Amb. (ret) Karl Hofmann, Health X Partners: “Not everyone curtails their job in Paris.”

Amb. (ret) Karl Hofmann is CEO of the recently launched Health X Partners (HXP), a parent company under which Population Services International (PSI) and the Elizabeth Glazer Pediatric AID Foundation (EGPAF) now operate. He explains his personal story—from a successful diplomatic path centered in Africa to a pivot and second career as President and CEO of PSI starting in 2007. And he explains the logic by which PSI and EGPAF agreed in 2024 to form HXP to achieve greater efficiencies and prepare prudently for the end of the 25-year era, begun around 2000, that has generated an “amazing chapter of human progress” in health but which, it had become increasingly obvious, would not last indefinitely. As the unforeseen tsunami of Trump 2.0 hit in early 2025, it was both fortuitous and doubly-risky for HXP, as it stood itself up. The new leadership at FSI and EGPAF suddenly had to come to terms with 50% reductions in staff, budgets, and programs, while consolidating and integrating audit, HR, and IT teams. Change had been expected, but it “turned out there was a lot more change” than anticipated. How to view 2026? Profound uncertainty. Yet there is also one clear message to NGO implementers: focus even more on cost effectiveness; and get much closer to needs on the ground, networked and connected to leverage scale and innovation.