HIV

This new issue of the GFO is devoted entirely to the 53rd meeting of the Global Fund Board, which took place from May 7 to 9, 2025, in Geneva, revealing a pivotal moment for the institution as it confronts major funding gaps, governance challenges, and the urgent need for reform. From the Executive Director’s call for unity and realism to debates over grant reprogramming, risk management, and ethical oversight, the meeting underscored the fragile balance between ambition and constraint.

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.

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 Office of the Inspector General’s audit report on the Global Fund’s grants to Madagascar does not paint a picture of progress. While factors outside program control have contributed to the worsening impact of malaria, the overall message is that significant improvements are required throughout the disease programs. There are also similarities with the recent audit report on Zambia. First, there appears to be a need for more rigour in routine performance assessment. Second, given the absence of any mention of the Country Coordinating Mechanism in the report, the role and performance of the CCM must be reconsidered; and this may impact the preparation of the forthcoming funding requests and the views of the Technical Review Panel when it reviews them.

ABSTRACT Although International Women's Day is over a century old, its commemoration remains more necessary than ever. Beyond the recreational aspect that is usually attached to it, it is an excellent opportunity to draw attention to the injustices and glaring inequalities that continue to plague the lives of women throughout the world, but especially in Africa. This article gives us the opportunity to redefine International Women's Day and why we still need to talk about women’s rights.

ABSTRACT Incremental funding of up to $46.4 million has been approved for the renewal of four grants in three countries. The largest amount of funding went to Eritrea for HIV and TB.

ABSTRACT Integrating TB and HIV programs in countries with high rates of TB-HIV co-infection is necessary and will produce benefits, but there will be some challenges in making it happen, experts say.

ABSTRACT The results of the recently closed HIV program in Russia are under threat due to the country‘s ineligibility for the Global Fund‘s transition funding and the unwillingness of the Russian government to continue to support the implemented activities. But since the preservation of the ‚NGO Rule‘ at the Global Fund‘s 39th board meeting, Russia may be in line for HIV funding again, for the 2020-2022 allocation period.