Culture Eats Strategy for Lunch: An Advent Reflection
by Doug Fountain, CCIH Executive Director
In recent months, I’ve found myself referring to the global development ecosystem often—not only because abrupt funding shifts in early 2025 severely damaged parts of it, but also because those changes revealed something deeper: the heart and mind of development itself. I remain convinced that constructive engagement among those who are directly responsible and accountable for outcomes will always have more lasting impact than a hundred externally funded, externally led projects.
In other words, over time, culture says more about what a society will achieve than strategy ever can. In business consulting, we often hear the phrase, “culture eats strategy for lunch.” It means that if you fail to understand what shapes people’s values, beliefs, and behaviors, even the most elegant strategies will prove short-lived.
A simple example: family planning services may be available, but uptake will remain limited if large family size is still seen as the primary measure of vitality and blessing. That isn’t a technical problem—it’s a cultural one.
Health, faith, family, economics, and identity are deeply interwoven. And that understanding shaped something important we did at CCIH just a few weeks ago.
What We Gathered to Do
Together with the Africa Christian Health Associations Platform (ACHAP) and the All Africa Conference of Churches, CCIH convened more than 50 leaders of Christian denominations and Christian health systems from ten countries across sub-Saharan Africa. We hosted archbishops and bishops, general secretaries, sisters and brothers, and youth leaders alongside national Christian health network leaders.
On the surface, the presenting issue was evident: the sharp decline in Official Development Assistance and the resulting strain on already-fragile health systems. Our stated objective was to discern how faith and health leaders, together, can strengthen locally led, sustainable health systems during a time of profound global transition. Beneath that, however, was a deeper purpose: to ask what kind of future the Church itself is being called to shape in this moment.
This ecumenical gathering easily could have exposed divisions within the Body of Christ. Not everyone in the room agrees on essential matters of theology or public policy. Yet those differences did not dominate the conversation. What united the room was a common concern for the health of communities and for the future our children will inherit.
We asked participants not to focus on what had been lost in 2025, but instead to speak with vision about the Africa they long to see in 10, 20, and 30 years. Out of prayer, debate, and shared conviction, the leaders produced a powerful Unity Statement—a public declaration that health is a shared moral responsibility, that disease knows no boundaries or biases, and that faith communities must act together for healing and resilience.
What Became Clear
There were also honest, even awkward moments. At times, church leaders and health system leaders realized they often work too independently of one another—despite serving the same communities and answering the same spiritual calling. In one conversation, it became clear that Christian health leaders were in difficult but essential discussions with U.S. government officials who are seeking new ways to engage local faith actors, while many senior church leaders were largely unaware of these developments.
These moments were not failures. They were signs of health. They showed us where deeper integration, mutual trust, and shared strategy are still needed.
Living in a Time of Disruption
I want to be candid with you. I do not personally condone the way major funding shifts in 2025 were executed. The manner of disruption was chaotic and deeply destabilizing for many countries and communities. Highly indebted nations—already struggling to prioritize health spending—were among the hardest hit. Faith-based health systems, which often serve the poorest and most remote populations, were not adequately considered in the process.
At the same time, history teaches us that shocks sometimes expose complacency. For too long, we in global health have often conflated well-designed projects with genuine long-term transformation. What has been revealed—painfully—is how dependent many systems still are on external financing, and how vulnerable that makes the poor when geopolitics shift.
We now find ourselves navigating a new U.S. “America First” Global Health Strategy built around bilateral compacts with national governments. Where will faith-based organizations and private nonprofit networks fit into these arrangements? That question is still being worked out. CCIH is actively engaged in those conversations.
Yet even as policies change again—as they inevitably will—my deepest hope is that one lesson remains firm: a renewed commitment to locally led development and to serious local resource mobilization. The future of health will require domestic financing, expanded insurance coverage, innovative finance, and debt relief. We will continue to work toward those systemic shifts.
The Last Mile Is Still Cultural
But financing alone will not change hearts and minds. And it is at the cultural level that the Church has always held a unique influence.
Reaching the “last mile” has long defined Christian health and humanitarian witness. Today, that “last mile” includes rural and remote communities—but also urban informal settlements, persons with disabilities, those living with mental health challenges, adolescents growing up in fragile families, refugees, displaced populations, and religious minorities who face both “soft” and “hard” persecution.
These are not abstract categories. They are neighbors. They are congregants. They are the people Christ consistently moved toward.
History reminds us that some of the Church’s most transformative health responses were born not from grants but from conviction. During the early HIV epidemic, churches did not act because funding was abundant. They worked because doing nothing was unthinkable.
Christian health and church leaders do not have the luxury of working separately. Our missions are intertwined and mutually dependent. And real change accelerates when partners approach local leaders not by asking, “Do you want this grant for the project we designed?” but instead by asking, “What do you need that would most accelerate the vision God has already placed in your hands?”
This is what I mean when I say we need platforms, not projects—spaces for shared leadership, sustained collaboration, and long-term capacity, rather than short-cycle interventions.
Advent Light in a Darkened World
As Advent begins, I find myself returning to a simple truth from physics: There is no such thing as darkness—only the absence of light. You cannot “turn on” darkness. You can only fail to bring light.
During the CCIH Advent Forum this week, one of the presenters shared about the Advent hymn O Come, O Come, Emmanuel, which echoes in my heart:
O come, O Bright and Morning Star,
and bring us comfort from afar!
Dispel the shadows of the night
and turn our darkness into light.
O come, O King of nations, bind
in one the hearts of all mankind.
Bid all our sad divisions cease,
and be yourself our King of Peace.
Uniting our spirit in Christ with our sisters and brothers across nations, denominations, and disciplines gives me deep hope in this unsettled season. It reminds me that while funding streams fluctuate, policies shift, and systems strain, our calling to heal, to accompany, and to reconcile remains unchanged. The peace we seek in health systems and communities is not merely the absence of crisis—it is the presence of justice, dignity, and faithful relationship.
As we wait again for the coming of Christ, the true King of Peace, may we be found not fearful of disruption, but faithful in our witness—bringing light where there is shadow, binding hearts where there is division, and strengthening the work of those who serve at the very edges of hope. This is the culture the world most needs, and it is the culture the Church is uniquely called to shape.
Thank you for walking this road with CCIH in a season of both uncertainty and promise. Your partnership, prayer, and commitment to locally led, faith-rooted health give tangible form to that peace we long for.
With gratitude and Advent hope,
Doug
Photo Credits: Alicia Hochst, CCIH, Wilkimages, Didgeman, PublicDomain Pictures