IPM Take
Cardiometabolic disease causes an enormous share of premature death, yet global health funding still treats it like a secondary concern.
The Novo Nordisk Foundation is moving into that vacuum with serious money, scientific reach and growing international ambition. That could accelerate prevention, earlier diagnosis and better integrated care in countries where obesity, diabetes, cardiovascular and kidney disease are rising faster than health systems can respond.
But money is never neutral.
The Foundation is institutionally separate from Novo Nordisk, with formal governance and conflict-of-interest safeguards. It also controls the pharmaceutical company through Novo Holdings. As its philanthropy becomes more influential, transparency, local priority-setting and public accountability must grow with it.
Private funding can catalyse change. It should not quietly become the institution that decides what global cardiometabolic policy looks like.
Executive Summary
The Novo Nordisk Foundation is increasing the proportion of its philanthropic funding directed outside Denmark and positioning cardiometabolic disease as one of its leading international priorities. Foundation CEO Mads Krogsgaard Thomsen told Devex that more than 20% of its giving went beyond Denmark in 2025 and that the proportion would increase in 2026. He described the Foundation as potentially the largest philanthropic organisation working specifically in cardiometabolic disease.
The scale is significant. The Foundation reported awarding DKK 11.8 billion, approximately €1.6 billion, in philanthropic grants and investments during 2025 across 2,206 awards. Denmark remained its centre of gravity, receiving DKK 9.4 billion, but the organisation’s international engagement is expanding. Cardiometabolic disease, including diabetes and cardiovascular disease, is identified as one of its principal health priorities.
The strategy is already producing concrete programmes. An international Global Science Summit Programme opened in July 2026, offering grants of up to DKK 7 million for projects using digital technologies and health data to improve early detection, follow-up and adherence in cardiometabolic care. The Foundation is also supporting an African innovation call focused on protecting people with diabetes and cardiovascular disease from extreme heat.
The opportunity is substantial. Noncommunicable diseases cause approximately 75% of deaths worldwide, but prevention and care remain fragmented and chronically under-resourced.
The governance questions are equally substantial. The Novo Nordisk Foundation is an independent Danish enterprise foundation, but through its wholly owned subsidiary Novo Holdings it held approximately 28.1% of Novo Nordisk’s share capital and 77.3% of its votes at the end of 2025. The Foundation states that governance principles maintain an arm’s-length relationship with the operating company, and employees of Novo Nordisk, Novo Holdings and other controlled companies are ineligible to receive Foundation grants.
This expansion should therefore be treated as a Signal. It may reshape global cardiometabolic research, prevention and implementation, but its legitimacy will depend on whether local health priorities, public accountability, affordability and long-term health-system ownership are built into the model.
Why it matters
- Policymakers and public authorities: Philanthropic investment can launch programmes quickly, but governments must retain responsibility for national priorities, sustainable financing and universal access.
- Researchers and academic institutions: The Foundation’s expansion creates major funding opportunities, particularly for implementation research, digital health, early detection and integrated cardiometabolic care.
- Health systems and providers: Projects should strengthen primary care, referral pathways and long-term disease management, not create temporary platforms that disappear when grant funding ends.
- Patients and advocates: Communities affected by diabetes, obesity and cardiovascular disease should influence programme design, research questions, outcome measures and decisions about data use.
- Industry and innovation partners: Philanthropic funding may accelerate the development of new technologies and therapies, but transparent rules are needed around intellectual property, commercialisation and access.
Global health has spent decades building institutions around infectious disease.
Cardiometabolic disease has been left to spread more quietly.
Diabetes is managed in one programme. Hypertension in another. Obesity is reduced to lifestyle advice. Cardiovascular and kidney complications often enter the system only after irreversible damage has occurred.
The diseases are connected.
The funding architecture is not.
The Novo Nordisk Foundation now appears ready to challenge that imbalance.
In July 2026, Foundation CEO Mads Krogsgaard Thomsen told Devex that the organisation is becoming increasingly international, with more than 20% of its 2025 giving directed beyond Denmark and a larger share expected in 2026. Cardiometabolic disease, covering obesity, diabetes and cardiovascular complications such as heart failure, stroke and ischaemic heart disease, will be one of its central priorities.
This is not a marginal donor adding another pilot project to an overcrowded field.
In 2025, the Foundation awarded DKK 11.8 billion in philanthropic grants and investments across more than 2,200 awards. Devex reported that annual giving had grown from approximately €228 million in 2018 to €1.6 billion in 2025.
Scale changes the politics.
A foundation of this size can determine which research questions become fundable, which technologies receive validation, which institutions build capacity and which definitions of “impact” dominate the conversation.
That influence could be transformative.
The Foundation’s 2026 Global Science Summit Programme is explicitly international and offers grants of up to DKK 7 million. It seeks projects using digital technologies and health data to improve cardiometabolic detection, continuing follow-up and adherence to treatment and risk-factor modification. The programme also recognises that fragmented primary and specialist care, siloed chronic-disease platforms and multimorbidity are major barriers.
That diagnosis is correct.
A person does not experience diabetes, hypertension, kidney disease and cardiovascular risk as separate funding categories. Health systems frequently force them to do so.
The Foundation is also moving into areas where cardiometabolic policy has been slow to respond. Through the Nexa Climate and Health Innovation Programme, it is supporting locally led African innovations intended to protect people with diabetes or cardiovascular disease from extreme heat.
That is an important signal.
Climate adaptation is rarely treated as part of diabetes or cardiovascular care, even though heat can disrupt medication storage, worsen dehydration, place additional stress on the heart and make access to clinics more difficult. Connecting environmental exposure with chronic disease could produce more realistic models of prevention.
The Foundation’s own public framing is also notably broader than a pharmaceutical model. It argues that people with cardiometabolic disease are too often blamed for their conditions while failures in food systems, health systems and economic policy are neglected. It calls for stronger implementation research, attention to sex and ethnicity, and more collaborative approaches to prevention and care.
This matters because cardiometabolic policy has spent too long pretending that information is the missing intervention.
Tell people to eat better.
Tell them to exercise.
Tell them to lose weight.
Then send them back into environments where healthy food is unaffordable, safe physical activity is difficult, primary care is inaccessible and medicines are paid for out of pocket.
A serious global cardiometabolic strategy must address these structural barriers.
But the Foundation’s growing influence also deserves scrutiny precisely because of where its wealth comes from and how its governance is structured.
The Novo Nordisk Foundation is not the same organisation as the pharmaceutical company Novo Nordisk. It is an independent Danish enterprise foundation. Its assets and ownership interests are managed through Novo Holdings, a wholly owned subsidiary.
At the end of 2025, Novo Holdings held approximately 28.1% of Novo Nordisk’s share capital and 77.3% of its voting rights, giving the Foundation a controlling interest. Its articles require it to provide a stable basis for the commercial and research activities of Novo Nordisk and Novonesis while also supporting scientific, humanitarian and social causes.
That structure does not prove that philanthropic decisions are commercially directed.
The Foundation has formal safeguards. Its governance principles state that an arm’s-length relationship should be maintained between the Foundation, Novo Holdings and operating companies. Novo Nordisk and Novo Holdings employees are ineligible to receive Foundation grants, and assessors with personal, professional or financial conflicts must recuse themselves.
Those safeguards should be recognised.
They should also be tested through continued transparency.
When a foundation financially connected through ownership to one of the world’s largest diabetes and obesity companies becomes a major global funder of cardiometabolic health, questions will follow.
Who determines the research agenda?
How much support goes to prevention and stronger public systems, compared with technologies that may eventually become commercial products?
Who owns the resulting data and intellectual property?
Will innovations be affordable in the countries and communities where the research is conducted?
Will local institutions lead projects, or merely implement priorities designed elsewhere?
What happens after the grant ends?
These are not accusations. They are basic governance questions that should apply to every powerful philanthropic actor.
The Foundation’s international expansion arrives at a politically vulnerable moment for global health. Government aid is under pressure, multilateral organisations face financing gaps and noncommunicable diseases remain poorly integrated into many donor programmes.
This makes private funding more valuable.
It also makes private funders more powerful.
The danger is not that philanthropy is entering cardiometabolic disease. The danger is that governments may use philanthropic activity as permission to withdraw further.
A foundation can fund a digital screening pilot.
It cannot guarantee universal primary care.
It can support a research consortium.
It cannot legislate healthier food environments, regulate commercial determinants of disease or guarantee affordable access to medicines.
It can help prove that a model works.
Only public policy can make that model a right rather than a project.
The strongest version of the Novo Nordisk Foundation’s global expansion would therefore be one that deliberately transfers power and capacity outward: locally led research, open and transparent evidence, public-interest intellectual-property conditions, meaningful patient participation and plans for government ownership from the beginning.
The weakest version would produce polished pilots, proprietary platforms and impressive conference presentations that never become routine care.
Global cardiometabolic disease does need more money.
But it also needs democratic accountability over what that money is allowed to shape.
The Novo Nordisk Foundation may be large enough to change the field.
The test is whether it strengthens public health systems, or becomes a substitute for the political decisions those systems still refuse to make.
