High-Impact Growth – "Funders: The Power to Change the System"

Host: Jonathan Jackson (Dimagi CEO & Co-founder)
Co-Host: Amie Vaccaro (Senior Director of Marketing, Dimagi)
Guest: Dr. Kevin Starr (CEO, Mulago Foundation)
Release Date: October 27, 2025

Episode Overview

This episode zooms in on the changing landscape of global development funding and the pivotal role funders play in shaping systems for greater impact. Dr. Kevin Starr, CEO of the Mulago Foundation, joins the show to discuss the pitfalls of traditional "big aid" models, why unrestricted and continuous support matters, and how funders can drive a revolution in impact by demanding more rigorous outcomes from grantees. The conversation is rich with experience-backed insights, practical frameworks, and a bold critique of the sector's status quo—especially timely for anyone grappling with resource shifts and the search for scalable solutions.

Key Discussion Points & Insights

1. From Doctor to Impact Entrepreneur: Kevin Starr’s Origin Story

• Personal Tragedy Led to Philanthropy: Kevin recounts how the loss of his mentor, Reiner Arnhold, in Bolivia in 1994 unexpectedly launched him into the philanthropic world.

  “Right after he died, I’d meet his family and find out … they’ve been in banking for generations … and [they] said … we want to create something that carries on Reiner’s work … will you help us do it?” – Kevin Starr (03:01)

• Starr’s approach was shaped by humility and a desire to learn what actually works, rather than assuming expertise.

  “I didn’t know what worked and I had better dive in and start figuring that out.” – Kevin Starr (04:12)

2. Diagnosing What Doesn’t Work in Philanthropy

• Three Patterns of Failure Observed:
  • Lack of intentional program design
  • Poor measurement and absence of impact data
  • Programs not being run in a businesslike way

  “Stuff wasn’t designed … things weren’t being measured … and things weren’t being run in a businesslike fashion.” – Kevin Starr (06:08)

• Starr realized the difference between just being “big” versus achieving real scale, i.e., sustained acceleration of impact.

3. The Mulago Model: Fellowship, Iteration, and Support

• Unique Fellowship Structure:
  • Selects 20 fellows a year (10 focused on poverty, 10 on the environment), chosen from thousands of applicants via a streamlined process (one-pager application, several calls).
  • Emphasizes qualities like “irrepressibility”—the unstoppable drive to make things happen.
  • Unrestricted, continued funding after a year-long, cohort-based fellowship including intensive courses on design for impact, strategy for scale, communications, and evidence.

  "That week [with the fellows], you get a group of people who are very close … and have a shared language and a framework to talk about.” – Kevin Starr (16:21)

• A deliberate move away from standard project-specific grants

4. The Value of Intensive, Cohort-Based Learning

• Creating a Shared Language:
  • The weeklong course is designed to help entrepreneurs step back and rigorously rethink their solutions in terms of scalability and impact.

  “If you want something remarkable to happen … you need to get [people] off by themselves ... that curriculum has developed over 20 years.” – Kevin Starr (14:41)

  • Strong connections are forged among fellows, allowing for ongoing peer support.

5. The Aid "Reality Bath": Why Big Aid Isn’t the Answer

• Big Aid was never sustainable at scale:
  • Most organizations in Mulago’s portfolio were never reliant on big aid anyway.
  • Focus has shifted to scaling via markets or government, not via funding streams from large institutional donors.

  “It wasn’t that important all along … it seemed like it was going to be important because it’s a lot of money ... but the prospects started to seem pretty dim.” – Kevin Starr (19:21)

• Key Criteria for Scalable Solutions:
  • “Good enough, big enough, simple enough, cheap enough.”
  • “The cheap enough is a huge focus for us right now.” – Kevin Starr (21:24)

6. Designing for Government and Market Scalability

• Knowing Your Payer and Doer at Scale:

  • Solutions must be designed for the entity that will pay (payer at scale) and deliver (doer at scale) in the long run.
  • Many organizations were misled by the profit margins that aid allowed, not considering what governments or markets would actually pay.

  “If you really thought you were selling [a solution] to government, not Big Aid, you would have known the price point was 10% of what you thought it was.” – Jonathan Jackson (20:37)

• Case Study: ‘One Day Clinics’ in Uganda

  • Example from the Fellowship: Nick Lang’s clinics use local nurses and low-cost operations ($2,000 to open, $1.50 per patient) to reach underserved populations, exploring public/private scalability options.

  “A nurse in a room … that cost and the possibilities of that role are remarkable. Especially if you start thinking about what AI might accomplish.” – Kevin Starr (23:32)

7. Technology: An Enabler, Not a Panacea

• Tech Should Amplify, Not Replace, a Solid Solution:

  “If it didn’t work with a pen and paper, it probably isn’t going to work with tech.” – Kevin Starr (33:50)

  • Tech amplifies reach or dramatically lowers cost, but cannot compensate for lack of a fundamentally viable model.

• Simplicity as a Design Principle:

  “Simple enough … there’s a ton of great ideas that are both incredibly valuable and really hard to do with technology … and it’s just too hard to pull it off.” – Jonathan Jackson (36:05)

  • For governments, “no additional spend” is the new rule—solutions must work within the existing budget line.

8. The “Zombie” Problem: Holding Funders to Account

• Funders Enable Organizational Stagnation:

  • Lack of rigorous measurement leads to ineffective organizations (“zombies”) that persist because funders don’t demand outcomes.
  • Starr calls for a sector-wide movement where funders prioritize impact as seriously as investors prioritize profit.

  “You could not have an investment industry where investors didn’t think seriously about profit. ... We can’t have a social sector that doesn’t think seriously about impact, both at the doer and the funder level. … It’s funders who ultimately will drive this ship.” – Kevin Starr (43:27)

• Positive Signals:

  • Movements around “decolonization” and supporting local leaders have created change—impact rigour could do the same.

  “Real impact … is the ultimate expression of equity and fairness.” – Kevin Starr (45:12)

Notable Quotes & Memorable Moments

• On How Philanthropy Needs to Change:

  "We need a fundamental kind of movement revolution in impact … funders take it really seriously and expect it from organizations. … We can’t have a social sector that doesn’t think seriously about impact."
  — Kevin Starr (43:20)

• On Defining Scalable Solutions:

  "It needs to be good enough, big enough, simple enough, cheap enough."
  — Kevin Starr (21:24)

• On Aid Dependency:

  "It wasn't that important all along … it was never a real path to scale."
  — Kevin Starr (19:21)

• On the Fellowship Model:

  "That week … you get a group of people who are very close to each other, have made real connections and have a shared language and a framework to talk about."
  — Kevin Starr (16:21)

• On What Qualities They Look For:

  "There's this one characteristic we look for, that's one of these, you know, when you see it things we call 'irrepressibility' and you know that in a phone call or two."
  — Kevin Starr (11:15)

Key Timestamps

• 02:19 Kevin's origin story and why he entered philanthropy
• 05:38 The patterns of what wasn't working in the social sector
• 08:02 Mulago Fellowship selection process and philosophy
• 14:40 Why immersive, cohort-based learning works
• 17:35 The "reality bath": Why traditional aid models are obsolete
• 21:21 The five criteria for scalable solutions: good/big/simple/cheap enough
• 23:00 ‘One Day Clinics’ as a scalable health solution
• 33:46 Technology as an enabler; must work without "tech first"
• 36:48 The challenge of "simple enough" design for scale
• 43:20 On “zombies” and the imperative for funders to demand impact

Actionable Takeaways & Final Reflections

• Funders Must Lead on Impact: A sector-wide shift is overdue—funders should require grantees to rigorously measure and demonstrate results.
• Design for Scalability, Not Aid Relics: Social entrepreneurs should define their “doer” and “payer” at scale early and build accordingly, especially focusing on cost, simplicity, and iterative design.
• Technology: Start Simple, Prove on Paper: Innovations should amplify solid existing models, not distract from fundamentals.
• Communities and Shared Language Matter: Intentional peer learning and connection spur confidence, accountability, and collective wisdom.

For further details and reading:
— Find more of Kevin Starr’s writing and frameworks in the show notes.
— To deepen your understanding of “doer at scale” and “payer at scale,” see the linked SSIR articles.

This is a must-listen for funders, entrepreneurs, and development professionals navigating the new landscape of scaling impact without dependence on big aid—and for anyone seeking candid, actionable wisdom drawn from decades on the front lines of social change.