Cara V. James, PhD, President and CEO, Grantmakers In Health
Yesterday, President and CEO of Grantmakers In Health (GIH), Cara V. James, delivered opening remarks at the 2025 GIH Annual Conference on Health Philanthropy in New Orleans. The conference is the largest gathering of health funders and professionals tackling many of the most pressing issues in the country. In her remarks, James discussed the vital need for bold action and partnerships to face the current threats to democracy, health access, and philanthropy’s freedom to give based on its values without fear of political retribution.
Copied below is an excerpt from James’s remarks that do not include acknowledgements and her opening presentation on GIH. The full video can be seen here.
Good afternoon. Welcome to New Orleans, and welcome to the 2025 Grantmakers In Health Annual Conference on Health Philanthropy. I am Cara James, President and CEO of Grantmakers In Health. It is my pleasure to see so many of you in this room at such an important time in our country, and in our field.
We are gathering at a time of significant turmoil and anxiety. There is a heaviness that many of us are carrying.
In just the first few months of this administration, we’ve witnessed a wave of harmful policies; devastating funding cuts; significant federal workforce reductions; and direct threats to freedom of speech, democracy, and the rule of law. As a country, we have witnessed the use of unlawful executive actions to intimidate, restrict, or punish universities, law firms, and nonprofits. People are being taken from their homes, places of work, and schools. These should be safe places for all of us. And, sadly, after the events of last weekend, we can add politically motivated violence to the list.
We have seen the elimination or significant reductions in funding for global health, public health, health equity, reproductive and maternal health, injury prevention, and others. We are disinvesting in our future by gutting workforce training programs, firing scientists in the middle of experiments, and cutting biomedical research funding that not only supports important studies, but also funds graduate students and faculty at colleges and universities across the country. We have turned our backs on data, science, and privacy by promoting misinformation and disproven theories; allowing unprecedented access to highly sensitive data; and removing datasets, reports, and certain words from publications and websites. As if by erasing those words they will erase the people.
We are destroying our federal civil service with the aim of replacing it with a patronage system that rewards people for their loyalty rather than hiring people with the knowledge and skills necessary for the job, something we moved away from 140 years ago following the passage of the Pendelton Act.
These acts are not limited to HHS. They are happening across the federal government and reverberating in states and communities. Add to this, the House “One Big, Beautiful Bill Act” and draft text from the Senate released yesterday, both of which seek to make dramatic cuts to Medicaid, SNAP and other important programs. We will see what passes, but I encourage everyone to reach out to your members to educate them about the impact these proposals would have on your community. Efforts to educate the Senate on the impact of the excise tax on foundations seem to be working, as it was not included in the draft Senate bill. But we need to keep up the pressure.
While much remains uncertain, it is clear these changes will not make us healthier. The very programs that protect the health and vital conditions of millions are being dismantled at a time when we need them most. In the end, it is people—particularly the most vulnerable—who will suffer the consequences. They threaten the very foundation of our democracy—and our basic freedoms, such as our freedom of speech, freedom of assembly, freedom to educate, freedom to promote a fair and just society, and of course, our freedom to give.
A healthy democracy depends on a vibrant and independent philanthropic sector—one that can act in accordance with its mission and values, and is free from political influence or intimidation to meet community needs and support lasting change. Our nation thrives when everyone can freely exercise their First Amendment rights, including the right to support the causes they believe in—even if we don’t believe in the same causes. And, our nation cannot achieve our highest level of health without a thriving democracy. The two are inextricably linked.
Philanthropy has long served as a vital force in America—catalyzing innovation, uplifting the most vulnerable, and addressing inequities that cannot be solved by government efforts alone. Health funders have played a critical role in supporting access to care in communities during the COVID-19 pandemic and during countless natural disasters over many decades.
As long-time partners to government on so many initiatives, foundations are uniquely positioned to uplift voices, seed change, co-create solutions, and promote the systemic transformation needed to sustain societal improvements.
As it always has done in moments of crisis, philanthropy is moving to support communities. Numerous foundations have announced plans to increase their giving. Funders are making changes to reduce risk to their grantees, offering resources to grantees to defend themselves if they are attacked, and using their voice.
GIH is also responding. We are pivoting to focus on strategic communications—to help Funding Partners use their voice to support the communities they serve, incorporate legal strategies into our policy and advocacy work, and foster collective action.
While these are important steps, we need to do more. It is important to remember that philanthropy cannot and should not replace government. It cannot because the math does not work—there are not enough resources to fill the gap indefinitely.
So, where do we go from here?
While we may feel like there is not much we can do or that it would be better to keep our head down and hope we will not be directly affected by what is happening, we all have a responsibility to do what we can. The path forward requires courageous action, forging new partnerships, and it requires us to work differently.
Key to our success is creating a vision for our future. Our systems have not served many of us, which contributed to their vulnerability and made it easier to pick apart.
Our vision should be co-created with partners from across all segments of our society, because it will require all of us to achieve success. Having a vision not only provides a source of hope and a framework for organizing; it can also lead to a more strategic defense and conservation of resources.
Our path forward also requires us to change narratives that have been coopted such as diversity, equity, and inclusion; health equity; and narratives about immigrants and refugees, low-income individuals, and civil servants. If you think about it, someone who is opposed to diversity, equity, and inclusion is essentially saying they are for homogeneity, inequity, and exclusion. We need to own our narratives. We need to change the narratives that are critical to our vision, and to ensure that our future is a future that works for everyone, not just a select few.
Finally, our path forward requires us to work differently. Twenty years ago, Hurricane Katrina hit New Orleans; it forced philanthropy to work differently. The same thing happened with COVID-19, and this moment cannot be met with business as usual. We must remain committed to advancing the long game and those courageous actions to achieve success.
One hundred sixty years ago this week, the last enslaved people were emancipated. The end of slavery in the U.S. did not happen overnight, it took generations. Achieving our vision will not happen overnight, nor will it happen if we deviate from our commitment to it. We also need to work together as a field rather than as individual organizations, and we need to forge new and different partnerships to succeed.
We are stronger together.
The last 5 months have been difficult, and we know there are more difficulties in the weeks, months, and years to come. The challenges ahead will be significant, but I see a lot of hope and possibility in this room. There is hope in the rising number of voices showing up and speaking truth. There is hope in the funders daring to act differently. And there is hope in the communities who continue to organize, despite attempts to silence them.
We still have the power to shape what comes next.But only if we move together—with courage, clarity, and conviction. Twenty years ago, Hurricane Katrina provided philanthropy with the opportunity to act differently. Today, we are again presented with an opportunity to work differently.
Let’s meet the moment.
Let us stand together, show up when it matters, partner with purpose, speak truth to power, and build a future in which all of our descendants have the opportunity to lead a healthy and productive life.
Thank you—and it is with great pleasure that I invite my colleagues to join me on stage for a discussion entitled Freedom to Give.
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Background on Grantmakers In Health and the GIH Conference on Health Philanthropy:
With over 225 Funding Partners, Grantmakers In Health is a nonprofit, educational organization dedicated to helping foundations, corporate giving programs, and other philanthropic organizations improve the health of all people for over 40 years. Its mission is to foster communication and collaboration among grantmakers and others and to help strengthen the grantmaking community’s knowledge, skills, and effectiveness.
The GIH Annual Conference on Health Philanthropy is held each year to bring together the most influential voices in the philanthropic sector. Our attendees include top leaders in the nonprofit, government, and private sectors. We have an impressive lineup of keynote speakers and workshops that provide our attendees with the knowledge and tools to make a lasting impact in their communities. The theme of this year’s conference is Forging Partnerships for a Better Tomorrow.