Published: 18 February 2025

Eighth Replenishment Investment Case

The Global Fund partnership has made remarkable progress in the fight against HIV, tuberculosis (TB) and malaria over the last two decades – saving 65 million lives and reducing the combined death rate from AIDS, TB and malaria by 63% since 2002.

But interconnected crises threaten those hard-won gains. If we don’t respond with the urgency that this moment demands, we risk reversing these lifesaving achievements. For our Eighth Replenishment, the Global Fund needs US$18 billion to save 23 million lives between 2027 and 2029, reduce the combined mortality rate by another 64%, relative to 2023 levels, and prevent around 400 million infections. It took the world 18 years to halve the combined death toll from AIDS, TB and malaria; with the right resources we can more than halve it again in only six years. Every life lost is one too many, but to be able to reduce the death toll from AIDS, TB and malaria from 2.3 million in 2023 to under 1 million in 2029 would be an immense achievement.

In times of crisis and uncertainty, investing in the Global Fund is one of the most effective ways to improve the livelihoods of millions while strengthening global health security.

Despite the challenges posed by economic stresses, conflict, climate change and the erosion of human rights and gender equality, the Global Fund has continued to make strong progress against HIV, TB and malaria. Through our proven model of turning donor dollars into impact at scale, the partnership is bringing the world closer to the Sustainable Development Goal 3 target of ending the three diseases as public health threats.

Yet HIV, TB and malaria are formidable adversaries that are quick to punish any dilution of effort. We cannot allow ourselves to go backwards. To finish the fight, we must sustain our investments and massively increase our focus on innovation and efficiency.

The Global Fund’s Eighth Replenishment is an opportunity to take bold action, investing in an accelerated effort to ensure that future generations can live in a world free from the deadliest infectious diseases. Together, let’s give it everything.

Our Investment Case shows how we will stop at nothing to drive impact, save lives and deliver lifesaving tools and resources where they are needed most.

Eighth Replenishment Investment Case
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Read the Annexes

The Global Fund’s Eighth Replenishment is a moment for philanthropists, foundations and companies to make a transformative impact on the world’s deadliest infectious diseases. With the right resources, and by optimizing the deployment of tools to fight diseases, we can dramatically accelerate progress toward ending AIDS, TB and malaria as public health threats.

A total of US$2 billion of private sector funding would save 2.5 million lives and deliver a return on investment of 1:19, with every dollar invested in fighting HIV, TB and malaria resulting in US$19 in health gains and economic returns.

Private Sector Investment Opportunity
Saving more than 2 million lives together
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Overall resource needs and projected available resources for HIV, TB and malaria
In countries where the Global Fund invests

With an investment of US$18 billion, the Global Fund partnership would:¹

Save 23 million lives.
Avert 400 million infections or cases.
Deliver a return on investment of 1:19, resulting in US$323 billion in returns over 2027-2029.
Strengthen health and community systems and enhance pandemic preparedness.
Close the equity gaps and accelerate service coverage.
Reduce global inequality in life expectancy by 7% between 2023 and 2029.
Catalyze improved and more targeted domestic investments for HIV, TB, malaria and health and community systems.
Improve resilience to climate change to safeguard progress against HIV, TB and malaria.
Save US$42 billion in primary health care costs, bringing the total savings since 2002 to US$145 billion.

Progress against HIV, TB and malaria in the world’s poorest countries has led to people living longer, healthier lives. Across 15 sub-Saharan African countries, life expectancy rose from 49 to 61 years, with over half of the increase due to progress in fighting the three diseases. In Zambia for example, life expectancy increased by 15 years, from 43 years in 2002 to 58 years in 2021. Such dramatic increases not only save millions of lives, but also have a transformational impact on society. People living longer means more children have grandparents. People living longer means a better return on investment in education and skill-building. Investing in health advances economic productivity and broader socioeconomic development.

Life expectancy in 15 sub-Saharan African countries
Increase from 2002 to 2021

Cost savings from reduced inpatient and outpatient utilization due to decreased burden of HIV, TB and malaria
In countries where the Global Fund invests, 2002-2023 (US dollars, billions)

The progress we have made in the fight against HIV, TB and malaria has freed up essential resources and capacities in health care systems to address other diseases.

Investments from the Global Fund and partners up to the end of 2023 are estimated to have freed up 2.9 billion hospitalization days and to have averted 5.5 billion outpatient visits, generating US$103 billion in cost savings.

We are ready to meet this moment. As a global movement of civil society, governments, private sector partners, philanthropists, technical partners and communities affected by the three diseases, we are working together to deliver impact in more than 100 countries – and build a healthier, safer, more equitable world.

Every US$100 million invested through the Global Fund to support HIV, TB and malaria programs will:

Save 125,000 lives through programs supported by the Global Fund, and;

Avert 2.2 million new infections or cases across the three diseases, and;

Create US$1.8 billion in economic returns through health gains, and;

Provide antiretroviral therapy for 160,000 people, and;

Provide medicine for 13,000 mothers to prevent transmitting HIV to their babies, and;

Provide HIV counselling and testing for 9.6 million people, and;

Reach 396,000 members of key populations with prevention programs, and;

Provide TB treatment and care for 134,000 people, and;

Screen 3.1 million people for TB, and;

Provide 3,600 people with treatment for multidrug-resistant TB, and;

Provide antiretroviral therapy for 5,400 HIV-positive TB patients, and;

Distribute 11 million mosquito nets to protect children and families from malaria, and;

Provide 3.1 million seasonal malaria chemoprevention to protect children and families from malaria, and;

Provide malaria treatment and care for 2.9 million people.

Estimates are derived from the modeling conducted to estimate impact of the Global Fund 2026-2028 Investment Case. To estimate the results of a given financial contribution to the Global Fund, first the current upfront disease split in the Global Fund allocation model is assumed, then results are derived by assuming a linear relationship between funding and results. An overhead count of 5.6% is deducted from the amount.

The Global Fund supports a range of interventions recommended by technical partners, which go beyond those presented in the results of this calculator.

The results reflect contributions of Global Fund investments to national programs and their results. The Global Fund strongly advises that, in using the numbers, it is important to clarify that these results are achieved together with partners.

In 2023 the Global Fund invested at a record pace to mitigate the impact of today’s global crises on the health programs that we fund. We also reached a new milestone on our journey to end AIDS, TB and malaria as public health threats: We put more people on antiretroviral treatment for HIV than ever before, we found and put on treatment more people with TB than ever before, and we distributed a record number of mosquito nets to prevent malaria.

Read the results report

[1] With an Eighth Replenishment of US$18 billion, the Global Fund would contribute to achieving these results alongside sustained levels of other external funding, scaled-up domestic financing, and more innovation, collaboration and rigorous execution.