How can we lead when the rules are unpredictable, the playing field is uneven, and the very legitimacy of SRHR is under siege?

In the global fight for sexual and reproductive health and rights (SRHR) within the current political climate - which includes massive funding cuts from the US Administration, it is increasingly becoming apparent that power rarely lies where we assume it does. Ideological currents, donor politics, judicial decisions, and cultural backlash (all powerful forces shaping this ecosystem) are often beyond the control of service providers, civil society actors, non-profit organizations and even governments (those who do the work). And yet, the expectation remains: deliver, scale, survive, thrive.

How?

For those of us working at the heart of the SRHR movement, this paradox is familiar. The terrain is political, volatile, and deeply unequal. When major funding decisions can be reversed by a single election, when misinformation campaigns can undo years of work, or when legal restrictions can criminalize healthcare provision suddenly, then the illusion of certainty and control becomes dangerous. Not only are we not governed by conventional market logic, but the unpredictable influence of non-market actors including religious groups, social movements, philanthropies, and international institutions whose priorities can shift overnight, ultimately shape our work. 

The recent dismantling of USAID is a sobering reminder of just how vulnerable we are as a sector. Unlike the Global Gag Rule, which followed an ideological cycle we had learned to anticipate, this decision came without warning, without precedent, and without the usual window for contingency planning. It exposed the fragility of our sector, not just to political tides, but to a global funding architecture that remains deeply skewed and susceptible to ideological interference. It is in this context that leadership must be reimagined.

This moment demands a deeper reckoning: how can we lead when the rules are unpredictable, the playing field is uneven, and the very legitimacy of SRHR is under siege?

The SRHR ecosystem sits at a high-stakes intersection of health, human rights, gender politics, and development. It is as much about clinics and commodities as it is about movements and messaging. Success is not only measured in service delivery numbers or program outcomes, but also by how well we navigate ideologically charged environments, how effectively we influence policy debates, and how resilient we are in the face of organized opposition. SRHR work is inherently political - no matter where we position ourselves on the spectrum. And political work demands political strategy, even when we’d rather stay neutral. This time, neutrality didn’t protect us. As we saw with USAID, they came for us all.

Are we truly acknowledging that survival can no longer depend on the ‘chop wipe mouth’ mentality, as we say in Pidgin – the notion of silently complying from the sidelines, discreetly signing documents and collecting cheques while the ‘abortion providers’ stand by, waiting for the next four-year cycle? The time for passive acceptance has passed; we must now recognise that survival requires active participation and meaningful change, not just quiet endurance.

Are we developing the capacity to collectively anticipate, influence, and position ourselves proactively by strategically engaging with both market and non-market forces? Do we better understand the interplay of these forces and refuse to be caught off guard by predictable surprises? Are we done playing catch up or playing the neutral gatekeeper of the status quo?

Too often, our sector becomes fixated solely on programmatic delivery, adopting a market-driven management approach: setting targets, optimizing processes, tracking performance, and demonstrating impact. However, this framework risks overlooking the deeper realities of our ecosystem. What we truly need is a more worldly approach—one that centres context, embraces systems thinking, and recognises the complex interplay of power, policy, and people. This mindset is part of a new wave of thinking I have been exploring thanks to the International Masters Programme for Managers, IMPM, and one which I hope can be integrated more consciously into how we work as organizations in a volatile sector.

At the International Planned Parenthood Federation (IPPF), this shift is already underway. In the wake of recent shocks, we are rethinking what it means to be resilient - not just operationally, but politically. We’re asking the tough questions: How can we anticipate change sooner? How do we build influence with non-traditional allies? How can we reimagine our systems to respond more quickly and intelligently to emerging threats, and how do we safeguard against funding losses?

Following a Federation-wide survey of our Member Associations and Collaborative Partners, IPPF has set up a Harm Mitigation Taskforce to assess the evolving crisis and fast-track emergency funding to the most severely impacted affiliates. The first round of grants was disbursed in May 2025 to ensure the continued delivery of essential healthcare services and uninterrupted access to life-saving health commodities.

While we cannot fully replace the funding losses, we can strategically inject resources to sustain life-saving services during such challenging times. Our partners on the ground are already doing this, delivering services in some of the world’s most challenging contexts. They are adapting their care pathways, diversifying partnerships, and pivoting their advocacy - all because they are deeply committed to their communities and trusted by them.

This moment also calls for a new orientation to leadership that moves beyond control and toward systems stewardship, because the leaders who will matter most in the coming decade are not those who can manage efficiently in stable times, but those who can read the landscape, anticipate shifts, build coalitions, and challenge the status quo. They are comfortable working in ambiguity, they ask better questions, and crucially, they understand that reclaiming agency does not mean eliminating uncertainty but rather learning how to lead within it.

While the sector often feels like it is in constant crisis mode, there is a deeper truth here: moments of disruption, however painful, also open space for reinvention. Crises expose weak points, surface unspoken dependencies and challenge outdated mental models. But they also present a window, however small, to lead differently. Are we listening?

At IPPF, we are using this window to ask ourselves what kind of institution we want to become. Not just one that adapts, but one that influences. Not just one that delivers services, but one that shapes systems. And not just one that survives shocks, but one that helps build a future where such shocks are less likely, less devastating, or more equitably absorbed.

This is not easy work. It requires confronting deeply embedded assumptions about what leadership is, how change happens, and who gets to drive it. It demands that we embrace both the visible and invisible forces shaping our context. And above all, it requires that we lead not from a place of fear or reaction, but from a deep, unwavering commitment to the world we are trying to build. We can do more than respond – we can lead.