The Global Fund at 20: Changing the Story

The Global Fund was born out of a refusal to accept the loss of millions of lives each year to diseases that were both preventable and treatable. This is the story of how that call for justice united partners around one table to show that even the most severe health threats can be beaten.

The history of the Global Fund begins in the late 1990s, when AIDS, tuberculosis and malaria were collectively killing more than six million people every year.

At the time, just 0.05% of people living with HIV in Africa were receiving antiretroviral therapy – medication that was already widespread in high-income countries. One million children were dying of malaria each year, while millions of tuberculosis cases went undetected and untreated.

Activists, especially in southern Africa, demanded equal access to treatment for everyone. Born from urgency, the call for justice grew louder, united around one goal: to save lives and end HIV, tuberculosis and malaria as epidemics.

Equal voices

The size of the emergency called for a flexible, fast response, unlike anything ever proposed before. With the backing of politicians, activists and development experts, the idea of a single fund to tackle AIDS, tuberculosis and malaria started to take shape. Kofi Annan, then Secretary-General of the United Nations, was our first donor. Annan was so convinced by the new approach that he personally pledged US$100,000 – his reward for winning the Philadelphia Liberty Medal.

The historic first meeting of the Global Fund Board took place in 2002. For the first time in the history of global health, everyone with a role in fighting epidemics had an equal seat and voice at the table – from sex workers and private sector companies to ministers from both donor and implementing countries.

Unprecedented impact

The Global Fund’s game-changing partnership has pushed the boundaries on how the world tackles disease, how countries contribute, how communities unite and how partners collaborate to solve seemingly unbeatable problems.

By venturing into uncharted territory, we have changed the story. In 20 years, we have saved an estimated 38 million lives – nearly halving the number of deaths caused by AIDS, malaria and tuberculosis. By the end of the decade, we expect to have helped to eliminate malaria in at least 35 countries.

Looking ahead

Today, the Global Fund partnership is stronger than ever, but the story is far from over. The COVID-19 pandemic represents an unprecedented threat to 20 years of progress against the three diseases. At the same time, the COVID-19 response is lacking essential resources.

We continue to work tirelessly to protect lifesaving AIDS, tuberculosis and malaria programs, while delivering critical supplies for the COVID-19 response to support overstretched health care systems and community health networks. If these systems collapse and health services are interrupted, the resulting increased death toll from AIDS, tuberculosis and malaria will likely massively outweigh the direct impact of COVID-19 in low- and middle-income countries.

Twenty years after our birth, the world faces a monumental health challenge, and others will inevitably follow. Once again, our strength lies in our partnership. We have changed the story before. Together we must step up and write another chapter in the story of fighting deadly infectious diseases.