Global Fund Board Backs Prioritization of Lifesaving Interventions amid Crisis, Urges Strong Eighth Replenishment to Protect Progress
14 May 2025
GENEVA – The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) held its 53rd Board meeting last week in Geneva.
Amid severe disruptions to health services across countries and growing global health funding uncertainty, discussions on grant reprioritization for the current cycle – and preparations for the next cycle beginning in 2026 – carried through each segment of the meeting.
Opening the meeting, Board Vice-Chair Bience Gawanas recognized that the world is confronting a convergence of threats – including conflict, shrinking civic space, overstretched health systems and increasingly constrained financing.
“It's a moment of reckoning and recommitment,” said Gawanas. “As we chart our way forward, we must do so with courage, clarity and unwavering focus on the people and communities we serve. In the face of adversity, we are reminded that the Global Fund is not simply a funder of programs; we are a partnership rooted in solidarity, shared responsibility, science and hope. We are here to keep the promise of a world where preventable diseases, or the place of birth, no longer decide one’s fate.”
“What is at stake is potentially millions of lives and many of the gains we have collectively fought so hard to achieve, including improvement in life expectancy and progress towards universal health coverage,” said Peter Sands, Executive Director of the Global Fund. “How we rise to this crisis will be a test for us as a partnership. We must stay focused on our mission and true to our values.”
Prioritize Access to Lifesaving Interventions
Amid the challenges, Board members acknowledged the need to adapt, defer and reprioritize investments within the current grant cycle while remaining focused on delivering impact in the fight against HIV, tuberculosis (TB) and malaria. In response, they supported the reprioritization of investments towards programs that preserve the continuity of essential health services and ensure access to lifesaving interventions.
The Board insisted that this process should be country-driven and involve meaningful engagement with civil society, communities, ministers of health, implementers, technical partners and key structures across the partnership – in particular Country Coordinating Mechanisms. It also stressed the importance of providing clear guidance to countries, including the criteria for reprioritization, the scope of lifesaving interventions, and the process and timelines for grant revisions. Board members agreed that these are critical conditions for ensuring a streamlined, transparent, and speedy process for quality decision-making and, most importantly, for implementation. The Secretariat committed to providing guidance to countries in the coming weeks and to updating the Board on progress.
“In a shifting landscape, swift and clear adjustments are essential to maximize the impact of available resources, safeguard hard-won gains and continue saving lives,” said Lady Roslyn Morauta, Chair of the Global Fund Board. “While the financial strain is real, so too is the resilience and adaptability across the partnership. The difficult but necessary reprioritization exercise must be guided by our values – equity, efficiency and the protection of impact.”
Reflection on Progress
In his update to the Board, Executive Director Peter Sands commended the remarkable progress made by the partnership in combating the three diseases over the past two decades, noting the United States’ central contribution through leadership, funding, technical expertise and bilateral initiatives.
Reflecting on recent achievements, Sands highlighted that investments in health and community systems are now larger and more effective than ever, significantly and clearly contributing to enhanced HIV, TB and malaria responses and pandemic preparedness.
He also praised the Global Fund’s Pooled Procurement Mechanism as “a core strength” – a critical driver of market shaping and value for money – and welcomed major advances in regional manufacturing and capacity building, marked by the milestone, just achieved, of the first delivery of Africa-made first-line HIV treatment supported by a Global Fund grant.
In addition, Sands stressed that the Global Fund’s organizational maturity, preparedness and agility allowed it to respond, once again, to external shocks with limited operational disruption, ensuring uninterrupted support to countries.
However, Sands acknowledged the magnitude of the current crisis affecting global health, stressing the major risks facing the most vulnerable communities while describing it as a potential catalyst for innovation and change. He emphasized the importance of advancing the transition agenda toward long-term sustainability. At the same time, he underscored the urgent need to ensure countries are adequately prepared, particularly in the face of escalating threats from malaria.
“We need to be realistic about the challenges,” he said. “Yet we need to be united, determined and ambitious. We owe it to the people we serve.”
Eighth Replenishment
On this note, Sands stood united with the Board in calling for strong support for the critical Eighth Replenishment, co-hosted by the Republic of South Africa – which holds the G20 presidency this year – and the United Kingdom (UK).
“The Global Fund has been a trusted partner in fighting HIV, TB and malaria, and in strengthening health systems across our country and continent,” said Dr. Mathume Phaahla, Deputy Minister of Health of South Africa and head of the Eastern and Southern Africa constituency on the Global Fund Board. “Only a fully replenished Fund can accelerate progress toward ending these diseases. We urge the global community to rise to the occasion, stand with us and continue investing in resilient health systems to promote solidarity, equity and sustainable development.”
Echoing South Africa’s call, the UK constituency urged all partners to unite behind the Eighth Replenishment by making ambitious pledges, increasing domestic health financing and contributing skills, investment and advocacy. The UK noted that its support is underpinned by the Global Fund’s strong and enduring commitment to breaking down human rights-related barriers to health.
Ensuring Long-Term Sustainability
In broad discussions on prioritization – covering both the current (Grant Cycle 7) and upcoming grant cycle starting in 2026 (Grant Cycle 8) – Board members acknowledged the need for agile responses to the current crisis, while underscoring the importance of maintained focus on sustainability as agreed at the 52nd Board Meeting last November. The Board encouraged responsible and gradual transitions toward increased domestic financing, while ensuring that no one is left behind.
To best prepare for the next grant cycle – particularly in today’s constrained environment – Board members encouraged the Global Fund to continue leveraging its many comparative advantages. These include its ability to accelerate equitable access to game-changing biomedical innovations, such as the promising injectable for HIV prevention, lenacapavir.
The Board also highlighted the value of the Global Fund’s unique model, which places governments – ministries of health in particular – and communities at the center of efforts to eliminate the three diseases, and its continued focus – through the active engagement of communities and civil society – on breaking down human rights and gender-related barriers to accessing health services.
Reflecting on the imperative to adapt the global health ecosystem, the Board urged the Global Fund to strengthen alignment and coordination with partners – especially Gavi, the Vaccine Alliance – in order to maximize impact, build resilience, consolidate country ownership and reduce transaction costs.
Revisions to the Technical Review Panel
In a dedicated session, the Board approved revisions to the Technical Review Panel to focus its engagement where it adds the most value – on High-Impact and Core Portfolios as well as transitioning countries – while allowing more flexible processes for others (Decision Point [ download in English ] ).
These changes reflect strategic priorities for the upcoming grant cycle, including simplification – and the subsequent reduction of the level of effort for applicants – sustainability, and differentiated support tailored to country needs.
“We have an unwavering commitment to our values and model, yet at the same time we are flexible and willing to change,” concluded Peter Sands.
Looking ahead, the Board Chair announced that the next Global Fund Board Meeting is set to take place in February 2026.