Pilot programs have been useful for demonstrating the viability of various funding mechanisms, but they haven't been able to fundamentally change the game.
As Maura O'Neill of USAID shared at a 2011 Global Conference panel on "Reinventing International Aid," the philanthropic world needs to take a page from the capital market playbook. Innovation can be spurred on if the appropriate incentives are there for public and private investment.
The Milken Institute's recent work in this space argues for greater use of pull mechanisms, aid tools that fund projects only when the desirable outcome is achieved. By paying for performance, the sector could create a more sustainable flow of capital. Indeed, these models of efficient deployment could be the antidote needed to overcome the lingering case of pilot-it is. For a practical case study of what these pull mechanisms can really do, jump to 40 minutes in to the video. You'll find out why we should all care a lot more about fungi.