Speaking solely on Global Health division (other divisions don't seem to have this level of dysfunction) - extremely hierarchical that comes from the very top with expectations for the bottom to execute without question. Otherwise, be prepared to be thrown under the bus.
The leadership are all from the same network of followers - disease teams used to be led by experts in the field and not from the same pharmaceutical empires. Doing "what is right" isn't about the community - but avoiding getting fired / laid-off. Support staff (assistants, coordinators) constantly shifting between teams or leave the foundation because they are overworked and unappreciated. Very few opportunities for career advancement, especially for program staff. Performance reviews don't appear to make a difference for managers or employees.
Endless strategy reviews throughout the year reflect a lack of trust and leave little time to get actual work done. It's not a coincidence that the average lifespan of a foundation employee is 2-3 years, with few exceptions - two years ago over 40% of employees admitted to be actively looking for a new job on a culture survey.
