Replenishment

Faced with a sharp decline in international aid, growing competing priorities, and an imminent risk of financial crisis, the Global Fund is making budget cuts—postponing certain expenditures related to infrastructure, equipment, and research—to keep its HIV, tuberculosis, and malaria programs running. While COVID-19 response efforts remain untouched for now, other critical initiatives risk delays, legal hurdles, and disruptions, particularly for frontline NGOs and contracted partners. The message is clear: “Protect what matters, adapt to the crisis.” The way forward? “Do more with less, without leaving the most vulnerable behind.” But were there really any unnecessary expenses to begin with? In any case, this new budgetary reality is expected to shape much of the discussion at the 53rd Board Meeting, to be held from May 7 to 9, 2025, in Geneva, Switzerland.

On 11 March 2025, the Global Fund Advocates Network Africa launched the ‘One World, One Fight’ campaign, which mobilizes civil society to advocate for a fully funded Global Fund in its Eighth Replenishment. The campaign emphasizes African leadership, domestic health investments, and sustained global commitments to fight HIV, tuberculosis, and malaria.

This article analyses the Global Fund’s 2024 OIG Annual Report, which was presented at the 53rd Board Meeting, from May 7 to 9, 2025, in Geneva. The report highlights the Global Fund’s progress amid global uncertainty, identifies key governance-related risks, and calls for bold operational reforms to maximize efficiency and safeguard billions in the fight against HIV, tuberculosis, and malaria.

This article highlights the key points of the Global Fund’s 2023-2028 Strategic Performance Summary Report, which will be presented at the 53rd Board Meeting, scheduled to take place from May 7 to 9, 2025, in Geneva, Switzerland. Without excessive pessimism, the prevailing feeling is a mix of hope and deep concern.

This special issue dedicated to the 53rd Board Meeting, to be held from May 7 to 9, 2025, explores the growing tension between strategic ambitions and budgetary constraints within the Global Fund. Balancing hope, warnings, and ethical dilemmas, it highlights the critical issues that will shape the decisions ahead.

ABSTRACT The $12.007 billion for 2014–2016 is a considerable improvement over the $9.2 billion pledged at the last replenishment conference, but the pledges fell short of the hoped-for $15 billion.

Bernard Rivers, founder of Aidspan and of GFO, returns briefly from several years away to consider four problems – two new and two old – that plague the Global Fund. What will it take for the Global Fund to recognize that these problems urgently need to be addressed?

ABSTRACT Civil society organizations have played a major role in the campaign for the Sixth Replenishment. They have shown once again how involved they are in the life of the Global Fund. In francophone Africa, through GFAN and CS4ME, more than twenty organizations from 15 countries have conducted awareness-raising and advocacy activities at the embassies of the main public donors in the runup to the replenishment, and publicly asked their countries to participate in the resource mobilization effort. The announcements made at the Pledging Conference have rewarded these efforts: African countries have mobilized twice the amount of money compared to three years ago, and their strong presence in Lyon demonstrates their commitment to fight and eliminate pandemics.

ABSTRACT With the Sixth Replenishment Conference just a few weeks away, the Global Fund has released its Results Report 2019 containing data to the end of 2018. The results show that health programs supported by the Fund have resulted in 32 million lives saved. In addition, 18.9 million people are receiving antiretroviral treatment; 5.3 million people were treated for TB in 2018; and 131 million mosquito nets were distributed in 2018.

ABSTRACT The 41st Board Meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria held in May 2019 was an opportunity for the organization to pledge its commitment and support to the LAC region, where $2.2 billion has already been invested to date to fight the three diseases. Investments include technical assistance to build resilient health system infrastructures in 36 countries in the continent, while maintaining an emphasis on co-financing commitments to cover key transition risks that include uptake of services for key populations. A member of the Latin America and Caribbean delegation to the Board offers his perspective.