For prominent Saudi businessman Khaled Juffali and his wife, Olfat Al Mutlaq-Juffali, philanthropy is an essential part of their lives. “My father was the one who taught us the principle of giving,” Khaled explains. “We used to go with him to very remote areas to visit those in need. That was our humble beginning. Since then, we have learned a lot, and hopefully, can continue to follow his lead.”

Together, the Juffalis have established health centers and donated medicines and machines, seeking to help the community.

However, in 2012, when the couple looked across the full range of health needs in the Middle East and Africa, the challenges seemed almost overwhelming: polio, human African trypanosomiases (“sleeping sickness”), meningitis A, and neglected tropical diseases (NTDs) like cutaneous leishmaniasis. These and other diseases afflict millions of vulnerable people, especially children, throughout the region. “We wanted to better address these critical health needs,” Olfat notes.

Philanthropists in the region, building on the long-standing traditions of charitable giving in the form of zakat and waqf, have supported initiatives that address some of the need. However, the Juffalis believe that no single philanthropist or charitable foundation, despite their best efforts, can really make more than a dent against diseases that claim the lives of millions. The need and funding gaps are simply too great.

“[One person’s] philanthropy can be a drop in the ocean,” explains Khaled Juffali, “and we wanted to maximize our impact. Our belief is: don’t give alone.”

In January 2012, seeking to find a way to act collectively instead of individually, the Juffalis hosted a gathering in their hometown of Jeddah, inviting Bill Gates and other friends and philanthropists. The Juffalis wanted to understand how organizations like the Bill & Melinda Gates Foundation (Gates Foundation) maximized the effect of their giving. The conversations were a lightbulb moment for Khaled and Olfat: they came up with the idea of establishing a collaborative giving initiative for themselves and other Arab philanthropists, targeting the region’s many health challenges.

To bring their idea to life, the Juffalis recruited other ambitious philanthropists, and teamed up with the Gates Foundation, to access the organization’s expertise and substantial experience working in health. In November 2012, the group took a learning journey to Senegal, where they visited health clinics treating malaria and tuberculosis. They also witnessed firsthand a campaign to combat meningitis A.

Informed and inspired by what they saw, the group strategized on how best to channel their giving to the highest-potential programs, approaches, and organizations. The Juffalis designed an approach to donor collaboration that they believed would lead to larger investments and accelerate progress on the issues relating to health and livelihoods afflicting the region’s most vulnerable people.

In April 2013, the Juffalis officially launched the Shefa Fund (“Shefa” means “well-being” in Arabic), a pooled fund focused on improving the health of vulnerable children and families in the Middle East and Africa.

The Shefa Fund represents a bold new approach to Arab philanthropy, with three particularly striking elements. First, the Shefa Fund aims to make meaningful progress on underfunded health issues in the region.

“We wanted to focus on health problems such as polio and neglected tropical diseases because there are not many people who focus on them [in the region],” says Olfat Juffali.

Though much of the funding for neglected tropical diseases comes from international aid agencies and local governments, a dramatic funding gap of $200 to $300m remains.

Second, by pooling funds and making grants together, more capital flows more efficiently to issues the participating donors care about. Members make a minimum contribution of $250,000 for a defined period, usually two years. The approach lets them learn together and benefit from shared expertise, rather than each having to find, vet, and manage their own philanthropic investments.

Additionally, they quite literally become a larger actor in the region’s health field, which puts them in a stronger position to narrow funding gaps for neglected health issues and also to influence the programs or funding of other actors. Collaborative approaches are becoming increasingly common across the global philanthropic community, including such examples as Co-Impact and Blue Meridian Partners.

Finally, the Shefa Fund takes a highly strategic approach to its grantmaking. It chooses investment areas where it can have a major impact, and carefully defines what success looks like and how to achieve it.

The Shefa Fund’s grants are substantial, with an average investment size of over $1m and a duration — lasting up to four years — that is long enough to see results. The Shefa Fund’s relationship with the Gates Foundation, which helps the fund identify promising investment opportunities while keeping its operations lean, is critical to this kind of strategic grantmaking.

Since its founding in 2013, the Shefa Fund has drawn on funding from over 20 different donors, and raised and deployed over $14m. The results thus far suggest that, in a region where individual and family giving is the norm, pooling funds has power and appeal.

For the Juffalis, there is no doubt that the Shefa Fund is having more impact than the family, or each individual member, could have had on their own. Through its investments — in combating diseases such as meningitis A, sleeping sickness, and cholera, and the Covid-19 pandemic; providing care for women and children; and supplying critical emergency relief to conflict zones — the SHEFA Fund has helped save or improve the lives of more than 16 million people.

A deep commitment to learning together has animated the Shefa Fund’s work from the beginning. That inaugural journey to Senegal became a model for how the fund would approach its work. Learning trips help members deepen and broaden their understanding of conditions on the ground, informing their thinking on the role the Shefa Fund can play in advancing progress.

“You cannot help people from a distance,” says the Juffalis’ daughter Dana. “Going to the field makes the issues come to life. It was inspiring to see how the END Fund and its partners treat people with sensitivity and respect.” 

These trips have directly shaped the Shefa Fund’s grantmaking. For example, they have influenced members to shift some of their giving to causes outside their home countries. They also led members to give not only to proven interventions but also to take risks and invest in research and pilots of new solutions.

Beyond the trips, the Shefa Fund learns from periodically assessing its grant portfolio to determine what is working and what is resonating with donors. The fund’s advisory board reflects on lessons to carry forward to future grantmaking.

Take, for example, the END Fund project to treat intestinal worms in Ethiopia. Local partners and the Ministry of Health helped identify three highly endemic regions to target, ultimately allowing the project to reach 2 million more children than the original goal. This practice of targeting high-density areas became a building block for future grantmaking decisions that focus on high-impact interventions, including the Shefa Fund’s 2015 grant to UNICEF. With a budget of $1.8m, this work helped immunize over 7 million children in Iraq and Syria against polio.

Or consider the fund’s work on cutaneous leishmaniasis, a neglected tropical disease that can cause debilitating lesions and scarring. The Shefa Fund approached the problem from multiple angles. It funded disease research, helped identify successful control methods, trained healthcare workers to identify cases, and cooperated with the Ministry of Health in Saudi Arabia to explore the possibility of integrating new interventions into the Ministry’s work.

These investments are mutually reinforcing, magnifying the impact beyond what any one giver or one approach could do to ecrease the burden of cutaneous leishmaniasis in Saudi Arabia. Increasingly, the Shefa Fund prefers this type of multipronged approach.

Most grants emerge from answering a simple question: What unmet needs can the Shefa Fund address? Grantmaking follows a rigorous assessment process that begins with a clear focus on addressing underfunded health and livelihood issues in the Middle East, Africa, or the broader Muslim world. To surface opportunities, the fund taps the extensive knowledge and networks of the Gates Foundation.

“They let us know where they see any major funding gaps,” says Dana Juffali. “That is the main pillar, but we also want to look for the highest quality [grantee] partners on the ground…those who know the community well.” The Shefa Fund’s advisory board considers impact, scale, and risk before making each grant decision.

Consider the Shefa Fund’s interest in research as one of several approaches needed to address cutaneous leishmaniasis. The Gates Foundation, in response to a request from the Juffalis, identified the Liverpool School of Tropical Medicine as a potential partner already researching health issues in Saudi Arabia. The Liverpool School was considering research on cutaneous leishmaniasis interventions and needed funding to evaluate new, on-the-ground approaches.

Since that initial discussion, the Shefa Fund has granted nearly $1.7m for this research, which is exploring novel diagnostic methods, evaluating current disease treatment protocols, and assessing new ways to control cutaneous leishmaniasis in Saudi Arabia.

The Shefa Fund runs a lean operation. It has one staff member and collaborates closely with key partners to screen grants, manage member engagement, deploy funds, and manage financial assets.

The Gates Foundation provides a vetted list of investment opportunities (based on extensive due diligence and its experience with hundreds of organizations working in global health), from which the Shefa Fund’s advisory board selects grantees and decides the grant amounts. A global philanthropic consulting firm with a presence in the Arab region supports the fund’s member outreach and communications. The firm helps organize advisory board meetings, tracks outcomes and grant reporting, and organizes member learning trips.

A donor-advised fund manages the Shefa Fund’s assets, overseeing both member contributions and grantee payments.

This partnership model is a rarity in the Arab region, where philanthropists typically choose instead to set up their own foundations and run their own programs — if they decide to institutionalize their giving at all. By partnering and outsourcing some functions, the Shefa Fund has created an efficient and effective alternative to the traditional foundation model — helping it grow rapidly, begin disbursements quickly, and gain access to a tremendous array of capabilities and expertise.

Through its roughly $14m in grantmaking targeting critical health needs, the Shefa Fund has helped improve the lives of over 16 million people.

Consider the Shefa Fund’s 2016 grant to the UN Foundation, which supported the distribution of 180,000 insecticide-treated bed nets in the Central African Republic. With an estimated 400,000 people contracting malaria each year in the country, these bed nets have the potential to address a large proportion of the unmet need.

The Shefa Fund also supported radio broadcasts and posters that help educate mothers about when to seek help for a sick child who may have malaria.

The Shefa Fund’s 2014 grant to the Liverpool School of Tropical Medicine was also powerful, supporting an effort to protect over 1 million people in Uganda and Chad from sleeping sickness, a potentially fatal parasitic condition transmitted by tsetse flies. The Shefa Fund’s grant allowed the Liverpool School to purchase over 47,000 insecticide-treated nets that attract and kill the flies. The nets reduced tsetse fly numbers by at least 90 percent in the treatment areas (which totaled 2,800 square kilometers), potentially reducing the risk of disease transmission for up to 1 million people.

Aiding its ability to make a difference is the fund’s minimal bureaucracy, which frees it to move fast. For example, the Shefa Fund made a grant to address urgent funding gaps for meningitis A vaccination in Ethiopia, Nigeria, Sudan, and the Gambia just four months after its founding. Since its rollout, the vaccine against meningitis A has all but eliminated the deadly disease from sub-Saharan Africa.

The Shefa Fund’s approach has drawn international notice. “The impact in only two years is impressive,” said Bill Gates in 2015. “I hope that others will follow [their] lead as philanthropists and change-makers in Saudi Arabia and beyond.”

Beyond the progress on health issues, the Shefa Fund also has helped fund members continue to grow their strategic philanthropy.

“Conversations with the Shefa Fund members at annual meetings have become more in depth,” says Jennifer Alcorn of the Gates Foundation.

At a membership event with the END Fund, “people were so engaged and asked a lot of questions,” recalls Dana Juffali. “One was even inspired to spin off a corporate social responsibility arm from his cosmetic business in Saudi.”

The Shefa Fund’s grantees have encountered their fair share of challenges, as they seek to gain the upper hand on underfunded health issues. As a result, the Shefa Fund enables its grantees to adapt and adjust as challenges emerge. Refugee populations on the move, for example, required the Liverpool School to be flexible to the changing context and explore new approaches to treating sleeping sickness in Chad. Unexpected supply chain delays for vaccines and drug treatments required the END Fund to modify targets and create new treatment plans for neglected tropical diseases in Yemen.

The Shefa Fund, like most novel approaches, has itself encountered challenges and is still learning and evolving. Attracting new members takes time and a great deal of cultivation. To reduce a barrier to participation and encourage more giving, the fund lowered its contribution threshold from $1m to $250,000. It is also exploring new approaches to governance — such as making advisory board seats available to members who commit to a specific funding threshold — to help attract and retain a diverse range of members.

Since donor collaboration is still a relatively new concept in the region, the fund conducts ongoing outreach to members and potential members through convenings, grantee site visits and newsletters. The Shefa Fund’s first hire — Naif AlObaid — focuses on member engagement and other operations.

“Donors here are not yet used to this type of philanthropy,” AlObaid explains. “My goal is to help them understand this type of grantmaking — to keep them engaged and committed.”

Education and impact stories play a major role in this approach, helping members understand how they can achieve greater impact by pooling their resources.

As the Shefa Fund continues to address unmet health needs in the region, it aims to expand its portfolio to include new focus areas and add new members. For example, Olfat Juffali has long cared about maternal and child health, which a learning visit by the Shefa Fund further illuminated. After learning that UNHCR, the United Nations Refugee Agency, lacked the financing to support a maternal and child health program at two refugee camps in Jordan, the Shefa Fund stepped in. This grant helped 805 refugees receive critical maternal health related services, inlcuding safe delivery, emergency care and post-natal support.

The fund is also working to attract new donors, including the younger generation. Says Olfat Juffali: “We are building an approach that will work in the future, for our children and their children.”

The Juffalis have involved their children in the fund’s work. Their daughters, Dana and Haya Juffali, have become particularly engaged in the fund and intend to increase their involvement.

“We want to help the Shefa Fund stay innovative and relevant,” says Haya. Dana adds: “Impact comes through scaling, collaboration, and partnerships. Shefa has saved many lives, but that doesn’t mean there isn’t potential for growth.”

With grant funding for new health areas and a push for new membership, the Shefa Fund is primed to continue its investments in confronting the region’s neglected health challenges.