Tuberculosis

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.

ABSTRACT In September 2020, DRAF TB and its partners (which include Alliance Côte d’Ivoire) conducted a rapid assessment of the challenges and responses of civil society organizations and NTPs to ensure continuity of TB services within the COVID-19 context. This was funded by the Initiative against HIV/AIDS, Tuberculosis and Malaria implemented by Expertise France.

ABSTRACT This is the second in a series of short interviews by Friends of the Global Fight with the Global Fund’s Senior Disease Coordinators. In this Q&A, Friends spoke with Dr. Wandwalo, the Senior Disease Coordinator specializing in tuberculosis, about the opportunities to fight TB covered in Friends’ report, “At the Tipping Point: U.S. Leadership to End AIDS, Tuberculosis and Malaria”.

ABSTRACT The United Nations General Assembly held its first High-level Meeting on Tuberculosis, to reaffirm Member States’ commitments to accelerating collaborative efforts to end the disease. Member States endorsed the ‘Political Declaration on TB’ calling for accelerated and concerted efforts against the disease.

ABSTRACT The government of India announced on 5 September that it would host the Global Fund’s preparatory meeting for the Sixth Replenishment. The pre-meeting will be in New Delhi on 8 February 2019.