Traveling thousands of miles from Melbourne to Minneapolis, Lauren Monaghan of The Ian Potter Foundation attended the 2023 GIH Annual Conference on Health Philanthropy to learn more about the American public health philanthropy sector at the country’s largest gathering of health funders. Founded in 1964, The Ian Potter Foundation has a vision of a fair, healthy, sustainable, and vibrant Australia. This vision informs the four main pillars of the Foundation’s funding. Lauren Monaghan serves as Program Manager of the health pillar, which focuses on public health and medical research. What can the American philanthropic community learn from our colleagues in Australia, and vice versa? To delve into the differences and similarities, Grantmakers In Health’s Miranda Wesley spoke with The Ian Potter Foundation’s Lauren Monaghan to discuss health philanthropy in Australia versus the US and Monaghan’s key takeaways from the GIH Annual Conference. This interview has been edited for length and clarity.
Why did you attend the 2023 Grantmakers In Health Annual Conference on Health Philanthropy?
Lauren Monaghan: My trip to the US and attending the GIH conference was an incredible opportunity to experience philanthropy on a global scale. The philanthropic sector is much smaller in Australia than [in] the US—in part, due to the much smaller population. So the opportunity to network with US-based foundations was an amazing opportunity to learn and exchange ideas.
In choosing to attend the conference, I really wanted to understand trends in health philanthropy outside of Australia, because the challenges we’re seeing in health—the changing burden of chronic disease, commercial determinants of health, climate change—they’re not limited to any one country. Attending your conference was a wonderful space to have those deeper conversations around the challenges in health philanthropy, learn from your members, and then be able to bring that knowledge back to inform our thinking here at the Foundation.
What did you enjoy or appreciate most about the conference? What are some of your key takeaways from it?
Lauren Monaghan: This is such a difficult question [because] there was so much that I enjoyed about the conference. What blew me away was the magnitude and depth of health-focused philanthropy in the States. I mentioned before that the philanthropic sector is comparatively much smaller in Australia versus the US—and again, health philanthropy as a subset of our sector is smaller—so it was a phenomenal experience to be in a space surrounded by hundreds of like-minded people all focused on the same issues. I found it inspiring, and it left me very energized for our work in Australia.
One of the most enjoyable parts for me was just the warmth and the generosity of your members. I had such a great time. My Aussie accent was a dead giveaway during the conference, and I was pleased to find everyone so welcoming, interested, and engaged to hear my perspective on Australian philanthropy and what I thought of philanthropy in the States as well. It was really fun.
What are The Ian Potter Foundation’s priority issue areas? And what work do you do there personally?
Lauren Monaghan: Sir Ian Potter established the Foundation in 1964. He had a fairly broad remit for the Foundation, wanting to contribute to the Australian community at large. Our vision at the Foundation is for a fair, healthy, sustainable, and vibrant Australia, and those elements are reflected in our program areas to this day, almost sixty years later.
My responsibilities lie in the health pillar as I am the Program Manager for our health-focused funding, which is split into two areas: translational public health research and medical research.
Public health research is the area of my portfolio that aligns most strongly with the conference [and the social determinants of health]. Our Public Health Research program has three focus areas, and one of those is improving Indigenous health outcomes. The second is improving mental health of older Australians as a priority underserved cohort. The third focuses on primary prevention of chronic diseases.
One such grant was recently awarded to The George Institute for Global Health, a medical research institute with a mission to improve the health of millions of people worldwide through innovative approaches to prevent and treat non-communicable diseases and injuries (NCDIs). The Food Policy Team at The George Institute aims to reduce death and disease caused by poor diets, in particular the over-consumption of salt in Australia and overseas. With our funding, The George Institute will work in partnership with governments, the food industry, and communities to support increased uptake of reduced-sodium salts by consumers and food companies.
Tell me about health philanthropy and philanthropy in general in Australia. How is grantmaking both similar and different from the US, especially because of the Australian universal health care system and single payer model compared to the American healthcare system?
Lauren Monaghan: Wow. We could spend the whole hour on this topic alone. I spent so much time chewing it over in my head and reflecting on the differences and the similarities. As I mentioned earlier, philanthropy in Australia is much smaller than in the US, and I only worked out these numbers during the trip itself.
In the US, your reports say that the total giving was just shy of $500 billion in 2022. In Australia, that number was $13.1 billion, so it’s a really big difference. Obviously, you have a much larger population, but when you look at total giving as a percentage of GDP in Australia, it’s 0.81%, and in the States, it’s 2.1%. It’s a lot smaller here in Australia. What’s really interesting is that we’re also smaller than our Kiwi neighbors in New Zealand, I think theirs sits at 1.84%. In the UK, it’s 0.96%. I was really curious whilst I was traveling as to why this discrepancy.
Our peak body, Philanthropy Australia, has completed some research assessing philanthropic environments. In essence, the research ranks how supportive the environment is to philanthropy. In this assessment, Australia ranks 19th in the world, so it’s not too bad. But it is below the rankings that were given to the US, New Zealand, and a lot of the Nordic countries where you see philanthropy as being quite high. There is this big push in Australia to grow philanthropy, with the aim to double structured giving by 2030. That was one of the big differences, just the size of the sector, relative to GDP as well.
A similarity that I realized—I was really pleased to reflect on this—is that grantmaking practice has followed a similar trajectory in Australia to that in the US. A lot of the key themes that I was witnessing in the US and that are coming out of the US have also been prominent here in Australia. There’s definitely been a shift from smaller, single-year grants to larger, multiyear grants. Our foundation certainly deals almost exclusively in multiyear grants. They’re all three to five years and growing much larger. Increasingly, many foundations, including ours, are also moving to funding capacity building.
In terms of differences, the focus on diversity, equity, and inclusion and racial justice—they were really prominent themes during my trip. I could feel the profound impact that George Floyd had had on the state of philanthropy, and there were lots of examples of that.
In terms of differences and similarities in health philanthropy, this is where it gets really interesting because the differences are quite profound. A lot of that goes back to the differences in the health systems within our two countries. The key one is the significant philanthropic support for advocacy on key issues at the moment in the US, such as gun control, abortion rights, and access to Medicaid.
In Australia, by comparison, we have a universal health care system. We had significant gun law reforms in the mid-1990s. Abortion has been decriminalized in every state and territory. [However], there are some access issues, but I think those issues are not as prominent for us here in Australia as they are in the US. Therefore, it’s a relatively smaller proportion of philanthropy that’s focused on those issues. Philanthropy is definitely engaged in supporting advocacy on key policies that impact health and other areas as well, but I would say philanthropy in Australia is probably more focused on climate change and environmental advocacy at present.
I also reflected while I was there on the differences in the health policy environment, with the regulation of public health specifically. I’m a public health person, so I’m proud, of course, that Australia has pioneered many public health interventions, from bike helmets to tobacco control, pool fences, [and] seatbelts. Again, philanthropy has been less focused on some of those issues because we have led the way on some of those policy reforms.
Lastly, is there anything else you would like to share?
Lauren Monaghan: I was thinking about why there are differences [between philanthropy in the US and Australia]. I thought, why are there other countries that have larger portions of philanthropic giving than we do? A big part of it is the environment for philanthropy. Whilst I was in the States, the inequity was often really stark—the extreme wealth juxtaposed with extreme poverty—particularly in DC and New York. Australia is called the ‘lucky country’. We consistently rank highly on livability scores [for] a lot of our cities. I think that life is pretty good for a large part of the Australian population. It’s not that we don’t have significant social inequity, but it’s not front of mind because we do have a universal healthcare system and pretty good social safety nets. We have really strong government support for the not-for-profit sector.
When I started my trip, I was thinking, “What about evaluation? Are you supporting evaluation for the programs that you’re developing?” Compared to the US, I think our sector has a stronger focus on evaluation and developing evidence because our federal and state governments implement evidence-informed solutions in areas like early childhood development, public health policy, employment, and other areas.
Because the role of government is much smaller in the United States, philanthropy has had to step up and be comfortable supporting the not-for-profit sector almost in perpetuity and playing that constant role. Whereas, because philanthropy in Australia is much smaller, we have tried to be more strategic with our dollars and said, “Okay, it is not our role to support ongoing service delivery, that is the responsibility of government.” However, what philanthropy should do is support organizations to develop programs that establish an evidence base so that these organizations can go to government and say, “Look, this is a program you should support. This is how government can save money.”