In more than 30 years of nonprofit work, I cannot recall a time when I have had to rely so heavily on planning for the worst. I also can’t recall a time when my faith has been so essential to my service—a guiding light for me and my organization as well as a light at the end of the tunnel that defines our current age of uncertainty.
I am not alone in this. Nonprofit leaders in every sector—many of them with faith-inspired missions—are operating in a world turned upside down, their federal funding cut or threatened by the unprecedented and unpredictable priorities of a new federal administration.
Is it possible for nonprofits not only to withstand the turmoil but to thrive? I believe the answer is yes, if we resolve to do two things: prepare rigorously for worst-case scenarios and reflect deeply on why we exist in the first place.
My organization is a case in point. The Catholic Medical Mission Board was founded in 1912 to advance human dignity by caring for the sick. A global health nonprofit, we deliver approximately $300 million worth of pharmaceuticals and medical supplies annually to people in need worldwide. We also lead the development of community health care programs in five developing countries. Much of our work is in preventing and treating infectious and noncommunicable diseases, such as H.I.V./AIDS, cancer, tuberculosis and diabetes.
So we were near the epicenter of the Trump administration’s recent decision to halt foreign aid funding, including for the President’s Emergency Plan for AIDS (Pepfar), which was founded in 2003 under the Bush administration and has saved millions of lives.
We were worried but ready. Several years ago, CMMB began to envision the consequences of an end to Pepfar and AIDS funding, and we played out scenarios accordingly.
This February, our worst-case scenario became a reality. Yet we weathered the administration’s initial funding freeze and stop-work order thanks to our board’s decision to cover the salaries of project staff who were not allowed to work while the administration’s review was underway. Two of our three federally funded H.I.V. treatment programs resumed after the freeze, and both run relatively smoothly today because we avoided furloughs and layoffs faced by other organizations.
Our third program, which helped continue treatment for young people who contracted H.I.V. at birth, was inexplicably canceled. We recently entered into a contract with another partner of the U.S. government to restart it; the funding is lower, but we are able to care for these youth throughout this year. Meanwhile, longer-term planning to care for H.I.V.-infected young people beyond 2025 is underway.
We want to be prepared to help should the operational costs of local clinics, hospitals and health ministries—many of which rely on donated pharmaceuticals and medical supplies—shift from the U.S. government to financially strapped local governments in other countries. Will the need for donated supplies become even greater?
We are also considering the impact of tariffs and Medicaid cuts in the United States, asking whether CMMB’s core competencies in distributing critical medical supplies will be needed in parts of this country.
Our focus on scenario planning is exhausting, but it is paying off—shoring up our existing programs while making us flexible and resilient. But perhaps the most gratifying outcome of our risk-containment strategy has been a deepening commitment to our faith-based purpose. As we guard against “black swan events”—unprecedented occurrences that may have catastrophic consequences—we also are contemplating why we do the work in the first place.
We are doubling down on a model that is a response to the call of the Gospel to serve others. To quote a CMMB donor who was extrapolating from the New Testament, “We must love our neighbor. And all of humanity is our neighbor.”
And we are building new partnerships with like-minded organizations to address the needs of our neighbors, exploring ways we can amplify our impact despite fewer dollars. Some of these organizations share our Catholic faith. Some are affiliated with other denominations, and some have no religious affiliation at all. We can still see each other as allies.
Here is what we all share: faith in people. And so we will forge ahead together, come what may.
This article appears in October 2025.