Health financing

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.

This article is an interview with Lucica Ditiu, Executive Director of the STOP TB Partnership, who discusses the impact of the US aid freeze and the US withdrawal from the WHO on the fight against TB in Africa.

In this interview, Olivia Ngou, Executive Director of Impact Santé Afrique, analyzes the impact of the US aid freeze and the US withdrawal from WHO on the fight against malaria in Africa. She highlights the challenges of international funding and underlines the urgent need for appropriate strategies to maintain progress in public health in the face of an unprecedented crisis.

ABSTRACT The Global Fund views parliamentarians as key influencers in encouraging governments to increase their spending on health. This is because their position and skill-set means that they are ideally placed to represent the views of interested parties and to influence decision-makers.

ABSTRACT With every replenishment comes a greater push toward domestic financing, says Aidspan Executive Director Ida Hakizinka in this commentary. The Global Fund has set a $14 billion target for its next three-year funding cycle. The Fund projects that domestic resources will contribute another $46 billion, an increase of 48% over the current cycle. Although we recognize that domestic funding has increased in recent years, Hakizinka says, the available funds are not enough to meet the needs laid out in the countries’ strategic plans. She adds that the upcoming Addis-Ababa and New Delhi meetings have the potential to influence the domestic financing trajectory.