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2024-12-31-accounts

Elrha is registered in England and Wales as a Charity (charity number 1177110) and as a private company limited by guarantee (company number 11142219).

r*>)JJbi Ert+%ty¥e ID. OB70F2D4D4>4ACgW￿E17C¢EE8E6l9 CONTENTS Message frorn the Chairof Trustees................................................................................. About Elrha........................................................................................................................... Trustees. Report................................................................................................................. Strategic Report....................................................................................................... Financial Report..................................................................................................... Structure, Governance and Management..................................................... 37 Independent Auditor Report to the Members of Elrha........................................47 Financial Ststements...................................................................................................... 51 Notes to the Financial Statements.............................................................................54

The last year has been one of great change and challenge for the humanitarian sector. While the number of people who find themselves in need of humanitarian assistance has been growing for many years, today’s crises are becoming ever more complex – from the catastrophic conflicts in the Middle East, Sudan and Myanmar, to the many communities increasingly impacted by the climate crisis.

Navigating such contexts is never easy, but it’s a reminder of how important it is to stay connected to the people and communities at the core of our mission – to remain grounded in the reality of those we strive to support and ensure the work we fund is as relevant and impactful as possible.

For Elrha, this year has also been one of change and growth. We said goodbye to Jess Camburn, our founding CEO, who has been such a fundamental part of our journey – from its early days as a small project at Save the Children to the organisation we are today. After 15 years with Elrha, Jess decided it was time for her next chapter, and while it was a bittersweet moment, we welcomed Fiona McSheehy in her interim role and embarked on finding Elrha’s new permanent CEO.

As the UK Humanitarian Innovation Hub (UKHIH), which we have hosted since 2020, nears the end of its pilot phase, we made the decision to integrate them fully into Elrha, as one organisation. The integration will take place during 2025, and we’re excited to work together to continue the great work started by UKHIH, increasing our collective reach and impact through combined efforts.

In the face of change, supporting our grantees to address the most critical humanitarian challenges has remained our top priority. Elrha-supported innovations are now being implemented in some of the world’s most complex crisis settings. In Haiti our grantees are providing mental health support to young adults and caregivers affected by trauma from the ongoing gang violence; while in Gaza, our funded work is enabling the distribution of reusable period underwear, addressing the need for quality, low-cost, culturally sensitive menstrual hygiene products.

We also began to meet the growing demand for solutions addressing the impacts of the climate crisis, identifying opportunities for environmental adaptation in WASH response, and unpacking the links between humanitarian health and climate change.

As we move into the next year, the work we fund must remain responsive to the needs of people living through crises and alert to the global issues that compound them.

The growing backslide on reproductive rights will no doubt amplify existing barriers to sexual health services in humanitarian emergencies. Our forthcoming research on sexual and reproductive health seeks to highlight missing evidence on improving future policy and practice and provide recommendations for the most impactful research and innovation funding.

In an increasingly siloed sector, our research and innovation forums taking place in Nairobi will be a chance to bring everyone together – partners, grantees, leading thinkers, donors, and the wider community – to share ideas and plan how we can bring about even bigger changes.

After a few years of limited in-person events, it feels like the perfect moment for these conversations.

As we look forward to 2025, I know that Elrha will rise to the challenge and play its part in more effective and accountable humanitarian response.

Dr Jane Cocking

Chair of the Board of Trustees

WE ARE ELRHA A global organisation that finds solutions to complex humanitarian problems through research and innovation.

OUR PURPOSE We work in partnership with a global community of humanitarian actors, researchers and innovators to improve the quality of humanitarian action and deliver better outcomes for people affected by crises.

OUR ROLE We are a leading actor in humanitarian research and innovation. We bring people together to tackle some of the most complex problems and strengthen the humanitarian system. And we support and champion robust research and proven innovations to improve humanitarian response.

OUR SCOPE We want to see the positive impact of our research and innovation in acute phases of emergencies and in complex and protracted conflict settings where it’s most needed, including work with internally displaced, refugee and host community populations.

STRENGTHEN AND CHALLENGE THE SYSTEM A system in which policy and

practice continuously improve through the sustainable and strategic resourcing and adoption of new evidence and innovative solutions.

ADDRESS THE CRITICAL CHALLENGES We want to see an equitable and cohesive humanitarian system that routinely identifies and addresses critical humanitarian problems through research and innovation.

We live by a clear set of values. They’re seen in our work within the humanitarian system and in how we operate and hold ourselves accountable as individuals and as an organisation and employer.

PUTTING PEOPLE AT THE CENTRE We are committed to being a truly inclusive and empathetic organisation that supports, encourages and recognises its people. We seek out and value diverse knowledge, experience and perspectives, listening to understand before we act. We believe people and communities affected by crises should be deeply involved in research and innovation processes, driving the changes they want to see.

WORKING WITH OTHERS We collaborate to bring about positive change. We build meaningful partnerships, investing in and nurturing our networks and creating space for open and honest dialogue. We understand the part we play in improving humanitarian response and we invite people to join our efforts, supporting others to lead where they are better placed to do so.

ACTING RESPONSIBLY We’re a responsible and principled organisation to our core. We champion ethical approaches in humanitarian research and innovation, calling out practices

that fall short and partnering only with organisations that share our commitment. We make decisions based on the best available evidence. We listen to and act on feedback, and we take accountability for our actions.

COMMITTED TO LEARNING We’re always looking to develop ourselves and our work; it makes us better at what we do and more effective in what we achieve. We are evidenceled in our decisions and actions. We take on board different views and ideas that will help shape the future of humanitarian response. This appetite for learning and for discussion, reflection and recognition of achievement is engrained in our culture and our practices.

INSPIRING CHANGE We’re ambitious in our vision for the future of humanitarian action. Positive, energetic, undaunted, we’re committed to long-term investment in research and innovation that will deliver transformative change for people affected by crises. We generate momentum, motivating others to work with us and to support the positive differences we make.

Our work is funded by: The UK Foreign, Commonwealth and Development Office (FCDO), the Norwegian Ministry of Foreign Affairs, Wellcome, and the Department of Health and Social Care (DHSC) through the National Institute for Health Research (NIHR).

For their guidance, dedication, and support throughout the year, we would like to acknowledge and thank Elrha’s Board of Trustees. We would also like to thank the members of our Funding Committees, Advisory Groups, Technical Working Groups and GPE Reference Group, for continuing to provide invaluable expertise to our work.

Finally, we would like to acknowledge all our incredible partners and grantees, and the organisations we have worked with in 2024 for their collaboration and partnership.

The Trustees (who are also Directors of Elrha for company law purposes), have pleasure in submitting their Annual Report and audited financial statements of the company for the year ended 31 December 2024.

Total grant expenditure: 7.7m

Active grants: 93 (HIF:41, R2HC: 41, UKHIH: 11)

New grants: 19 (HIF: 14, R2HC: 1, UKHIH: 4)

Thematic funding areas: 8 (WASH, MHPSS, GBV, Scale, NCDs, DOAI, CLIP, Undernutrition) Locally led innovation projects: 64

Underpinning our work at Elrha, is a drive to see a humanitarian sector that can deliver better outcomes for people affected by crises, and for 15 years now we have funded vital research and innovation to this end. When we began, we were one of few working in these areas – now, we are one of many. This expansion is welcome but brings with it even greater responsibility to demonstrate impact.

We know meaningful change takes time, which is why our Strategy, defines our work until 2040. Encapsulating our vision, values, our theory of change and long-term commitments, it lays out our plans to partner and collaborate with the wider community, to realise a collective vision for research and innovation, and to position them at the core of humanitarian practice.

To ensure we continue to progress against our goals, commitments and resolutions, we set out five strategic priorities for the organisation in 2024.

1. Meeting our donor commitments

We are committed to meeting the requirements of our donors, ensuring we deliver on our planned activities each year. In 2024, we delivered our commitments across all of our programmes and achieved strong satisfaction from our funding partners. Both HIF and R2HC received high ratings from FCDO for its work, with our R2HC programme commended for its timeliness, topical evidence, influence on humanitarian policy and practice, and significant contributions at outcome and impact level.

2. Our MEAL systems and processes effectively measure and communicate impact

To ensure we are effectively and accurately measuring and communicating our impact, we have increased our focus on our monitoring, evaluation, accountability, and learning (MEAL) systems. This year we introduced a range of improvements to support our organisational understanding of impact and how to document and communicate it.

As aid budgets struggle to keep pace with mounting need, and humanitarian innovation faces growing demands to prove its worth, we have continued to develop our approach to Value for Money for humanitarian innovation – a metric the wider community is not currently equipped to meaningfully assess. In 2024, we worked with a Learning Partner, a core group of innovators, and an expert reference group to develop core methodological principles, to be integrated throughout our grant-making process.

Building on our goal to ensure all grants are assessed at closure against their intended objectives – to give us some initial indications of impact – all the systems are now in place to carry out the assessments and we have begun using them for recently completed grants.

3. Visibility of Elrha’s work is strengthened through external engagement

Partnerships are a core component of our strategic approach, and a vital way to share and collaborate with our community.

For our upcoming forums, taking place next year in Kenya, we have established regional partnerships. Our Innovation Forum will benefit from the support of the Response Innovation Lab. Our Research Forum will be co-hosted with the African Population & Health Research Center. We also continued to nurture and reinforce existing partnerships with colleagues from ALNAP, SPHERE and the Clusters.

Events are another key avenue for increasing the visibility of our work, and over the last year Elrha staff have attended, presented or been a panelist at 22 external events, including Humanitarian Networks and Partnerships Weeks, AidEx, the Climate and Health Africa Conference, and the Sexual Violence Research Initiative Forum. Read more about our events on p25 .

4. Implementation of our Strategy is advanced through programme development, embedding long-term commitments and strengthening organisational culture

It’s critical that our staff understand our approach to delivering our long-term Strategy, so that we can consistently and collectively make progress against it. This year we have been thinking ahead to our next three-year plan (2026–2028), a key outcome of which will be clarity and confidence in our strategic direction among staff.

This outcome will also be embedded into the organisational development project we began this year, that will help Elrha become a more effective and holistic partner and funder. We have already begun outlining a more joined-up approach to research and innovation, with the aim of developing a cross-programme funding call.

5. Diversifying our funding and securing long-term funding from 2026

To ensure that we continue to be sustainable and resilient to shocks, we focused on developing new funding partnerships with a greater diversity of donors.

Following the change of government, we were invited to submit a costed extension to the FCDO ahead of our full funding proposal. The extension was approved, ensuring our existing programmes and the UK Humanitarian Innovation Hub (UKHIH) are now funded until 2026. Following the extension submission, we submitted a full five-year proposal to the FCDO in December for 2026–2031.

We actively engaged multiple donors, partners, and critical stakeholders to secure strategic future partnerships and funding to advance our programmatic objectives. By aligning on shared priorities and demonstrating our programmatic vision, we have strengthened our funding pipeline and positioned ourselves for sustained financial support. This engagement has laid the groundwork for 2025 and beyond, to reinforce the long-term success and scalability of our initiatives.

As a member of the international humanitarian community, we recognise the legacy of our sector and that, as an influential, UK-based organisation, we hold a position of power and privilege that others do not. To hold ourselves accountable to people affected by crises, as part of our new long-term strategy we established three commitments to formalise the things we believe in, and how they will steer what we do and how we do it. In 2024 we made the following progress against these commitments:

Commitment 1: Become an anti-racist organisation

We continued to acknowledge our role and our responsibility to address racism in our work and culture.

Commitment 2: Be climate responsible

We have actioned ways to minimise the impact of human-induced climate change through measuring and reducing our carbon footprint as an organisation.

Commitment 3: Shift the power to low- and middle-income countries

We continued to proactively seek practical ways to shift the power in our programmes and communications.

Our combined focus on research and innovation is central to our belief that the humanitarian system urgently requires robust evidence-based solutions. This allows us to invest in both with confidence, knowledge, and expertise.

Humanitarian Innovation Fund (HIF)

The HIF aims to improve outcomes for communities affected by humanitarian crises by identifying, nurturing, and sharing more effective and scalable solutions. The HIF is a leading actor in the development and testing of innovation in the humanitarian system. Through the HIF, we fund, support, and manage innovation at every stage of the innovation process through:

Research for Health in Humanitarian Crises (R2HC)

Our R2HC programme aims to improve health outcomes for people affected by humanitarian crises by strengthening the evidence base for public health intervention and to bring about positive change in humanitarian response. We achieve this by:

The R2HC programme has built a unique community across humanitarian public health practice and research. This community represents a wealth of expertise and experience. We work hard to maximise the potential of research for the humanitarian system by commissioning studies and facilitating critical conversations for the sharing of knowledge and experience.

Global Prioritisation Exercise (GPE)

Our flagship initiative, the GPE for Humanitarian Research and Innovation (HRI) is the first of its kind in the research and innovation space. The GPE aims to improve outcomes for people affected by crisis and address gaps in knowledge about how HRI operates. Through understanding the landscape and highlighting changes that could improve things further it is aimed at amplifying the impact of investments in HRI.

Through a programme of global research, mapping, and consultations across the humanitarian system we aim to reveal investment trends and activities in HRI, to highlight successful examples, identify what humanitarians and communities affected by crisis believe are the most pressing areas for investment, and support the development of an inclusive coordinating mechanism that enable actors to target activity to the most pressing needs.

The role of research and innovation at global, regional and national levels is crucial to ensuring a constant commitment to humanitarian work achieving the best possible outcomes for people affected by crisis.

The culmination of our multi-year work on global prioritisation through our GPE initiative, we launched our landmark report – Global Insights: The Humanitarian Research and Innovation Landscape 2024 – which offers the most comprehensive overview of the humanitarian research and innovation (HRI) ecosystem to date, highlighting insights and actionable guidance for policy and practice changes. From this helicopter view of the sector, five core recommendations emerged:

We launched the report online with over 300 people from 59 countries in attendance. Attendees were polled on which of these five recommendations they considered the highest priority and the results found that promoting local leadership and Global South decisionmaking was most critical.

The report has generated further interest and engagement opportunities – we hosted a Cluster Roundtable at Humanitarian Networks and Partnerships Weeks (HNPW), where we presented tailored findings and recommendations to the leads of nine clusters, OCHA and donors. Our Director of Impact and Engagement, Colette Fearon, also participated in a panel at the AidEx conference, discussing how the sector can scale, localise and drive innovation in conflict and protracted crises.

The synthesis report is based on 16 thematic, regional and country-level consultations, providing recommendations for implementing culturally and contextually appropriate HRI. We have so far published two regional reports for West Asia and North Africa, and Latin America and the Caribbean, and one national report on Lebanon. A further four regional consultations and two national consultations have been prepared for publication and will be launched in 2025.

We have been at the forefront of HRI for more than 15 years, contributing to the improvement and advancement of humanitarian response. More than ever, researchers, innovators, and their funders – including us – are increasingly called upon to demonstrate the impact and value of their work so that evidence can reach humanitarian stakeholders who can use it to enhance programmes, policy and practice for people affected by crisis.

As well as a tool to inspire and guide our grantees, case studies are central to how we assess and illustrate our impact and that of the wider R&I community. Over the last year, we have commissioned ten case studies that offer guidance for researchers and innovators, and evidence on how R&I can continue to support and improve humanitarian response.

Innovation impact

Our HIF programme published a new set of impact case studies, documenting the successes and learning from four of our funded projects:

We also produced short videos to demonstrate the value of investing in evidence-based innovations, and to highlight the human stories and transformative effects of these innovations. For Humanitarian Networks and Partnerships Week ~~s~~ ( p25 ) we produced videos for our funded protection sector innovations and commissioned three on the outcomes of our Data Driven Inclusion Challenge to support older people and people with disabilities.

Research impact

Our aim is for the research we fund to influence humanitarian policy and practice. This year we commissioned research impact evaluations for six of our funded studies:

The case studies will be published in spring 2025, joining our research programme’s growing case study collection, and helping us to further develop our Research Impact Framework.

Innovation Snapshot Addressing Reproductive Coercion in Health Settings (ARCHES) Ipas ARCHES is a clinic-based harm reduction intervention to help women use family planning methods without interference. It was developed in United States family planning clinics and has since been adapted for use in a wide range of countries including Kenya, Mexico, and Nigeria. It consists of three core elements: a rights-based counselling and screening session on reproductive coercion; counselling and screening for intimate partner violence without pressure to disclose; and the offer of a discreet information booklet. Through two of our innovation grants, Ipas has pioneered its use in a humanitarian context, adapting ARCHES to Cox’s Bazar, Bangladesh, where displaced Rohingya women face many challenges to their autonomy including intimate partner violence and reproductive coercion. Ipas translated materials into Rohingya and contextualised them with input from community members and an advisory group. The pilot saw a 92% increase in women wanting to use modern contraceptive methods despite partners’ opposition, and a 17% increase in women feeling empowered to access intimate partner violence support services. The intervention reached over 25,000 Rohingya women and girls and United Nations Population Fund (UNFPA) has provided funding to roll it out across more health centres in Cox’s Bazar. While the original ARCHES is a clinic-based intervention, our second grant has supported further adaptation for delivery, developing a community-based ARCHES intervention, to be implemented through community health-workers to reach women and girls with limited access to health clinics.

Engaging and collaborating with the humanitarian community is key to understanding the role HRI can play in crisis contexts, for incentivising uptake, embedding it into response programming, and for promoting strong, inclusive partnerships across the sector.

Our Adoption Challenges aim to tackle barriers around the scaling and uptake of innovations by humanitarian organisations. These challenges incentivise and support humanitarian response agencies to adopt promising solutions, adapt them to new settings and evaluate their effectiveness.

Adopting innovations in high severity settings

In the world’s most high-risk humanitarian settings, the challenges of scaling are even more pronounced. Yet it is these settings that stand to benefit most from new solutions, particularly those informed by and adapted for local communities. This challenge incentivised organisations working in acute crisis contexts to pilot any of the 140 innovations supported through our HIF programme since 2012.

Through this call, three innovations, have now been adopted by aid agencies and are being implemented in some of the world’s most challenging humanitarian situations:

Rapid response

Drawing on learnings from our response to the Pakistan Flood in 2022, we designed and launched a Rapid Response funding call in October 2023. The successful grantee team, Oxfam and Reemi, began preparations for implementation in Gaza in March 2024, to support the response to the Israel-Gaza war.

This funding call gave us a unique opportunity to accompany a grantee during one of the most complex, acute, conflict-based crises in recent decades. Two learning partners were engaged to accompany this work: one to evaluate the effectiveness, efficiency, feasibility and sustainability of Oxfam implementing Reemi in Gaza; a second to evaluate the opportunities and barriers that innovations face when navigating a rapid onset or acute crisis. The learnings will be published in 2025.

Innovation Snapshot

Supporting mental health in Haiti

SOS Children's Villages

Haiti is in urgent need of mental health support. Long-running political instability, gang violence, widespread poverty and the impacts of successive natural disasters have left citizens fearful and, in many cases, deeply traumatised. Despite mounting need, mental health services in Haiti are skeletal, with just 23 psychiatrists and 124 psychologists to support 11 million people.

Developed by the World Health Organization, Problem Management Plus (PM+) is a lowintensity, low-cost intervention that can be adapted to local needs, contexts and mental health conditions. Crucially, it can be delivered by lay health workers. The innovation allows for community management of low-level mental health conditions such as depression and anxiety, reducing the burden on the public health system and ensuring those with severe mental health conditions can access more intensive clinical treatment.

Using a scalable ‘train the trainer’ model, SOS is training ten PM+ Helpers as trainers-oftrainers, who will then aim to train a pool of 30 more PM+ Helpers, potentially reaching 320 clients in a 12-month period. Due to the escalating gang violence in the country, the team, with support from the University of Verona, adapted the tool to be delivered virtually.

– Faimy Loiseau, National Director

of SOS Children’s Villages Haiti

Tool Snapshot

Partnership health checks

Strong partnerships are a vital cornerstone of high-quality research, and our R2HC programme work tirelessly to improve the equity and inclusivity of these working relationships among grantees, particularly for partners based in LMICs.

Informed by our partnership principles of equity, mutual benefit, transparent communications, and shared values, we have been developing a Partnership Health Check tool. The approach is comprised of an individual assessment survey that is translated into a shared action plan for the team to take forward. The tool is designed to strengthen grantee collaboration, increase the participation of LMIC partners in ongoing grant delivery and identify partnership challenges that can be addressed by lead partners and our research team.

The tool has now been piloted with three grantees and will be evaluated before sharing the learning at the Research Forum in 2025.

For R&I to play a central role in improving humanitarian action, knowledge of best practice and a shared understanding of priorities is important for effective coordination. Over the year we’ve produced evidence-based tools to help researchers and innovators make their work more targeted, inclusive and impactful.

Research priority settings (RPS) provide a nuanced understanding of knowledge gaps and points for expansion in specific areas of practice. Composed of key research questions, they are intended to guide humanitarian practitioners, academics and donors who want to improve humanitarian interventions through research.

Since 2019, we’ve highlighted the key research questions for mental health and psychosocial support (MHPSS), water, sanitation and hygiene (WASH), and non-communicable diseases (see Snapshot below). We have recently commissioned a new RPS on sexual and reproductive health and rights, to better understand the gaps and needs in this area.

Research Snapshot

Research priority setting for non-communicable diseases

Commissioned by Elrha, conducted by International Rescue Committee (IRC) & the American University of Beirut

Non-communicable diseases (NCDs) are a growing and often overlooked threat in humanitarian contexts. Globally, they are responsible for 74% of deaths, but in countries affected by crises, the numbers are even more staggering.

Despite their growing prevalence, NCDs are often neglected in crisis settings, when there are so many competing priorities, from infectious disease to maternal health, to trauma care. But as crises and disease outbreaks continue to occur at more rapid and widespread rates, they will become an even greater priority for health responders.

Conditions such as heart disease and diabetes compound the challenges faced by vulnerable populations, straining already fragile healthcare systems. This is one reason why this exercise focused on cardio-metabolic syndrome – a cluster of conditions that increase the risk of heart disease, stroke and type 2 diabetes.

The exercise gathered the inputs of specialists from around the world, to rank 43 questions. The highest-ranked priorities focused on outcomes and processes of care, demonstrating that frontline health workers need better evidence for what works to provide quality, contextually appropriate care for their patients. By highlighting integrated and sustainable models of NCD care, we can also support health actors to make the most of their staff and financial capacity.

To ensure the findings of this research agenda were easily digestible for practitioners and policymakers, we developed an interactive tool which allows users to search by region, area of focus and profession to find the most relevant questions for them.

While the humanitarian research and the evidence base has grown over the past decade, the impact of that research on humanitarian policy and practice has not kept pace. Humanitarian researchers and their partners face multiple barriers translating evidence into use, and practical guidance on producing research with greater impact is highly sought after.

Research Impact Toolkit

Our Research Impact Toolkit is a set of resources available to R2HC grantees. Over the last year, we have continued to develop these resources, including launching French translations of our online courses to enable our Francophone study teams to benefit from the materials.

We also commissioned two expert consultants to review our research impact materials for cultural relevance to humanitarian policymakers and practitioners in the Middle East and East Africa. The review has already begun to generate recommendations for tailoring course content, such as culturally relevant case study examples, and guidance on communicating research through instant messaging apps, a priority channel in the Global South. We aim to update and launch these courses for the benefit of the wider humanitarian health research community.

As global conflicts and the increasing effects of the climate crisis continue to drive humanitarian need, our funding must remain reactive to emerging crises, as well as to the new and existing priorities of practitioners and communities in affected regions.

In collaboration with the UK Humanitarian Innovation Hub (see p28 ), we have been working to scope out the emerging humanitarian AI landscape and support humanitarian practitioners to influence its future.

Funding Snapshot

AI Learning Journey

Artificial intelligence (AI) has the potential to drive innovation and vastly improve humanitarian outcomes. While we see the importance of investing in AI research and capacity strengthening to unlock its transformative power for action, we also see the risks – and challenges it poses both morally and operationally. As part of our funding, we want to support and advocate for the responsible and ethical use of AI in decision-making processes and service delivery.

Our research on AI and emerging technologies has indicated that currently technology development and deployment is disproportionately led by technologists based in high income settings. This top-down approach means that innovations often fail to address priority needs and crisis-affected populations rarely get to express their technology-use preferences.

Our AI for Humanitarians learning journey, which ran from June–November 2024, aimed to develop an enhanced understanding of the future potential impact of engagement with AI in humanitarian settings, led by those with lived experience and contextual knowledge.

Through the learning journey, we supported a group of ten grantees to take a problem-led approach and explore the opportunities and risks associated with AI to identify future areas of impact for further investigation and potential investment. Each project varied greatly, from using AI to predict floods, manage disease outbreak and optimise the aid supply chain, to integrating it into mental health support and establishing how the technology can accurately reflect the voices of local communities.

With the learning journey now complete, we’re collaborating with University College London on an AI Learning Guide that will package the curriculum, recordings and presentations from the sessions for future use. Separately we will collate learnings and reflections from the grantees to better understand the potential of AI for humanitarian innovation.

Women and girls face distinct challenges in humanitarian contexts and their inclusion, empowerment, and protection are essential to creating effective and equitable solutions. In 2024 we were able to support and progress key pieces of research and vital innovations aimed at ensuring the unique needs of women and girls are centred within humanitarian response.

Overcoming barriers to safe abortion

Access to safe abortion is a recognised human right but Ministries of Health and humanitarian agencies often fail to offer this essential service in crisis settings, resulting in unsafe abortion becoming a major cause of maternal mortality.

Barriers to safe abortion in humanitarian settings are now being compounded by a global backslide on reproductive rights – ensuring safe abortion access and care in crisis settings should be firmly on the agenda for the humanitarian sector.

In 2024, four grantees focused on abortion in humanitarian settings, completed their studies. These included improving access to comprehensive abortion care for internally displaced women; understanding the burden and severity of post-abortion complications; documenting women’s experiences of self-managed abortions to identify access gaps; and establishing guidance on how humanitarian actors can improve post-abortion care. In 2025, we hope to commission a policy brief that draws on the findings of these studies, providing guidance for safe abortion and post-abortion best practice for humanitarian policymakers.

GBV tech innovations

Gender-based violence (GBV) disproportionately affects women and girls, and in situations of displacement and humanitarian crisis their risk of exposure to violence increases - significantly. In January, we began supporting four technology based interventions enabling earlier, faster and more effective action to address GBV in these settings.

The projects were each unique in their focus, and included a virtual reality training programme for response actors, a chatbot that provides guidance and support to Community Outreach Workers, a platform that provides Arabic-language information and remote service provision on sexual and reproductive health and rights (SRHR) and GBV, and a tech-based case management system to support lesbian, bisexual and trans women, and others with gender identities that place them at heightened risk, in a highly constrained and sensitive context.

Menstrual hygiene management

Each month, 1.8 billion people around the world menstruate. Of that number it’s estimated that 500 million will struggle to access menstrual products or suitable facilities to manage their periods.

Accessing products and services is just one of a complex set of challenges that contribute to period poverty. Around the world, cultural taboos and societal stigmas continue to impact the health, dignity and wellbeing of girls, women, and other people who menstruate. In a humanitarian crisis, these factors are intensified, with a lack of privacy, basic materials and safe sanitation facilities only adding to the sense of shame, fear and isolation.

Innovation Snapshot

Reemi: Zero waste menstrual hygiene solution

Reemi & Oxfam

Reemi, is social enterprise that produces culturally appropriate period underwear and washing and drying bags. By offering a reusable, low-cost, and culturally sensitive alternative, Reemi supports not only the practical aspects of menstrual hygiene but also the environmental and socio-cultural dimensions of the communities it serves.

A core component of this innovation are the education sessions delivered alongside the products, for women, adolescent girls and men, to debunk the stigma and myths around periods and reduce barriers to safe menstrual hygiene management and social participation.

Through our High Severity and Rapid Response adoption challenges, Oxfam have been working in five countries to distribute Reemi products.

Central African Republic, Mali and Somalia

As in many high severity contexts, menstrual hygiene products available in Central African Republic (CAR), Mali and Somalia are failing to meet the needs of community members. Prohibitive costs, lack of availability and poor-quality products mean that women and girls do not have what they need to manage their menstrual cycle with dignity. However, previous distributions of reusable products in Somalia and CAR have evidenced a demand for them.

In the last year, Oxfam have been able to give 750 women and girls across these three contexts access to Reemi products, as well as developing and delivering the accompanying educational workshops, including two sessions for men.

Gaza and Lebanon

In March, Oxfam expanded its work further to Gaza through our Rapid Response call. Given the complexity of implementation during a rapidly changing and increasingly complex crisis, we worked closely with Oxfam and Reemi to develop a clear and responsive workplan.

The team worked for six months to get an initial 5,000 kits into Gaza. Given the restricted access, delays and the high chance of further delays transporting kits into Gaza, we and our partners deployed a contingency plan, directing a portion of the kits to Lebanon, which was also seriously impacted by the Israel-Gaza conflict. With additional products crowdfunded by Reemi, Oxfam will be distributing 7,132 kits in both Gaza and Lebanon once humanitarian access is restored.

– Emily Au-Young, co-founder of Reemi

Undernutrition and food insecurity

There are currently 258 million people across 58 countries and territories facing acute food insecurity, with women and children particularly vulnerable to undernutrition in these contexts. While we have long known what is needed to keep women and children healthy, there remain many unknowns about how to do this in humanitarian contexts facing food insecurity.

Our Prevention of Undernutrition programme was developed by our R2HC programme in 2022, in response to the hunger crisis in the Horn of Africa. Our partners, NutritionWorks, are developing the core deliverable from this programme – to develop and test of a package of interventions aimed at preventing undernutrition in pregnant and lactating women and children under five.

This year, NutritionWorks carried out a comprehensive evidence review which identified effective interventions for preventing undernutrition among women and children, which will help to inform the development of ‘prevention packages’ which we will trial in the next phase of the programme. It will also contribute to a decision tool and resource guide to help implementers know which interventions are most effective in what context.

Climate change is one of the greatest threats to lives and livelihoods globally. Environmental destruction, extreme weather events, natural disasters and food and water scarcity are just some of the effects being felt by populations around the world, but for those living in humanitarian contexts, the impacts can be even greater.

Linkages between the climate crisis and humanitarian health

This year we commissioned a situational analysis looking at the impacts of the climate crisis on humanitarian health. The report examines the interlinkages between the climate crisis and humanitarian health, helping us to understand the evidence available and identify the key stakeholders working across the climate and humanitarian health nexus.

The report highlighted that, although there is a growing body of evidence on climate change and health, there is little evidence specific to humanitarian populations and high levels of uncertainty on what to do about this evidence gap. The report also found that the humanitarian sector is largely absent from conversations related to the climate crisis, particularly those happening in the research-policy space.

Water, sanitation and hygiene (WASH) is one of the most fundamental elements of humanitarian response and has been a key focus for us since our inception. The projects we’ve funded collectively address some of the most pressing challenges faced by humanitarian WASH practitioners globally, and to date, we’ve supported more than 40 innovation projects and research studies in this area.

Faecal-sludge management

Around 3.6 billion people live without safely managed sanitation, with displaced individuals often living in highly congested environments where water supply and sanitation systems are difficult to deliver, damaged, destroyed, or non-existent. Safely managing human excreta in such situations is challenging, where the risk of disease outbreaks is high. This is particularly the case in densely populated settings such as those found in refugee settlements.

Building on key findings from our WASH Gap Analysis and Problem Exploration on Faecal Sludge Management reports, we launched an innovation challenge focused on faecal sludge treatment solutions that addressed disease outbreaks in densely populated humanitarian settings. Through this challenge we funded two promising innovations, one using microbial tools to optimise the tried-and-tested mineral lime treatment of faecal sludge, and the other trialling solar thermal pasteurisation to destroy harmful pathogens.

Follow-on funding allows our grantees flexibility to carry out activities in the face of unforeseen circumstances, and to extend the reach and impact of their projects.

Uptake and Supplementary Funding grants

Uptake and Impact grants are awarded to previous and existing R2HC-funded study teams to fund engagement, communications, or capacity-strengthening uptake activities. Grantees are supported to translate their findings and assist humanitarian actors, including policymakers, practitioners, and community stakeholders, in understanding, using, and applying research outcomes. Throughout 2024 we supported seven grantees under this initiative, and opened applications for a new cohort in December.

Our Supplementary Funding grants are awarded on an exceptional basis to cover unforeseen shortfalls in their existing budgets, such as losses due to currency exchange rates, inflationary pressures or incurred as a result of culture or policy change. In 2024, two grants received additional funding to complete research and uptake activities despite challenges and unforeseen cost increases. One in Afghanistan was awarded due to delays, inflationary pressures and additional costs following the Taliban takeover of the government. The second grant was split between study contexts in Yemen and Bangladesh to account for exchange rate fluctuations. A further opportunity for existing grantees to apply for supplementary funding was launched in September.

Dissemination grants for disability and older-age inclusion

Between April and December, three disability and older age inclusion (DOAI) grantees have been supported to further develop their innovations by sharing their results with new audiences and building new partnerships. The HIF-funded innovation teams showcased a - range of approaches to engaging their new audiences, including mobile video making workshops to support local advocacy efforts in ten Indian cities, and sharing the findings from an inclusive data collection tool with local governments and communities.

Research Snapshot

Heat Emergency Awareness and Treatment Bundle

Johns Hopkins University School of Medicine, Aga Khan University & the Aman Foundation

With heatwaves expected to rise due to the climate crisis, there is increased need for locally informed, evidence-based interventions to manage their impacts on health and wellbeing.

Originally funded in 2015 through our open call, the ‘HEAT (Heat Emergency Awareness and Treatment Bundle) Trial’, led by Johns Hopkins University, sought to develop and test an intervention to reduce the impact of extreme heat in Karachi, Pakistan. Initial outcomes included improved knowledge and care practices of emergency department staff, and the increased ability of communities to protect themselves from heat-related illnesses.

We awarded the study further funding to support uptake and dissemination activities. A small team, led by Aga Khan University, used the funds to produce a video containing key - community focused messages for recognising and managing symptoms of extreme heat, and convened a meeting of district commissioners in Pakistan to discuss findings of the study and advocate for extreme heat plans. Following this meeting, city authorities requested that the study team support them to develop extreme heat management plans for their cities.

– Dr Junaid Razzak, Principal Investigator, Director of the Centre of Excellence for Trauma and Emergencies, Aga Khan University and Professor of Emergency Medicine and Population Health, Weill Cornell Medicine

For our work to have impact, we can’t keep it to ourselves. Sharing updates and insights from both funded projects and our own research is a big part of what we do, from promoting high-level reports aimed at strengthening the humanitarian system, to highlighting the most useful guidance for our grantees and their partners.

Research Snapshot

Failure to Scale

Commissioned by Elrha, conducted by Neil Townsend

To understand what works for scaling humanitarian innovation, it’s vital to investigate what doesn’t.

Our ‘Failure to Scale’ report examines the challenges faced by humanitarian organisations in scaling successful innovations to achieve broader impact. Scaling innovations is complex: Many humanitarian innovations and interventions that are successful in small-scale pilots fail to scale effectively, and the complexity of the environments where these interventions are applied makes scaling difficult. A set of key barriers continue to hinder scaling efforts, including lack of resources, fragmented funding, inflexible systems and resistance to change among potential adopters.

The report captures 50 recommendations for supporting scaling efforts at all levels of the humanitarian system, highlighting the need for collaboration among stakeholders, adaptive and flexible strategies, and, crucially, building local capacity to ensure sustainability of scale and community ownership of the solutions.

While many of these recommendations are not new, their effectiveness relies on a collaborative and strategic approach. They cannot be applied piecemeal or all at once. What is needed is a collective, joined-up response.

People with disabilities and older people are disproportionately affected during humanitarian crises and yet are often excluded from shaping the initiatives designed to assist them. Despite global frameworks advocating for disability inclusion, practical implementation remains a challenge. Bridging this gap requires innovative solutions and actionable evidence.

Meaningful participation for older people and people with disabilities

In December 2024, we finalised the publication of our paper ‘Participation of Organisations of Persons with Disabilities and Older People in Humanitarian Action: Lessons from ’ Measuring Effectiveness of Meaningful Participation Innovation Challenge . The report is based on the evaluation of two projects funded through our Meaningful Participation Innovation Challenge:

The paper highlights the transformative impacts of both projects, and shares findings and reflections for humanitarian actors wanting to embed meaningful participation into their practices.

Events offer a vital avenue for showcasing our research and insights, and the work of our grantees. In 2024, we attended several global conferences, where we shared insights and evidence from both our own funded research and the work of our grantees.

We also hosted a range of webinars to launch, discuss, and revisit key pieces of funded research, and showcase promising innovations. A few examples of these included:

Showcasing innovations in protection sector programming

At this year’s Humanitarian Networks and Partnerships Weeks (HNPW) we hosted an online showcase of our funded innovations in protection sector programming, specifically GBV and inclusion of persons with disability and older persons. The webinar highlighted eight innovations, including tools for safer programming, assessment and monitoring and evaluating frameworks that orient programmes towards more inclusive programming and better outcomes for people affected by humanitarian crises.

Menstrual hygiene management in humanitarian crises: What have we learned and how far have we come?

This event reviewed the progress and ongoing challenges of menstrual hygiene management (MHM) in emergency settings a decade on from the development of the MHM in Emergencies toolkit. Co-hosted by Columbia University, Mailman School of Public Health, it brought together specialists in humanitarian MHM to share experiences from the field, discuss whether evidence and expertise is currently informing response, and share insights on future priorities for best practices.

Addressing gender-based violence in humanitarian settings

Our recent webinar series showcased projects tackling GBV in humanitarian settings. The webinars were an opportunity to give past grantees a platform to reach new audiences and discuss future aims. The webinars heard from Ipas discussing their ARCHES innovation, and the International Rescue Committee on the latest additions to their GBV outcome scales toolkit, which enables humanitarian caseworkers and supervisors to monitor and improve the impact of their work, using data gathered through their work with survivors.

As part of our long-term commitment to shifting the power and promoting a more equitable humanitarian system, we have supported locally led innovation projects around the world.

As a member of the CLIP consortium, we work with partners in Indonesia, the Philippines, Guatemala and South Sudan, to develop community-rooted networks and hubs that support the development of locally-driven solutions to humanitarian problems, identified by those most affected by crises.

The consortium is made up of organisations who share the same vision of supporting community-led innovation. These organisations are: Yakkum Emergency Unit in Indonesia, the Center for Disaster Preparedness in the Philippines, Asociación de Servicios Comunitarios - de Salud in Guatemala, and the CAFOD Trocaire partnership and the Titi Foundation in South Sudan. At the programme coordination level, the CLIP is jointly managed by Elrha, Start Network, and Asia Disaster Reduction and Response Network (ADRRN).

2024 was the first full year of the CLIP’s second phase, marked by a greater focus on scaling and sustainability for first phase innovations, a new cohort of community-led projects, an expansion into South Sudan, and a view towards future rollouts in in other high severity contexts.

Find out more about the national partners below and explore the CLIP’s collection of case studies.

Indonesia / Yakkum Emergency Unit (YEU)

Through their IDEAKSI initiative, YEU has focused on financially supporting a new round of community innovators, while continuing to involve previously supported innovators with non-financial support through workshops, training, and sustainability guidance. Fifteen new community innovations have been supported in Yogyakarta, which focus on managing crises related to climate change, improving disaster preparedness and response plans, and improving the inclusion of people with disabilities in disaster management. Two additional community innovations have been supported in Sulawesi, which focus on food security and disability inclusion.

Philippines / Centre for Disaster Preparedness (CDP)

This year, CDP’s Pinnovation Academy entered its scaling phase and worked with their innovators to deliver support towards sustainability. The design of each scaling support package was defined and finalised by the innovators themselves, tailored to their aspirations about how the innovations should and could continue to grow. Eight previously funded projects received full scaling grants and support. Five innovators who were not selected for full follow-on support were awarded smaller capacity development grants. Five new community innovations were also selected this year, focused on food insecurity, emergency rescue, and disability support in emergencies.

Guatemala / Start Network Hub Guatemala, hosted by Asociación de Servicios Comunitarios de Salud (ASECSA)

ASECSA continued to work with innovators across four regions of Guatemala. Eight new community innovation teams have been supported, with innovations focused on managing the effects of drought and food insecurity, flood early warning, and safe water capture. ASECSA selected the innovation teams through their unique approach of building a relationship with communities first, to collectively identify and prioritise humanitarian problems faced, before forming groups with complementary skills to develop solutions. Previously funded innovator teams were supported towards sustainability and growth of their innovation, through ASECSA’s own contextualised model, which identifies the innovation’s unique potential for growth, then finds and facilitates the specific pathway to achieve social, technical, financial and collaborative sustainability for the project.

South Sudan / Start Network Hub South Sudan, hosted by CAFOD-Trocaire and the Titi Foundation

The South Sudan programme completed the final stages of its programme design, training, and socialisation, and began their first round of selecting community innovation teams, supporting the emergence and development of food security and livelihood innovations – areas identified by community members. Through a series of Innovation Bootcamps, 18 innovation ideas were developed and presented, and a final ten selected to support. Selected innovations focus on addressing food insecurity and malnutrition, lack of clean water, and locally produced reusable sanitary pads.

Innovation Snapshot

Binnadang Emergency Nutri-Bar

Tanglag Women’s Organization, Community Health Education, Services and Training in the Cordillera

Embedded in everyday lives of the indigenous peoples in the Philippines’ Cordillera Region is the culture of binnadang (translation: ‘mutual help’) – the practice of cooperation by helping people in need through community support. In the face of ongoing poverty and vulnerability, the Tanglag Women’s Organization, a group of indigenous women from the region’s Tanglag Tribe, migrated south to Baguio City in search of better opportunities. Supported through CDP’s Pinnovation Academy, these women have developed an emergency food source made from locally-sourced ingredients, the Binnadang Nutri-Bar.

The Binnadang Nutri-Bar is a nutritious, ready-to-eat product that has become part of the Tanglag village community disaster preparedness and response plans. In comparison to imported alternatives, Nutri-Bar is made with high-quality locally-available ingredients.

The Tanglag Women Organization has continued its journey through this year of the CLIP, where the Nutri-Bar has undergone further prototyping, product development and shelf-life testing. The innovation team has continued its collaboration and partnership with national stakeholders from the government, academia and private sector, and is currently working towards formal accreditation to be used in emergency response plans and evacuation centres.

Since 2020, Elrha has hosted the UK Humanitarian Innovation Hub (UKHIH), an FCDOfunded initiative which aims to undertake responsive research and problem-led systems innovation in the humanitarian sector.

In 2024 the UKHIH conducted its work through three main modalities: Systems Innovation Partnerships (formerly Accelerated Innovation Collaborations), the Humanitarian Rapid Research Initiative, and ecosystem research.

The UKHIH’s Systems Innovation Partnerships (SIPs) are strategic, multi-year collaborations designed to tackle complex systemic challenges and catalyse action. The SIPs are constructed around collaboration, evidence gathering, assessing concepts, and builds in adoption/scale partners.

In 2024 the UKHIH launched a new partnership on mortality estimation (see Snapshot on - p29 ), advanced existing SIPs on satellite technology for humanitarian decision making and collective crisis intelligence for frontline responders, and supported partnerships for strengthening humanitarian surgical capacity and community engagement around vaccine delivery in humanitarian contexts. These partnerships moved from ideation to systems-level innovation development, producing reports and hosting 14 sector events. Three further projects and support activities were progressed the SIP workstream:

Emerging technology research

The UKHIH has been supporting The Foresight Initiative to understand how emerging technologies can be systematically adopted and deployed by humanitarian actors. Developed by a consortium of RAND Europe, Athena Infonomics and glass.ai, the aim of the initiative is to understand and define trends in the adoption and use of emerging technologies within the humanitarian sector, identify key emerging technologies that could strengthen practice, and envisage a research and innovation journey for the identified technologies.

The consortium developed three reports covering current practices for using emerging technology, exploring how they might be used in the future, and foresight methods and tools for responsible adoptions. Two case studies – on biometric assistance and techenabled cash and voucher assistance – were also completed, helping inform responsible technology adoption.

The second phase of this work is now underway, and will see the generation of a participatory methodology for involving community preferences in the development and deployment of emerging technology in humanitarian response.

Humanitarian AI

A joint initiative with HIF (see p18 ), this SIP aims to aid humanitarians to navigate the navigate the complex and rapidly evolving AI landscape, understand what humanitarian use cases are being developed or underway, map the available evidence and engage with humanitarian actors to build consensus on emerging challenges.

The UKHIH’s literature review and stakeholder consultations have already garnered significant interest, with preliminary findings influencing agendas at key events like a highlevel discussion on humanitarian AI at Wilton Park.

Strengthening capacity

Including researchers based in low- and middle-income countries is central to the work of the UKHIH – in addition to building and supporting local capacity, these researchers provide invaluable insights and connections with local people. This includes institutional capacitybuilding efforts that allow partners to map their needs and suggest suitable learning formats, ensuring the best support for LMIC-based researchers and innovators even in instances where the fellowship approach isn’t the best route.

This year, as part of their vaccines SIP, they have not appointed a fellow, but instead provided funding for training, mentorship and learning exchanges to support 20 staff specifically to strengthen qualitative and ethnographic research capacities.

SIP Snapshot

Crisis in Gaza : Scenario-based health impact projections

London School of Hygiene and Tropical Medicine & Johns Hopkins Centre for Humanitarian Health

Critical to assessing needs objectively, and key for evaluating humanitarian responses, in practice, mortality estimation is rarely accurate or comprehensive in these settings. And while attempts have been made to develop a more robust approach, only a small number of research groups exist with the right expertise and capacity, mostly based in high-income academic institutions.

The UKHIH launched the mortality estimation SIP as an opportunity to develop a systematic strengthening of mortality evidence generation and uptake in humanitarian settings. The initial research was carried out by a consortium of London School of Hygiene and Tropical Medicine (LSHTM), SIMAD University in Mogadishu, and Evidence for Change (e4c) in Nairobi.

With the broader SIP established, the UKHIH team were able to rapidly support scenariobased health projections to estimate excess deaths in the Israel-Gaza conflict, led by the LSHTM and Johns Hopkins Centre for Humanitarian Health.

The research group have since published four reports covering models for projecting excess deaths and traumatic injury deaths across different scenarios, and examinations of food availability and its impacts on nutritional outcomes. The work has been cited almost 950 times in the media and referenced in the UK parliament, the US Senate, The International Court of Justice and among leading humanitarian agencies, contributing to ceasefire advocacy and shaping humanitarian aid decisions. The UKHIH are now supporting LSHTM and a Sudanese research team to replicate the nutrition model in Sudan.

Humanitarian Rapid Research Initiative

The Humanitarian Rapid Research Initiative (HRRI) conducts rapid, real-time research during new or emerging humanitarian crises. The aim is to provide practical insights for immediate response efforts and identify opportunities for systematic change, contributing to a more resilient and future-ready humanitarian system.

In 2024, the UKHIH, through their partnership with Humanitarian Outcomes, developed an ethical decision-making tool (see Snapshot below), and investigated global humanitarian – surge capacity the ability to quickly mobilise and deploy additional financial, human, and material resources to meet needs where existing response capacities are insufficient.

To ensure the learnings produced through the HRRI were accessible to frontline humanitarian responders, the UKHIH conducted an exploratory study, in collaboration with ALNAP, to understand and facilitate real-time learning in emerging crises. Off the back of the findings, the UKHIH are supporting Centre for Humanitarian Change to undertake a set of workshops in Somalia focused on adaptive learning and drawing out the tacit or implicit knowledge of frontline humanitarian actors.

Responsive Fund

In December, the UKHIH launched a new funding opportunity – the Responsive Fund – designed to address emerging humanitarian crises with agility and impact. The fund aims to:

Four projects were selected for funding, responding to evolving contexts in Lebanon, Sudan, and other crisis-affected locations. These focused on children’s education, mutual aid group modalities, the scale-up of NGO coordination, and establishing diaspora research networks.

Operational disparities between innovators or academics and the humanitarian sector have traditionally created barriers to collaboration. The UKHIH’s ecosystem research is designed to break down these barriers, providing in-roads for greater and more effective collaborations between the two groups.

Leveraging UK expertise in science and technology

The UKHIH worked with Science Practice to map humanitarian research and innovation capacity and identify barriers to collaboration between UK academics and humanitarian actors – including consultations, networking events, and an online forum.

starting point for making sense of the field and available specialisms and highlights the range and diversity of existing expertise that can be called upon to address humanitarian needs.

Tool Snapshot

A humanitarian's guide to ethical principled decision making

Humanitarian Outcomes

Ethical dilemmas are all too common in humanitarian action: from immediate operational choices to bigger strategic questions. A 2023 report, Navigating Ethical Dilemmas for Humanitarian Action in Afghanistan, made it clear there is no existing framework for humanitarians addressing ethical dilemmas, and when no choice is obvious or ideal, the principles of humanity, impartiality, neutrality, and independence alone cannot always help us make the decision.

Informed by real-world challenges and developed with the oversight of a team of ethicists, ‘No easy choice’ helps organisations and individuals to make better choices for principled humanitarian action. The guide includes a tool and a process for deliberating ethical conflicts, ensuring decisions align with core values and stakeholder needs.

The tool was piloted with humanitarians working in Myanmar, Afghanistan and Libya, and it’s role is to improve decision-making across crises, with next steps including field testing, wider adoption, and bespoke training sessions to embed its use.

To make it as useable and accessible as possible for frontline responders, it has been published in seven languages and a short video summary and interactive guide produced to aid rapid understanding of the tool and its uses.

Our priorities for the 2025 are guided by our strategy and core principles. As both the scale of humanitarian need and the impacts of climate- and conflict-linked disasters grow, HRI emerges as vital to enhancing the acceptability, effectiveness, and efficiency of response, improving resilience in vulnerable communities, and fostering sustainable, locally-led practices. We will remain committed to being a responsible funder and use our funding, expertise, and convening abilities to identify and support pioneering research and innovation solutions to ongoing and emerging crises.

Next year will see the expansion and evolution of our organisation as we begin to integrate the UK Humanitarian Innovation Hub (UKHIH) into our team. We will support our colleagues throughout the process to make sure the transition is smooth and the end combination of Elrha and the UKHIH is a secure and aligned union. To strengthen our ability to deliver our strategy and long-term commitments, we will further develop our approaches to anti-racism, grant-management, external engagement and organisational structure to ensure a more resilient and effective Elrha.

We will continue to target our funding to address priority challenges, exploring research opportunities and potential partners to help strengthen the mpox response in the Democratic Repoublic of Congo, and an update to our 2020 gap analysis on disability and older age inclusion will assess progress and opportunities to drive further innovation, particularly in the humanitarian response phase. The UKHIH will relaunch its Responsive Fund, to support networked humanitarian actors to actively respond to emergencies through innovative and problem-led projects, convening around shared challenges, and strengthening sector-wide learning.

We will enhance the skills and knowledge of partners and stakeholders through targeted capacity strengthening initiatives, mentoring, and learning exchanges, particularly focusing on LMIC-based partners. We want to enable them to deliver high-quality HRI, build sustainable skills, attract future funding, and become leaders in HRI beyond the duration of the grant. With this objective in mind, we will also provide dissemination grants to help grantees effectively share and spread the findings and insights from their projects beyond the initial funding period, ensuring that valuable project outcomes reach a broader audience and have a lasting impact.

We will create new tools and guidance to support effective and responsible HRI, sharing findings from our latest research priority setting for sexual and reproductive health and rights (SRHR) and collating the module materials and feedback from our AI learning journey grantees on their experience. As our food insecurity and nutrition work enters its next phase, we will support the development of a framework and guidance on effective resources and interventions for addressing undernutrition. Into 2026, we’ll be launching a call for academic-humanitarian partnership teams to test the tool in emergency settings.

We will identify more opportunities to bring together researchers, innovators and humanitarian actors, sharing insights from our cross-programme WASH initiative on the possibilities of climate adaptation in WASH response, as well as joint R&I opportunities in humanitarian WASH. We will bring these groups together through events and conferences, including our Research and Innovation Forums, which will take place in Nairobi, Kenya next year, offering actors from across the sector the chance to explore pressing challenges affecting humanitarian R&I, and the transformative solutions available to address them.

The financial statements have been prepared in accordance with the accounting policies set out in notes to the accounts and comply with the charity’s governing document, the Charities Act 2011 and the second edition of Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102), published in October 2019.

The financial overview for 2024 is set out in the Statement of Financial Activities on p51 .

Income received during 2024 was comparable to the previous year and totalled £12.7m (2023: £12.7m), of which 99.93% was restricted (2023: 99.99%). Restricted income comprised of grants from institutional donors including the UK Foreign, Commonwealth and Development Office (FCDO), the Netherlands Ministry of Foreign Affairs (NL MFA), the Department for Health and Social care (DHSC) and the Norwegian Ministry of Foreign Affairs. Elrha also received income from Wellcome Trust, in the form of a grant.

As all restricted income is recognised on a performance basis, the amount recognised in the financial statements is determined by expenditure on the relevant charitable activities.

Unrestricted gift in kind income of £7k was recognised being transferred from restricted reserves in 2024, (2023: £0), arising from historic gift in kind income previously recorded as donor income during 2021. No unrestricted donations were received during the year (2023: £24).

Total expenditure increased slightly in 2024 to £12.6m (2023: £12.7m). Within the main cost categories of Elrha’s activities, the level of grant disbursements made in 2024 fell by £0.9m to £7.7m (2023: £8.6m) representing 61% of the total spent (2023: 69%). This is due to grants receiving lower disbursements in the later stages of their project timelines. Direct activity costs in 2024 increased from the amount spent in the previous year, totalling £3.0m (2023: £2.5m), representing 24% of the total expenditure (2023: 20%), due to increased activity levels and additional support offered to grantees within the UKHIH and HIF programmes.

Humanitarian Innovation Fund (HIF) expenditure

Expenditure by the HIF programme constituted 43% of Elrha’s total spend in 2024, 4% higher than that incurred in 2023, totalling £5.4m (2023: £5.2m). Whilst a new grant cohort was launched during the year, most current active grantees are moving towards the latter stages of their project timelines, requiring lower value disbursements resulting in the amount expended in grants disbursements during 2024 being 17% lower at £3.0m (2023: £3.6m). Costs associated with directly implemented activity rose by 67% to £1.5m (2023: £0.9m), and programme support costs increased by 29% to £0.9m (2023: £0.7m) consistent with an increase in the work undertaken to offer non-financial support to active grantees and to demonstrate the impact of their work.

Research for Health in Humanitarian Crises (R2HC) expenditure

Total expenditure incurred by the R2HC programme fell by 16% during 2024 to £4.4m (2023: £5.1m), constituting 35% of Elrha’s total spend. Following the launch of a large grant cohort in 2023, grant disbursements in 2024 fell by 22% to £3.1m (2023: £4.0m) due to lower value disbursements being required for second and subsequent tranche payments. Directly implemented activity costs also fell from £0.8m in 2023 to £0.7m in 2024, as the initiatives in child and nutrition health research and food insecurity were completed during the year.

Global Prioritisation Exercise (GPE) and the UK Humanitarian Innovation Hub (UKHIH) expenditure

The GPE programme ended in during 2024 with only final £96k being expended, compared to £626k in 2023. Costs attributed to the final stages of this programme primarily related to the production and dissemination of synthesis and impact reports.

The UKHIH spent a total of £2.7m (2023: £1.5m) during 2024, an increase of 80% from 2023. Grants disbursements rose to £1.6m (2023: £1.0m), and during 2024 the UKHIH increased its level of non-grant making activity by 136% to £0.7m (2023: £0.3m), as explained in more detail on p28–31 .

Operational support costs

Across all programmes, Elrha’s operational support costs, totalled £1.9m (2023: £1.4m), and include spending on items that are related to:

During 2024 the total value spent on operational support has increased by £476k (33%) and constituted 15% of Elrha’s overall spend. The increase reflects the additional support required to meet the increase in direct programme activity and expenditure incurred to support governance, organisational and systems improvements.

Our total reserves as of 31 December 2024 were £721k (2023: £693k), of which £518k relates to restricted funds (2023: £454k), which means Elrha’s restricted reserves increased by £64k in 2024. There were no designated reserves.

Elrha’s reserves policy is to retain sufficient funds to safeguard operational continuity in the event of temporary income disruption, or to enable an orderly wind-down if continuation is

not possible. In line with the Delegation of Authority, any use of reserves must be approved by the Chair of the Board of Trustees or the Board Treasurer

While Elrha is currently awaiting the outcome of the UK Government’s funding review, introducing some longer-term funding uncertainty, the Trustees remain confident in the organisation’s short- to medium-term financial position. They believe that future incoming resources will be sufficient to support the continuation of existing projects and activities, and to respond to other needs under reasonable downside scenarios. The Trustees are therefore satisfied that Elrha has adequate resources to continue operating for at least 12 months from the date of approval of this report.

Accordingly, Elrha continues to adopt the ‘going concern’ basis in preparing the financial statements.

The Trustees are actively taking steps to seek and secure additional funding, from both current and new sources of income, with a view to protect Elrha’s sustainability in the longer-term future

Investments

Elrha held no investments during the period.

Elrha employs a structured approach to risk management, ensuring the identification, analysis, and mitigation of potential risks that could affect the achievement of its objectives, including financial reporting.

Every year, Elrha develops an organisational risk register which integrates financial risks, ensuring that all relevant risks are identified and assessed. The register clearly outlines:

Risk Analysis and Management

Elrha uses a systematic approach to analyse and manage risks by scoring both the likelihood of a risk occurring and the potential impact it could have on the organisation. Risks are categorised based on their scope, from transactional risks at the grant or team level, to managerial risks that affect programme objectives or functions, and organisational risks that could impact the entire organisation.

Elrha applies a risk matrix to define tolerance levels for each risk, helping to determine the appropriate management actions. This process helps the organization prioritize its efforts, ensuring resources are allocated to the most significant risks.

Ongoing Risk Monitoring

Elrha also maintains programme-level risk registers for initiatives like R2HC and HIF , which are reviewed quarterly and updated as needed. These risk registers are submitted to donors as part of annual reporting, ensuring external accountability. High-level risks are reviewed monthly by the Directors Group and, since 2024, presented to the Board's Risk & Audit Committee for oversight. Additionally, Elrha works closely with grantees and partners during the early stages of project selection, ensuring the objectives are clear and that risks are thoroughly identified. Grantees are required to submit a risk matrix as part of their proposal.

In summary, Elrha’s risk management process is dynamic and comprehensive. By integrating detailed risk registers, regular assessments, and robust mitigation strategies, the organisation ensures that risks are effectively managed, protecting its objectives and financial integrity while supporting its work and mission.

Elrha is registered at 1 St. John’s Lane, London EC1M 4AR under the laws of England and Wales as both a private limited company by guarantee (11142219) and a charity (1177110). A second office is located at 8 Cathedral Road, Cardiff, CF11 9LJ.

The charity was incorporated on 10 January 2018, although its activities had commenced in 2009, hosted by Save the Children Fund. At time of incorporation, the related assets were transferred to the separate legal entity on 1 May 2018 for nil consideration. The sole member of Elrha is the Save the Children Fund, of which Elrha therefore acts as a wholly owned subsidiary.

Under Elrha’s Articles of Association, dated at incorporation, certain decisions are reserved for the member. These include, but are not limited to:

The following individuals were members of the Board of Trustees (and Directors of Elrha for company law purposes), at the date on which the financial statements were approved and during the year:

End of Trustee Tenures & Resignations during 2024

Day-to-day management of the charity is delegated by the trustees to Elrha’s Directors Group. As at the date of approval of this report and during the year, the members of the Directors Group were:

Auditor: KPMG LLP, 15 Canada Square, London E14 5GL

Bankers: National Westminster Bank, PO Box 83, Tavistock House, Tavistock Square, London WC1H 9NA

Elrha’s governance structure is formed by three categories of governing bodies:

(a) Elrha Board of Trustees: its main purpose is providing strategic direction to the organisation, holding overall responsibility for how Elrha implements its strategy, safeguarding, the responsible use of its resources, and ensuring governance standards are upheld.

(b) Programme-based advisory groups and committees: depending on the scope of work defined in their terms of references, this category of governance bodies would (i) advise the Board of Trustees on the strategic direction of their programmes; and/or (ii) provide technical advice to the programme teams and make recommendations regarding programmatic priorities; and/or (iii) provide independent assessment and recommendations on funding decisions.

(c) Directors Group: is responsible for day-to-day management of Elrha’s business, as delegated by the Board.

The UK Humanitarian Innovation Hub (UKHIH) : is a hosted initiative within Elrha. Ultimate accountability for the UKHIH sits with the Elrha Board of Trustees, who delegates day to day responsibility for oversight and direction to the UKHIH Steering Committee, Advisory Group and UKHIH Director. The UKHIH Steering Committee is comprised of Elrha and FCDO representatives and the Chair of the Advisory Group.

UKHIH’s Governance paper clearly captures roles and responsibilities of the different stakeholders (SC, UKHIH Director, Advisory Group, Elrha Board of Trustees and staff) and their different scope and level of authority in regard to UKHIH’s activities and operations.

The UKHIH is, however, legally part of Elrha and, as set in the Memorandum of Understanding (MoU) describing the hosting arrangement, UKHIH follows Elrha’s operating policies and procedures, unless otherwise agreed.

As part of Elrha, UKHIIH is under the mandate of Elrha Board of Trustees, who has the final authority to ratify UKHIH governance structure and annual budgets (approved as part of Elrha overall annual budget), and in overseeing risks and potential liabilities of UKHIH activities that could significantly impact Elrha. Progress on UKHIH activities and budget execution is regularly reported to the Board of Trustees. At the Board meeting in September 2024, the Board of Trustees approved a recommendation for the Hub be integrated into Elrha by March 2026 to achieve the greatest collective impact.

‑ Trustees, all of whom are non executive, have been drawn from diverse backgrounds in business and professional life, and bring a broad range of experience and skills to Board deliberations. They are appointed in accordance with the provisions of Elrha’s Articles of Association and are recruited through open and competitive processes (except for one trustee appointed by Save the Children), against relevant skills and experience identified by the existing trustees as needed for the Board to perform their duties.

All trustees receive a full induction, including meeting with members of the Directors Group, designed to help them understand their statutory responsibilities, their role as Board members, the governance framework within Elrha, Elrha’s work, and the risk environment. Ongoing training is arranged as and when a need is identified.

There are clear distinctions between the role of the Board and the Directors Group, to which day-to-day management is delegated. The principles of ‘management proposes’ / ‘Board decides’; ‘management implements’ / ‘Board monitors’ form the basis of the Board and executive management team interaction. Items such as Elrha’s policies, strategic and annual plan, budget and risk assessments are prepared by the Directors Group for consideration and approval by the trustees. Members of the Board cannot, under the governance regulations of the charity, receive remuneration for services to Elrha and may only be reimbursed for incidental expenses claimed.

The Board carries out an informal annual self-assessment, wherein the Chair of the Board meets with each individual trustee and writes up a report identifying areas of strength and areas for improvement in the functioning of the Board.

As per the Board’s Terms of Reference, the Board met four times in 2024 and held an extraordinary meeting in July to address the transitioning to and plan for the recruitment of a new CEO for Elrha following Jessica Camburn’s announcement to leave Elrha at the end of September 2024.

Board attendance was as follows:

Board attendance was as follows:
Name Meetings
Dr. Jane Cocking 5/5
Andrew Toby Smith (Deputy Chair) 5/5
Andrew Shellard 1/1 – as observer & tenure ended Feb 2024
Andy Katz 1/1 – tenure ended April 2024
Ebrima Saidy 4/5
Freddy Bob-Jones 2/2 – tenure started Sept 2024
Genevieve Kiff 3/5
Karen Twining Fooks 5/5
Margie Buchanan-Smith 4/5

Name Meetings Dr. Marta Tufet Bayona 1/5 Mathieu Cantegreil 2/2 – tenure started Sept 2024 Rhea Tariq 3/5 Sorcha O’Callaghan 3/5

Risk & Audit Committee

In March 2022, the Board agreed to set up the Risk & Audit Committee (RAC) as a permanent committee to strengthen and provide advice to the Board on its oversight of risk and audit review. The committee comprises:

The RAC met four times in 2024, with an additional close out meeting with the auditors in June. The responsibilities of the RAC are to scrutinise the quarterly financial reporting and review the annual risk report. Additionally, the RAC, after review and consideration, recommends to the Board whether to approve the Annual Report and Accounts and the proposed Annual Budget for the following year.

Business Development Committee

The Business Development Committee (BDC) was created in June 2023, to provide advice to the Board on fundraising in support of the implementation of Elrha’s new Strategy and the ongoing effective and sustainable resourcing of the organisation. The BDC does not hold any delegated authority from the Board, but provides advice and assurance to the Board and Elrha’s management in three key areas:

Each governing body described below has a clear term of reference that sets out their roles and responsibilities. It also sets out the process to avoid and manage potential conflict of interests, ensuring that the bodies uphold the highest standards of transparency and accountability.

Programme Advisory Groups

The HIF and R2HC Advisory Groups advise Elrha on the strategic direction of our grantmaking programmes. These groups provide advice to the programme teams and make recommendations regarding programmatic priorities, set the direction and framework for grant-making, and are involved in the selection of Funding Committee members. The Chairs of the Advisory Groups report to the Elrha Board on an annual basis.

Programme Funding Committees

The function of our two Funding Committees, one for HIF and one for R2HC, is to provide independent assessment and recommendation of funding decisions. The Chairs of the Funding Committees report to their respective Advisory Group.

Technical Working Groups

The Technical Working Groups provide a greater depth of technical expertise for the focus areas on our HIF programme. The Chairs of the Technical Working Groups report to the HIF Advisory Group.

Our HIF Technical Working Groups for 2024 were in WASH, GBV, and DOAI.

Our Funders

Our programme funders retain the ability to veto the funding of a particular proposal before a final decision is made to grant restricted funds to a third party. However, programme funders cannot require that a third party receive a grant, and any final decision on whether a grant should be made remains with Elrha.

In addition, Elrha’s funders may have observer status on the advisory groups and/or funding committees. This may be an ad-hoc or a regular arrangement and is agreed on a case-bycase basis.

Statement of trustees' responsibilities in respect of the trustees’ Annual Report and the financial statements

The trustees are responsible for preparing the trustees’ Annual Report and the financial statements in accordance with applicable law and regulations.

Company law requires the trustees to prepare financial statements for each financial year. Under that law they are required to prepare the financial statements in accordance with UK Accounting Standards and applicable law (UK Generally Accepted Accounting Practice), including FRS 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland.

Under company law the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charitable company and of the income and expenditure for that period. In preparing these financial statements, the trustees are required to:

The trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charitable company’s transactions and disclose, with reasonable accuracy, at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are responsible for such internal control as they determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error, and have general responsibility for taking such steps as are reasonably open to them to safeguard the assets of the charitable company and to prevent and detect fraud and other irregularities.

The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company’s website. Legislation in the UK governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

KPMG LLP have expressed their willingness to continue to act as auditors. A resolution to reappoint them, under section 485 of the Companies Act 2006, was approved at the meeting in June 2024.

In the case of each of the persons who are directors at the time when the directors’ report is approved, the following applies: so far as the directors are aware, there is no relevant audit information of which the company’s auditor is unaware; and the directors have taken all steps that they ought to have taken as directors in order to make themselves aware of any relevant audit information and to establish that the company’s auditor is aware of that information. This confirmation is given and should be interpreted in accordance with the provisions of s418 of the Companies Act 2006.

Trustees have a duty to develop strategic plans to ensure that Elrha provide public benefit and achieve the charitable objectives as set out in our governing document. These objectives include the relief from hardship in cases of war, natural disaster, or catastrophe anywhere in the world; the promotion of education and training, and of research for the public benefit concerning these matters; and making publicly available the results of such research. These objectives fall under the purposes defined by the Charities Act 2011. We have referred to the Charity Commission’s general guidance on public benefit when reviewing our aims and objectives and in planning our future activities. In particular, the trustees consider how planned activities will contribute to the aims and objectives they have set.

No political donations were made during the period.

Elrha’s fundraising activities are currently limited to institutional donors and trusts. Elrha does not engage in fundraising from members of the public.

Elrha and UKHIH are working to maximise the impact of funded projects in alignment with strategic goals. Elrha provides funding through its programmes to various legal entities, and the eligibility criteria for these grants may vary depending on the specifics of the funding call. Each funding opportunity may have distinct requirements based on the challenge or focus area.

Proposals submitted go through the following process:

The Funding Committee has the authority to make funding recommendations up to the amounts agreed in the budget. For the R2HC programme, these recommendations are then approved by the donor(s).

After the Funding Committee evaluates the quality of a proposed project, the applicant organisation undergoes Elrha’s due diligence process, which is a critical component of our risk management framework and part of our Mandatory Operating Procedures. As part of our due diligence process, implementing organisations and key project staff are vetted against sanctions, anti-terrorism, and other international risk monitoring lists. The policies of the lead organisation are checked to ensure they align with our safeguarding and financial control principles. Elrha evaluates the risk associated with granting to the lead organisation, and the grant is only confirmed once we are satisfied that risks are within acceptable limits or that sufficient mitigations are in place.

Maintaining the safety and protection of those we work with, and our staff, is highly important across Elrha. This includes staff, governance groups, grantees, and the people our grantees work with. We have a zero-tolerance approach towards all forms of unethical behaviour, including bribery, facilitation payments, tax evasion and money laundering.

Criminal record checks are completed for all staff and trustees, and more enhanced checks are performed following a risk-based approach. As part of our due diligence process for grantees, we review their safeguarding policies to make sure they are in line with our policies.

We have an Incident Prevention and Management Policy – with a wide definition of vulnerable groups – and clear organisational values. These policies set out the standards of behaviour expected from all staff, trustees, grantees, and all others that we work with, particularly in relation to safeguarding. R2HC research studies are subject to review by an Institutional Review Board (IRB) to ensure they achieve recognised ethical approval before research is funded.

We have an incident reporting mechanism and are committed to investigating any potential breaches of our policies, whether within Elrha or the projects and studies we fund. All complaints are investigated, following established investigation guidelines, and should internal breaches be substantiated, disciplinary action would be taken, up to and including dismissal. With our grantees, substantiated breaches may result in us withdrawing funding and any other support.

We are committed to openness, and to keeping our donors informed of any complaints and the progress of any investigations. We are also committed to inform and work with our regulators and any relevant law enforcement agency where the complaint warrants this.

While we believe that our systems are effective, we are committed to their ongoing review and development. We will continue to identify and implement measures that will enhance policy and practice to ensure our standards meet or exceed best practice in the sector.

Our 2024 staff engagement survey revealed that our staff are highly motivated to support organisational goals and are inspired by our vision and purpose. Our staff expressed high levels of satisfaction with their relationships with line managers and immediate teams, feeling supported and valued in their roles.

Our staff are actively engaged through various activities including monthly all staff meetings, bi-annual away days, and monthly lunch and learn sessions which supports cohesion whilst working remotely. Staff are also encouraged to work on organisational initiatives such as Anti-Racist Working Group and the Staff Representative Group to support cross-team collaboration.

We remain committed to monitoring and enhancing staff wellbeing. Based on feedback from the 2023 Staff Engagement Survey, and as outlined in our annual plan, we launched our first Workplace Stress Audit in 2024.

The Workplace Stress Audit revealed that staff feel confident in understanding their roles and objectives and believe there are sufficient opportunities to discuss changes with managers. However, it also highlighted areas for improvement around managing high workloads, which are being addressed as part of a broader organisational plan.

Elrha’s approach to wellbeing is reflected in our commitment to enabling staff to achieve a healthy balance between working from home and the office. Our new Workplace Flexibility Policy empowers employees to make decisions about where and when they work to suit their needs. We have expanded our resources to support mental health, resilience, and connection among colleagues; staff can access wellbeing support through our established Employee Assistance Programme (EAP) and easily find wellbeing resources through improved signposting on the Elrha intranet.

Staff Representation Group

Our Staff Representation Group was established in October 2023 to strengthen staff engagement with leadership and in organisational decisions. In its pilot year, the group engaged staff on key topics raised in the 2023 Staff Survey, including role motivation and internal communications, and put together a staff panel for the new CEO recruitment. In October 2024, staff voted in favour of extending the pilot for a further six months, during which time new facilitators will be recruited to take the group into its next phase.

Elrha is an equal opportunities employer, as demonstrated by our HR policies and practices, which are rooted in the Equity, Diversity & Inclusion (EDI) principles approved by our Board in 2021, along with the provisions of the Equality Act 2010.

We believe that inclusion is closely tied to staff engagement and wellbeing. Our culture is built on kindness and fairness, and we are dedicated to championing employee wellbeing, recognition, and appreciation. We ensure that our supportive and flexible working environment keeps staff connected, motivated and well-informed.

We are committed to fostering an inclusive and supportive working environment, free from discrimination, harassment, and victimisation. We actively promote equal opportunities and respect for diversity, and these values are clearly reflected in our EDI principles, policies and procedures.

In recruitment, our goal is to increase the diversity of our staff to better represent the communities we support. To achieve this, we actively use a variety of recruitment platforms to reach a broad pool of candidates and encourage applications from diverse background, reinforcing this message clearly on our job advertisements. We recruit and promote based on merit and continue to explore internal opportunities for staff development and succession planning.

We want our staff to feel valued and appropriately rewarded and recognised for the work they do, and put ourselves in the best position to attract, retain and inspire exceptional individuals to help us achieve our purpose. We aim to reward our staff fairly and consistently in relation to their level of work and to ensure our pay processes are simple and easy to understand.

Our Salary and Progression Structure ensures that staff are paid competitively according to the role that they do. Our salary bands are benchmarked externally against those of similar sized charities. We are fully transparent about pay when we advertise for any role, sharing the starting salary in all instances. We are proud to continue to support the charity sector’s call for salary transparency.

We also aim to offer an attractive benefits package including pension, life cover, organisational sick pay and family friendly pay and leave schemes; incremental increase in annual leave depending on length of service; opportunities for learning and development; a comprehensive EAP and a strong ethos of flexible working.

Salary progression is awarded according to our Annual Salary Increase Principles, which allow for pay progression for staff who remain in the same role over time, rewarding their increasing proficiency and expertise in that role. In addition, our reward approach seeks to mitigate any impact of cost-of-living increases when and if relevant. The new approach, introduced in 2023, has provided Elrha with a clear framework to set salary levels for new positions.

Like many organisations in our sector, we have experienced a period of higher-than-usual staff turnover, reflecting broader trends across the job market. This has impacted the

organisation with knowledge loss, prompting us to implement simpler, more effective ways for teams to share knowledge and reduce the risk of gaps.

The increased turnover has resulted in greater recruitment activity and associated costs as we replace departing staff. In addition, we have created new roles to meet the evolving needs to the organisation. We are pleased to have attracted and onboarded exceptional candidates through our recruitment efforts. Our comprehensive induction programme ensures new team members feel welcomed and well-prepared, and we regularly review this process to provide the best possible start to their journey with Elrha. We remain committed to listening to our staff and identifying ways to improve retention rates.

The Trustee’s Report ( pp6–46 ) was approved by the Board of Trustees on 30 October 2025 and signed on its behalf by:

Dr Jane Cocking Genny Kiff Chair of the Board of Trustees Treasurer

We have audited the financial statements of Elrha for the year ended 31 December 2024 which comprise the Statement of Financial Activities, Balance Sheet, and the Cash Flow Statement and related notes, including the accounting policies in note 1.

In our opinion the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (“ISAs (UK)”) and applicable law. Our responsibilities are described below. We have fulfilled our ethical responsibilities under, and are independent of the Charitable Company in accordance with, UK ethical requirements including the FRC Ethical Standard. We believe that the audit evidence we have obtained is a sufficient and appropriate basis for our opinion.

Going concern

The Trustees have prepared the financial statements on the going concern basis as they do not intend to liquidate the Charitable Company or to cease its operations, and as they have concluded that the Charitable Company’s financial position means that this is realistic. They have also concluded that there are no material uncertainties that could have cast significant doubt over its ability to continue as a going concern for at least a year from the date of approval of the financial statements (“the going concern period”).

In our evaluation of the Trustees’ conclusions, we considered the inherent risks to the Charitable Company’s business model and analysed how those risks might affect the Charitable Company’s financial resources or ability to continue operations over the going concern period.

Our conclusions based on this work:

However, as we cannot predict all future events or conditions and as subsequent events may result in outcomes that are inconsistent with judgements that were reasonable at the

time they were made, the above conclusions are not a guarantee that the Charitable Company will continue in operation.

To identify risks of material misstatement due to fraud (“fraud risks”) we assessed events or conditions that could indicate an incentive or pressure to commit fraud or provide an opportunity to commit fraud. Our risk assessment procedures included:

We communicated identified fraud risks throughout the audit team and remained alert to any indications of fraud throughout the audit.

As required by auditing standards, we perform procedures to address the risk of management override of controls.

We have not identified a fraud risk related to revenue recognition. The majority of revenue relates to grant income, which is agreed in advance, and has simple recognition criteria relating to expenditure incurred.

We did not identify any additional fraud risks.

We also performed procedures including:

Identifying and responding to risks of material misstatement due to noncompliance with laws and regulations

We identified areas of laws and regulations that could reasonably be expected to have a material effect on the financial statements from our general commercial and sector experience, and through discussion with management as required by auditing standards. Additionally, we discussed with management the relevant policies and procedures regarding compliance with laws and regulations.

We communicated identified laws and regulations throughout our team and remained alert to any indications of non-compliance throughout the audit.

The potential effect of these laws and regulations on the financial statements varies considerably.

The Charitable Company is subject to laws and regulations that directly affect the financial statements including financial reporting legislation (including related companies’ and charities’ legislation) and taxation legislation and we assessed the extent of compliance with these laws and regulations as part of our procedures on the related financial statement items.

Whilst the Charitable Company is subject to many other laws and regulations, we did not identify any others where the consequences of non-compliance alone could have a material effect on amounts or disclosures in the financial statements.

Identifying and responding to risks of material misstatement due to noncompliance with laws and regulations

Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. For example, the further removed non-compliance with laws and regulations is from the events and transactions reflected in the financial statements, the less likely the inherently limited procedures required by auditing standards would identify it.

In addition, as with any audit, there remained a higher risk of non-detection of fraud, as these may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls. Our audit procedures are designed to detect material misstatement. We are not responsible for preventing non-compliance or fraud and cannot be expected to detect non-compliance with all laws and regulations.

The Trustees are responsible for the other information, which comprises the Trustees' Annual Report. Our opinion on the financial statements does not cover the other information and, accordingly, we do not express an audit opinion or, except as explicitly stated below, any form of assurance conclusion thereon.

Our responsibility is to read the other information and, in doing so, consider whether, based on our financial statements audit work, the information therein is materially misstated or inconsistent with the financial statements or our audit knowledge. Based solely on that work:

Under the Companies Act 2006 we are required to report to you if, in our opinion:

We have nothing to report in these respects.

As explained more fully in their statement set out on pages 41-42 the Trustees (who are also the Directors of the Charitable Company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view; such internal control as they determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error; assessing the Charitable Company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern; and using the going concern basis of accounting unless they either intend to liquidate the Charitable Company or to cease operations, or have no realistic alternative but to do so.

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue our opinion in an auditor’s report. Reasonable assurance is a high level of assurance, but does not guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of the financial statements.

A fuller description of our responsibilities is provided on the FRC’s website at www.frc.org.uk/auditorsresponsibilities.

This report is made solely to the Charitable Company ’ s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the Charitable Company ’ s members those matters we are required to state to them in an auditor ’ s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the Charitable Company and its members, as a body, for our audit work, for this report, or for the opinions we have formed.

Joanne Lees (Senior Statutory Auditor)

for and on behalf of KPMG LLP, Statutory Auditor

Chartered Accountants

15 Canada Square, London, E14 5GL

31 October 2025

For the year ended 31 December 2024

For the year ended 31 December 2024
Notes
Donations
3
Charitable Activities
4
Total Income
Charitable Activities
5
Total Expenditure
Net Income and net movement in funds
Reconciliation of Funds:
Total Funds Brought Forward
Movement in Funds		 Unrestricted
funds
Restricted
funds
Total funds for the
year to
31/12/2024
Total funds for
the
year to
31/12/2023
£
£
£
£
7,200
(7,200)
-
24
1,683
12,669,746
12,671,429
12,717,716
8,883
12,662,546
12,671,429
12,717,740
(45,583)
(12,598,534)
(12,644,117)
(12,495,974)
(45,583)
(12,598,534)
(12,644,117)
(12,495,974)
(36,699)
64,012
27,313
221,766
239,543
453,704
693,247
471,481
(36,699)
64,012
27,313
221,766
Total Funds Carried Forward
 202,844
517,716
720,560
**693,247 **

The statement of financial activities includes all gains and losses recognised in the period

As at 31 December 2024

Notes
Current Assets
Debtors: amounts falling due within one year
11
Cash at bank and in hand
16
Liabilities:
Creditors: amounts falling due within one year
12		 31/12/2024 31/12/2023
£
£
2,558,768
2,327,607
303,530
55,743
2,862,298
2,383,350
(2,141,738)
(1,690,103)
(2,141,738)
(1,690,103)
Net assets
 720,560
693,247
The funds of the charity:
Restricted income funds
15,16
Unrestricted funds
16		 517,716
453,704
202,844
239,543
Total Funds
 720,560
**693,247 **

The notes on pp51–67 form part of the financial statements.

Approved by the Board on 30 October 2025 and signed on its behalf by:

Dr Jane Cocking Chair of the Board of Trustees

Genny Kiff Treasurer

For the year ended 31 December 2024
Notes
Year to
31/12/2024
Year to
31/12/2023
£
£

Cash flows from operating activities

Net cash provided by operating activities
a)
247,787
(46,168)
Change in cash and cash equivalents in
the reporting period

247,787
(46,168)
Cash and cash equivalents at the beginning
of the reporting period
55,743
101,911
Cash and cash equivalents at the end of
the reporting period
b)
303,530
55,743

NOTES TO THE CASH FLOW STATEMENT

(a) Reconciliation of net income to net
cash flow from operating activities
Year to
31/12/2024
Year to
31/12/2023
£
£
Net income
27,313
221,766
Adjustments for:

Decrease/(increase) in debtors
(231,161)
(918,389)
Increase in creditors
451,635
650,456

Net cash provided by operating
activities

247,787
(46,168)

(b) Analysis of cash and cash
equivalents
Year to
31/12/2024
Year to
31/12/2023
£
£

Cash at bank and in hand
303,530
55,743

Total cash and cash equivalents

303,530
55,743

General Information and Basis of Accounting

Elrha is a charitable company incorporated in England and Wales and domiciled in the United Kingdom under the Companies Act 2006. The address of the registered office is: 1 St. John's Lane

London

EC1M 4AR

Elrha is a public benefit entity. The nature of Elrha's operations and its principal activities are set out in the trustees' report (including the strategic report) on pp7–32 .

Save the Children UK (company number 00178159; charity numbers 213890 (England and Wales) and SC039570 (Scotland)) is the sole member of Elrha. Save the Children UK's principal purpose is to save children's lives and tackle global child poverty. Elrha's results will be consolidated with those of Save the Children UK and the consolidated accounts can be obtained by the public at the registered office address given above.

Basis of Preparation

The accounts have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

The functional currency of Elrha is pounds sterling because that is the currency of the primary economic environment in which Elrha operates.

As of 31 December 2024, Elrha’s total reserves stood at £721k (2023: £693k), of which £518k relates to restricted funds (2023: £454k). There were no designated reserves.

Elrha’s reserves policy is to retain sufficient funds to safeguard operational continuity in the event of temporary income disruption, or to enable an orderly wind-down if continuation is not possible. In line with the Delegation of Authority, any use of reserves must be approved by the Chair of the Board of Trustees or the Board Treasurer.

Going concern

The UK government department, FCDO (Foreign, Commonwealth and Development Office), is currently Elrha’s principal donor. Elrha has confirmed funding through to September 2026 from the FCDO, which is in line with our forecasts, and we expect confirmation of our longterm funding position by January 2026. While this introduces a degree of uncertainty, particularly regarding future UK government support, Elrha is actively seeking to diversify its

funding base to strengthen financial resilience. The Trustees have also considered Elrha’s ability to access the Credit Facility Agreement with SCUK, which could be used, if required, to provide financial flexibility during this period of uncertainty. As at 31 December 2024, £2.5 million of the £2.5 million facility remained undrawn. The facility is uncommitted, repayable on demand, and bears no interest. The going concern assessment covers a period of at least 12 months from the date of approval of the financial statements, extending beyond the current FCDO funding horizon.

Elrha has recently expanded and developed a healthy pipeline of new opportunities from multiple sources, including new partnerships and diversified income streams beyond FCDO. This proactive approach, combined with strategic planning and strong financial oversight, positions Elrha to manage future challenges effectively and continue delivering impact across our programmes.

The Trustees remain actively engaged in securing additional funding from both existing and new sources to support Elrha’s sustainability beyond the current funding horizon. The Trustees acknowledge that reliance on FCDO funding and the discretionary nature of the credit facility introduces inherent uncertainties.

To strengthen resilience under future funding scenarios, Elrha is planning a strategic restructure from April 2026. This will involve streamlining staffing roles to ensure they are aligned with effective and efficient delivery, and can accommodate reduced funding levels if required.

The Trustees have prepared cash flow forecasts for a period of 12 months from the date of approval of these financial statements. These have been prepared using prudent assumptions, based solely on secured and committed income, and incorporate the potential impact of severe but plausible downside scenarios. Having reviewed these, the Trustees are confident that Elrha has sufficient resources to continue operating and delivering its planned activities for at least 12 months following the approval of this report.

Accordingly, Elrha continues to adopt the ‘going concern’ basis in preparing the financial statements.

Fund accounting

Unrestricted funds are those which are available for the general purposes of Elrha at the discretion of the trustees. The trustees may elect to dedicate some funds for specific purposes. No funds have been dedicated in this way during the period.

Restricted funds are funds that are to be used in accordance with specific restrictions imposed by donors or that have been raised by the charity for particular purposes. Costs are charged against the specific fund in line with donor wishes. An analysis of each restricted fund is set out in note 15.

In case of a deficit or surplus in restricted funds, the following approach is applied:

condition does not apply, any shortfall must be immediately made up through a transfer from unrestricted funds.

Income

Income is recognised in the statement of financial activities when Elrha is legally entitled to the income, receipt is probable, and it can be effectively measured.

Grant income

Most of Elrha's income is donor funding, which is granted either directly from donors, or via Save the Children UK. In general, grants represent restricted income from governments, agencies and foundations, corporates and trusts and have been included as 'Incoming resources from charitable activities' where these grants specifically outline the goods and services to be provided to beneficiaries. For these performance related grants, in the absence of specific milestones to determine entitlement, income is recognised to the extent that resources have been committed to the agreed outcomes and outputs as this is deemed to be a reliable estimate of the right to receive payment for the work performed. In this case cash received in excess of expenditure is included as a creditor (as deferred income) and expenditure in excess of cash included as a debtor (as accrued income). Unless otherwise specified by donors, restricted funds are not held in separate bank accounts.

Consulting income

Consulting income is income arising from services provided by Elrha to other humanitarian organisations. Such services are closely aligned with Elrha's charitable objectives and expertise and include activities such as training and research to support other organisations with which Elrha shares common goals. Income from these contracts is unrestricted and any profits generated are used to fund Elrha's other charitable activities. As with grant income, consulting income is recognised either upon the achievement of specific milestones, or in the absence of such milestones, income is recognised to the extent that resources have been committed to the agreed outcomes and outputs, until contract completion allows for a final and accurate accounting of profit or loss.

Gifts in Kind income (GIK)

GIK (Gifts in Kind) include goods for project distributions or resale, pro-bono services and supplies. GIK must be included in the accounts as income and expenditure and valued at market value by management and/or the donor. No monetary value is attributed to volunteer work.

Expenditure

All expenses are recognised on an accruals basis.

Expenditure on charitable activities is any that relates directly to fulfilling the charitable objects of Elrha.

Grant funding expenditure comprises the direct value of sub-grants made by Elrha to partner organisations during the year, as detailed in note 7. Grants funding costs are reported against the programme to which they relate.

Expenditure on 'activities undertaken directly' includes all costs of activities directly attributable to specific programmes or projects.

Support costs represent core activities and services, such as general management, governance, human resources, communications, financial management and premises costs, and are allocated across the categories of charitable activities in proportion to the services provided.

Staff costs are analysed and apportioned on the basis of management's estimation of the time spent on each activity and are allocated to activities undertaken directly or support costs according to the role of the staff concerned.

Termination benefits

Termination benefits are payable when employment is terminated, or whenever an employee accepts voluntary redundancy in exchange for these benefits. Termination costs are recognised at the point at which Elrha is committed to incur these costs.

Provisions

Provisions for liabilities are recognised when there is a legal or constructive obligation for which a measurable future outflow of funds is probable. Elrha held no provisions at the balance sheet date. (2023: nil)

Financial instruments

Financial assets and financial liabilities are recognised when Elrha becomes a party to the contractual provisions of the instrument. All financial assets and liabilities are initially measured at transaction price (including transaction costs). Elrha only has financial assets and financial liabilities of a kind that qualify as basic financial instruments.

Trade and other debtors are recognised at the settlement amount due after any discount offered. Prepayments are valued at the amount prepaid, net of any trade discounts due. Creditors and provisions are recognised where Elrha has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party, and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.

Defined pension contribution scheme

Save the Children UK operates a defined contribution retirement benefit scheme for all qualifying employees of group entities, including Elrha. For all schemes the amount charged to the statement of financial activities is in respect of the pension contributions payable in the year. Differences between contributions payable in the year and contributions actually paid are shown as either accruals or prepayments in the balance sheet.

In the application of Elrha's accounting policies, which are described in note 1, the trustees are required to make judgements, estimates and assumptions about the carrying amounts of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.

The trustees do not consider there are any critical judgements or sources of estimation uncertainty requiring disclosure, with the exception of income recognition. In light of the guidance set out in the Charities SORP (FRS 102) all awards have been reviewed to determine their performance related conditions, see Accounting Policies (Grant income).

Year ended 31 December 2024

**Unrestricted ** Restricted Year to
31/12/2024
£ £ £
Gift in kind income 7,200
(7,200)
-
Other - - -
Total 7,200 (7,200) -

Year ended 31 December 2023

**Unrestricted ** Restricted Year to
31/12/2023
£ £ £
Gift in kind income - -
-
Other 24 - 24
Total 24 -
24
Humanitarian Innovation Fund
(HIF)
Research for Health in
Humanitarian Crises (R2HC)
Global Prioritisation Exercise (GPE)
UK Humanitarian Innovation Hub
(UKHIH)
Other Charitable Activities
Total		 Unrestricted
Restricted
Year to
31/12/2024
Year to
31/12/2023
£
£
£
£
-
5,264,565
5,264,565
5,671,817
-
4,402,010
4,402,010
5,143,093
-
75,443
75,443
280,156
-
2,927,727
2,927,727
1,622,650
1,683
-
1,683
-
1,68312,669,746
12,671,429
12,717,716
Raising funds
Charitable activities
Humanitarian Innovation Fund
(HIF)
Research for Health in
Humanitarian Crises (R2HC)
Global Prioritisation Exercise
(GPE)
UK Humanitarian Innovation
Hub (UKHIH)
Other Charitable Activities		 Grant
funding
Activities
undertaken
directly
Support
Costs
Year to
31/12/2024
Year to
31/12/2023
£
£
£
£
£





2,986,630
1,487,522
948,399
5,422,551
5,187,781
3,154,353
691,257
534,969
4,380,579
5,143,093
-
75,890
19,887
95,776
626,150
1,593,500
761,208
344,919
2,699,627
1,538,950
-
(1,485)
47,068
45,583
-
7,734,483
3,014,392 1,895,242
12,644,117
12,495,974

Total resources expended include the following:

Fees payable to the auditor

Year to Year to
31/12/2024 31/12/2023
£ £
Audit of financialstatements 38,940 28,200
Total audit fees 38,940 28,200
Governance
General Management
Financial Management
Communications Support
Human Resources
Information Technology
Premises and Facilities		 Year to
31/12/2024
£
Year to
31/12/2023
£
71,971
60,215
773,492
530,258
232,325
226,727
286,348
269,603
267,969
90,592
132,927
122,401
130,210
119,359
1,895,242
1,419,155
HIF R2HC UKHIH 2024 2023 Total
Total
£ £ £ £ £
ACTION AGAINST HUNGER 77,517 30,899 - 108,416 155,033
ALIMA BUREAU - 60,000 - 60,000 -
ALLIANCE FOR INTERNATIONAL MEDICAL ACTION (ALIMA) - 230,000 - 230,000 407,821
AMERICAN UNIVERSITY OF BEIRUT (AUB) - (GBP) - 100,040 - 100,040 97,850
AMREF HEALTH AFRICA 22,476 129,857 - 152,333 196,582
AMREF HEALTH AFRICA IN SOUTH SUDAN - 79,912 - 79,912 -
ARBEITER-SAMARITER-BUND DEUTSCHLAND E.V. - - - - 45,000
BRANDEIS UNIVERSITY - - - - 49,729
BRONZE LIGTH TECH LTD 14,915 - - 14,915 -
CARIBOU DIGITAL (UK) LTD - - 384,397 384,397 79,159
CARTONG 15,000 - - 15,000 -
CENTER FOR GLOBAL DEVELOPMENT - - - - -
CHATHAM HOUSE - - - - -
COLUMBIA UNIVERSITY - 51,047 - 51,047 153,591
COMMUNITY PARTNERS INTERNATIONAL - 79,969 - 79,969 139,945
CONSILIENT LIMITED 87,320 - - 87,320 66,603
CWS JAPAN 384,786 - - 384,786 733,976
DANIELE LANTAGNE 3,932 - - 3,932 -
DIGNITY DANISH INSTITUTE AGAINST TORTURE - 39,570 - 39,570 -
ECOLE D'ECONOMIE DE PARIS (GBP) - - - - 37,498
EPICENTRE 14,581 118,866 - 133,447 162,578
ETHIOPIAN PUBLIC HEALTH ASSOCIATION - 34,888 - 34,888 134,550
GONDAR UNIVERSITY HOSPITAL - - - - 250
GUJARAT MAHILA HOUSING SEWA TRUST - - - - 3,837
HANA ROHAN - - 27,140 27,140 -
HANDICAP INTERNATIONAL - 47,039 - 47,039 -
HEALTHRIGHT INTERNATIONAL 2,182 9,037 - 11,220 66,641
HUMANITARIAN OUTCOMES LTD - - 150,924 150,924 498,646
HIF R2HC UKHIH 2024 2023 Total
Total
£ £ £ £ £
IBIS REPRODUCTIVE HEALTH INC - 67,473 - 67,473 19,250
INDO GLOBAL SOCIAL SERVICE SOCIETY - - - - 1,863
INNOVATIONS FOR POVERTY ACTION - - - - 283,210
INTERNATIONAL CENTRE FOR DIARRHOEAL DISEASE RESEARCH 45,000 - - 45,000 89,999
BANGLADESH (ICDDR,B)
INTERNATIONAL FOUNDATION FOR RECOVERY AND 15,000 - - 15,000 -
DEVELOPMENT
INTERNATIONAL MEDICAL CORPS - (75) - (75) -
INTERNATIONAL MEDICAL CORPS UK 15,000 - - 15,000 -
INTERNATIONAL ORGANISATION FOR MIGRATION (GENEVA) 51,000 - - 51,000 102,000
INTERNATIONAL RESCUE COMMITTEE UK 40,000 129,486 - 169,486 246,629
IPAS 40,000 9,423 - 49,423 129,277
ISLAMIC RELIEF WORLWIDE - - - - 44,250
IsraAID 134,174 - - 134,174 -
JOHN HOPKINS UNIVERSITY (US BANK) - - - - 2,247
JOHNS HOPKINS UNIVERSITY - 87,757 58,324 146,081 87,757
KAROLINSKA INSTITUTET , INSTITUTION OF PUBLIC HEALTH - 157,680 - 157,680 197,099
SCIENCES
LEH NUTRITION PROJECT - - - - 6,790
LIGHT FOR THE WORLD INTERNATIONAL 86,465 - - 86,465 65,046
LONDON SCHOOL OF HYGIENE & TROPICAL 81,828 2,642 141,495 225,965 87,208
MCGILL UNIVERSITY - - - - 2,258
MERCY CORPS EUROPE 133,654 - - 133,654 -
MONASH UNIVERSITY - - - - 53,438
NESTA - - 410,204 410,204 26,436
NORWEGIAN REFUGEE COUNCIL LEBANON - (6,095) - (6,095) -
NOSSAL INSTITUTE LIMITED 132,881 - - 132,881 121,547
ODI 77,439 - - 77,439 -
OXFAM (OXFORD) - - - - 2,448
OXFAM GB 497,031 - - 497,031 261,131
HIF R2HC UKHIH 2024 2023 Total
Total
£ £ £ £ £
PESITHO HOLDING ApS - - - - 57,718
PHILIPPINE GEOGRAPHICAL SOCIETY - - - - 3,269
PHYSICIANS FOR HUMAN RIGHTS - - - - 43,411
PLAN INTERNATIONAL UK 23,498 - - 23,498 67,500
PRAGYA - - - - 85,768
QUEEN MARGARET UNIVERSITY EDINBURGH - - - - 2,568
QUEEN MARY UNIVERSITY OF LONDON - 2,688 - 2,688 -
QUEENS UNIVERSITY AT KINGSTON 2,386 - - 2,386 28,872
RAND EUROPE COMMUNITY INTEREST COMPANY - - 185,981 185,981 -
REACH OUT CAMEROON - 7,270 - 7,270 -
ROYAL COLLEGE OF SURGEONS ENGLAND - - - - 88,200
SAVE THE CHILDREN (UK) - 160,329 - 160,329 180,659
SEARCH FOR COMMON GROUND 14,980 - - 14,980 -
SOCIETE DE COOPERATION POUR LE DEVELOPPEMENT 15,000 - - 15,000 -
INTERNATIONAL
SOS CHILDREN S VILLAGES UK 22,448 - - 22,448 89,792
STANFORD UNIVERSITY - 41,632 - 41,632 -
START NETWORK 668,412 - - 668,412 740,160
STICHTING VU - 118,883 - 118,883 -
STONEWALL EQUALITY LTD 29,700 - - 29,700 89,100
SWISS TROPICAL AND PUBLIC HEALTH INSTITUTE (SWISS TPH) - 79,597 - 79,597 79,597
TEARFUND 31,994 - - 31,994 19,808
TERRE DES HOMMES FOUNDATION - - - - 86,987
THE AGA KHAN UNIVERSITY - 12,936 - 12,936 12,936
THE BRITISH RED CROSS SOCIETY 90,000 141,018 - 231,018 -
THE GEORGE WASHINGTON UNIVERSITY - - - - 34,479
THE LONDON SCHOOL OF ECONOMICS - 199,672 - 199,672 174,713
THE POPULATION COUNCIL (KENYA) - 33,509 - 33,509 -
THE UNIVERSITY OF SYDNEY - 39,937 - 39,937 -
TOPLUMUN PARLAK GELECEGI DERNEGI 9,193 - - 9,193 -
HIF R2HC UKHIH 2024 2023 Total
Total
£ £ £ £ £
Trustees of Boston College - 100,000 -
100,000		 208,790
UCL CONSULTANTS LTD 52,321 - -
52,321		 -
UNIVERSITY NEW SOUTH WALES - 193,539 -
193,539		 143,982
UNIVERSITY OF APPLIED SCIENCES AND ARTS NORTHWESTERN 3,372 - -
3,372		 13,488
SWITZERLAND
University of Brighton Academies Trust 18,998 - -
18,998		 151,986
UNIVERSITY OF CALIFORNIA REGENTS - 16,368 -
16,368		 -
UNIVERSITY OF COPENHAGEN - - -
-		 5,186
UNIVERSITY OF GENEVA, FACULTY OF MEDICINE - - 235,035
235,035		 333,254
UNIVERSITY OF LEEDS - - -
-		 3,772
UNIVERSITY OF WASHINGTON - 131,465 -
131,465		 130,867
URMUL SEEMANT SAMITI - - -
-		 4,056
USTTB- FMOS-R2CH PROGRAMM - 55,616 -
55,616		 152,943
WATERSCOPE 8,221 - -
8,221		 27,118
WOMEN'S REFUGEE COMMISSION - - -
-		 -
WORDS RHYTHMS IMAGES 20,000 - -
20,000		 9,769
WORLD ALLIANCE FOR LUNG AND INTENSIVE CARE MEDICINE - 159,668 -
159,668		 139,710
IN UGANDA (WALIMU)
WORLD HEALTH ORGANIZATION - 197,642 -
197,642		 490,684
WORLD VISION UK - 3,169 -
3,169		 -
YORK UNIVERSITY 3,926 - - 3,926 46,063
2,986,630 3,154,353 1,593,500 7,734,483 8,606,376

The trustees received no remuneration during the year.

During the year £3,144 (2023: £658) was expended on travel and accommodation expenses for three trustees (2023: 3) to attend and participate in meetings of the Board of Trustees. No donations were received from trustees during the year (2023: nil).

Payroll costs were as follows:

Wages and salaries
Social security costs
Pension costs
Other staff costs		 Year to
31/12/2024
Year to
31/12/2023
£
£
2,139,837
1,857,201
225,530
197,346
128,867
108,028
34,244
32,234
2,528,478
2,194,809

Payroll costs are included within expenditure classed as 'Activities undertaken directly' or 'Support costs' in Note 5 to these financial statements.

No redundancy costs were incurred in 2024 (2023: nil).

The average monthly number of employees during the year was:

Elrha Average headcount1
Average FTE
headcount2
2024
2023
2024
2023
44
44
44
43
44
44
44
43

1 Headcount is defined as the number of roles filled by employees.

2 FTE headcount is defined as headcount adjusted to take into account hours worked, where employees do not work on a full-time basis.

During the year the following number of employees received employee benefits (excluding employer pensions costs) within the bands shown below.

Year to
Year to
31/12/2024 31/12/2023
£60,001-£70,000 1 1
£70,001-£80,000 2 2
£80,001-£90,000 1 1

4 4

The total amount of employee benefits received by key management personnel during the year was £397,192 (2023: £316,773).

Elrha is a registered charity and as such is not liable to United Kingdom income or corporation tax on charitable activities or primary purpose trading activities.

**31/12/2024 ** 31/12/2023
£ £
Trade debtors -
89,844
Amounts due from parent company 1,808,599
1,791,327
Grant debtors 736,309
434,223
Prepayments and accrued income 5,782
2,908
Other debtors 8,078
9,305
2,558,768 2,327,607

There are no debtors expected to pay after a period of longer than one year.

**31/12/2024 ** 31/12/2023
£ £
Trade creditors 493,096
358,304
Taxes and social security costs 49,058
50,258
Grant Obligations 124,776
-
Accruals 442,657
436,418
Deferred income 1,032,141
845,113
Other creditors 10 10
2,141,738 1,690,103

The table below shows the charity's commitment to donors in delivering projects on their behalf, which are expected to be completed over a number of years. Elrha’s obligation to deliver on these projects is conditional upon donor funding being received in accordance with grants agreements.

In years two to five 1,225,374 3,916,266 After five years - - 13,612,481 19,613,262

Sub Grant Commitments

The table below shows the charity's commitment to donors in delivering projects on their behalf, which are expected to be completed over a number of years.

A proportion of the funds needed for these programmes has already been received and is included within deferred income in note 12. For those not yet received, there are legal agreements with donors to ensure that Elrha will be reimbursed for completion of those projects. As described in note 1 (Going concern), Elrha retains the right to withdraw from these commitments in the event that donor funding is cut unexpectedly.

Within one year
In years two to
five
After five years		 HIF
R2HC
UKHIH 31/12/2024
31/12/2023
£
£
£
£
£
2,368,082
3,042,178
646,981
6,057,241
8,986,650
182,500
-
-
182,500
2,073,245
-
-
-
-
-
2,550,582
3,042,178
646,981
6,239,741
**11,059,895 **

Year ended 31 December 2024

Unrestricted funds
Restricted funds		 Opening balance
Income
Expenditure Transfers
At
31/12/2024
£
£
£
£
239,544 1,683
(45,583)
7,200
202,844
453,704
12,669,746
(12,598,534)
(7,200)
517,716
693,248
12,671,429 (12,644,117)
-
720,560

Year ended 31 December 2023

Unrestricted funds
Restricted funds		 Opening balance
Income
Expenditure TransfersAt 31/12/2023
£
£
£
£
239,519 24
-
239,544
231,962
12,717,716
(12,495,974)
-
453,704
471,481 12,717,740 (12,495,974)
- 693,247
HIF
FCDO - UK Foreign Commonwealth and
Development Office
MFA Netherlands
Government of Norway
R2HC
Wellcome Trust
Department of Health (UK)
FCDO - UK Foreign Commonwealth and
Development Office
Global Prioritisation Exercise (GPE)
FCDO - UK Foreign Commonwealth and
Development Office
MFA Netherlands
UK Humanitarian Innovation Hub (UKHIH)
FCDO - UK Foreign Commonwealth and
Development Office
Other
Other movements in restricted funds
Total restricted funds		 Opening balance
Income
Expenditure
Transfers At 31/12/2024
£
£
£
£
£
(127,206)
4,773,234
(4,931,351)
(35,665)
(320,987)
(301,478)
1,207
(1,076)
301,348
-
-
490,124
(490,124)
-
-
(428,684)
5,264,565
(5,422,551)
265,683
(320,987)
-
1,126,046
(1,122,046)
(4,000)
-
-
633,521
(616,090)
(17,431)
-
-
2,642,443
(2,642,443)
-
-
-
4,402,010
(4,380,579)
(21,431)
-
15,048
75,443
(95,647)
5,156
-
301,478
-
(130)
(301,348)
**- **
316,526
75,443
(95,777)
(296,192)
-
112,158
2,927,727
(2,699,627)
(19,271)
320,987
112,158
2,927,727
(2,699,627)
(19,271)
320,987
453,704
(7,200)
-
71,212 517,716
453,704 12,662,546 (12,604,534)
- 517,716

Effective on 2 September 2020, the Department for International Development (DFID) merged with the Foreign and Commonwealth Office to create the Foreign, Commonwealth and Development Office (FCDO).

All arrangements previously entered into with DFID transferred to the FCDO as of the date of the merger.

Since Elrha's establishment in 2018, funding arrangements have been in a process of transition, going via SCUK subgrants, to funding agreements directly between Elrha and external donors. In 2024, all Elrha’s funding was received directly from donors with the exception of funding from Wellcome, which continues to be provided via SCUK.

The transfer movement in restricted funds relates to the balance arising from unutilised ICR funding during the year

Debtors: amounts falling due within one year
Cash at bank and in hand
Creditors: amounts falling due within one year		 Unrestricted
funds
Restricted
funds
At
31/12/2024
£
£
£
202,047
2,356,721
2,558,768
797
302,733
303,530
-
(2,141,738)
(2,141,738)
202,844
517,716
720,560

Save the Children UK operates a defined contribution retirement benefit scheme for all qualifying employees of group companies, including Elrha. The total expense charged to the statement of financial activities in the year ended 31 December 2024 was £128,867 (2023: £108,028). Pension contributions are included under Expenditure as 'Activities undertaken directly' or 'Support Costs' in Note 5 to these financial statements.

The contributions outstanding at 31 December 2024 were £0 (2023: £0).

Save the Children UK (company number 00178159; charity numbers 213890 (England and Wales) and SC039570 (Scotland), registered address; 1 St John's Lane, London, EC1M 4AR is the sole member of Elrha.

During 2024 Elrha received sub-grant income from Save the Children UK (SCUK) of £1,126,046 in relation to awards where SCUK maintain the relationship with the donor. SCUK received sub-grant income from Elrha of £160,329 in relation to an award for deliverables under the R2HC programme, as shown in Note 7.

Under the shared services agreement Elrha paid SCUK £373,387 for the support services provided during the year, including use of office space. In addition, SCUK paid £12,051 towards one staff position within Elrha.

As at the 31 December 2024 the amount due from the parent company, SCUK, to Elrha was £1,808,599 as shown in Note 11.

There are no post balance sheet events to report.