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Published: 05 June 2025

Innovative Finance

The Challenge

Significant investments in health over the past two decades have yielded striking progress in the fight against AIDS, tuberculosis (TB) and malaria. Much of that has come through domestic resource mobilization and traditional development assistance. But the health financing landscape is shifting, countries are facing significant economic pressure, and these three diseases are constantly evolving to become more difficult to beat. In response to these challenges, the Global Fund partnership is pursuing new opportunities to add more funding and increase value for money to accelerate the fight to end HIV, TB and malaria as public health threats.

Our Response

The Global Fund connects countries with partners – development and health funders, multilateral donors, private sector investors, philanthropists and civil society organizations – to develop and implement practical, innovative financial mechanisms. These solutions complement government spending and amplify domestic health financing, in line with the Global Fund Strategy.

Our experience shows that innovative finance can have significant impact against the three diseases by leveraging additional resources or influencing existing resources to raise funds for program delivery, increasing efficiency and supporting countries to strengthen sustainability.

By the Numbers

  • The Global Fund has made 14 blended financing investments, totaling US$211 million.
  • US$335.5 million has been pledged and US$240 contributed into lifesaving programs through 14 Debt2Health transactions to 11 Global Fund implementer countries – Cameroon, Côte d'Ivoire, Democratic Republic of Congo, El Salvador, Egypt, Ethiopia, Jordan, Indonesia, Mongolia, Pakistan and Sri Lanka.
  • US$785 million has been mobilized for HIV programs in Africa through (RED).

Blended Financing

Blended financing allows the Global Fund to combine grant funds with multilateral banks (such as the World Bank) and other financial institutions. It complements traditional Global Fund grant financing and is part of the Global Fund’s overall approach to raising additional resources for health. Blended finance also makes it possible to strengthen alignment with other partners, leveraging borrowing to support the health sector and the fight against three diseases, and tailoring the way we invest to suit each country’s programmatic priorities and economic situation.

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Debt Swaps (Debt2Health)

Launched in 2007, Debt2Health allows creditor and debtor countries to convert – or swap – part of their debt into lifesaving health investments. Currently focused on the conversion of official bilateral debt, all swaps are flexibly and independently negotiated in partnership with the Global Fund and are designed to meet the needs of creditor and debtor countries alike.

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Consumer Donations

The Global Fund fosters partnerships that empower millions of individuals to contribute to the cause of global health. We work with organizations that raise funds when individuals purchase products or services, or create grassroots fundraising mechanisms. Some or all of the proceeds support Global Fund-supported programs.

(RED) works with the world’s most iconic brands and organizations to develop branded products and services that, when purchased, activate corporate giving to the Global Fund. (RED) has generated US$785 million to support the fight against AIDS in Africa through the Global Fund.

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Philanthropic and Impact Investing Platforms

Innovative philanthropic investment funds allow different types of investors, such as foundations and philanthropic leaders, to pool their financial contributions to the fight against the three diseases. These pooled funding mechanisms aim to mobilize and distribute funds in a more coordinated and efficient way.

The Global Fund supports countries, implementing partners, technical agencies and global convenors to collaborate on impact investing platforms to attract more private sector investment to global health through technical assistance and coalition building. We have supported the Health Finance Coalition, a group of leading health donors, investors and technical partners seeking to scale blended finance solutions to achieve Sustainable Development Goal 3 and universal health coverage in Africa. In 2022, the Coalition launched the Transform Health Fund, an impact investing fund that initially raised US$50 million for innovative health care delivery models in Africa.

Triple I Initiative: The Global Fund has also joined the Triple I (Impact Investment Initiative) for Global Health, to raise awareness and promote impact investment in global health. The initiative was launched by the government of Japan at the United Nations General Assembly High Level Meetings in September 2023. The aim of the Triple I is to promote capital mobilization through impact investments in global health and ensure better access to quality health services without financial hardship; reduce health inequality; and contribute to issues such as advancing universal health coverage and pandemic preparedness and response.

Results-based Financing

Payment for results is a results-based financing modality in which the Global Fund makes payments to Principal Recipients after verifying that results have been achieved. This approach allows for the use of grant funds within pre-agreed parameters and is not based on monitoring and managing inputs. Payment for results can be applied to an entire grant or a specific component of a grant.

The Global Fund has supported results-based financing models in El Salvador, India and Rwanda. In Rwanda we support a results-based financing approach called the national strategy financing model. It enables Rwanda to evaluate performance against pre-defined targets and shift resources as priorities change.

Outcome-based Financing

Outcome-based financing is the disbursement of funds after pre-defined outcomes are achieved, with the donor or private investor generally providing upfront financing to a program implementer.

If the pre-agreed outcomes of the program are met, the investment is repaid, often with a financial return. This financing includes social impact bonds, which focus investments on programs that yield effective social outcomes in the fight against the three diseases.