I found myself reflecting on what it truly means to create impact that lasts. At WDF, sustainability has never been an afterthought. It has been a cornerstone from the very beginning, guiding how we partner, the projects we support, and how we approach long-term change. 

We have consistently asked ourselves a simple but demanding question: what does meaningful, lasting change look like in the context of diabetes and related non-communicable diseases (NCDs) in low- and middle-income countries? 

For us, the answer goes beyond individual interventions. It lies in supporting efforts that are locally anchored, driven by country demand, aligned with national plans and priorities, and able to continue evolving long after our direct funding ends. Central to this is a commitment to listening, ensuring that the projects we support are shaped by local needs, priorities, and ambitions, rather than defined externally. 

This perspective has fundamentally shaped our partnership model. We work closely with national and local partners, building on existing structures and aligning with country priorities. From the outset, this also means being clear about shared responsibility: WDF support is catalytic, while political commitment, ownership, leadership, and the partner’s own contribution to essential running costs - such as staff, facilities, and basic operations - help create the conditions for continuity. 

It requires patience and a long-term view, strengthening capacity step by step, adapting to changing contexts, and learning along the way. Progress is rarely linear, but the result of sustained engagement and trust over time. 

Over the years, WDF has evolved alongside this approach. We have moved from supporting smaller, stand-alone initiatives to contributing to broader, more integrated efforts within national health systems. Yet the ambition remains the same to sow a seed for locally defined solutions that are owned by those closest to the challenges, grow within existing systems, and continue well beyond our involvement. 

The two stories featured in this year’s Impact Report bring this to life. 

In our work on type 1 diabetes in Africa, we see the value of taking a long view. For children and young people living with the condition, access to appropriate support and care remains a critical challenge in many countries. Programmes such as PETCA and CDiC illustrate how change can develop over time, from training a small group of endocrinologists to becoming more comprehensive, locally anchored initiatives that continue today long after WDF funding has come to an end. What began as targeted efforts has, in many settings, evolved into nationally embedded approaches shaped and sustained by local partners. This progress reflects what can be achieved through sustained engagement and a consistent focus on building local capacity. 

Our work in Jordan illustrates how engagement in a complex humanitarian setting can evolve over time. In close collaboration with the Ministry of Health (MoH) and the Royal Health Awareness Society (RHAS), an initial response to urgent needs has gradually shifted towards more sustainable solutions, connected to national systems and able to serve both refugees and host communities. It highlights how learning from partners on the ground can drive more inclusive and lasting approaches, even in complex settings.  

Across both examples, what stands out is how sustainability is shaped over time, through deliberate choices in how programmes are designed, how partnerships are built, and how we engage. Often, this means prioritising what is possible and realistic over what may seem perfect on paper, and choosing the slower path when it offers stronger prospects for long-term ownership and impact. 

This is not always the easiest path. It requires time, trust, and a willingness to work within complex systems. But it is also what helps avoid creating dependency and allows impact to extend beyond individual projects, contributing to broader, lasting change.  

As we share this report, I am encouraged by what these stories represent, and by the commitment of our partners. Together, we continue to learn what it takes to build something that lasts - and why it matters.