Global Fund Board Makes Unprecedented Set of Decisions to Strengthen Sustainability and Prepares for Eighth Replenishment – Press Releases

The Global Fund Board is making an unprecedented set of choices to strengthen sustainable development and is preparing for its eighth replenishment

November 26, 2024

– The Executive Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) held its 52nd meeting in Lilongwe, Malawi, last week. The country was chosen to host the event in recognition of the remarkable progress within the fight against HIV, tuberculosis (TB) and malaria in recent a long time, which has helped to extend life expectancy within the country from 44.7 years in 2000 to 62.5 years in 2021

The meeting was opened by Dr. Lazarus Chakwera, President of Malawi, who praised the Global Fund for its groundbreaking contribution to the fight against HIV, tuberculosis and malaria within the country, noting a 39% reduction in malaria cases and a 25% reduction in malaria deaths, and significant progress within the fight with HIV and AIDS. Between 2004 and 2024, greater than 10 million people received HIV testing and almost 1 million received life-saving antiretroviral therapy. President Chakwera stressed that the Global Fund has consistently stood by Malawi, supporting the country through challenges starting from Covid-19 and floods to mpox.

Significant policy changes to create a sustainable impact

During the three-day meeting, the Board recognized that the Global Fund’s mission faces quite a few challenges, including excessive fiscal pressure on countries, restrictive civic spaces, global conflicts and climate change. To protect gains made within the fight against HIV, tuberculosis and malaria, while contributing to sustainable progress toward ending these diseases, the Board adopted an unprecedented, wide-ranging set of policy changes.

These changes, in preparation for the following three-year grant cycle starting in 2026 (grant cycle 8), were introduced by revising the 4 principles which have the best impact on determining how Global Fund resources are allocated and used: Eligibility Policies; Allocation methodology; Policy of sustainable development, transformation and co-financing; and catalytic investments. The changes were adopted by the Management Board unanimously.

Changes to eligibility policies and allocation methodologies will shift funding to lower-income countries and increase the proportion of funding for tuberculosis and malaria treatment. Changes to sustainability, transformation and co-financing policies will strengthen the rigor and specificity of co-financing requirements and enable higher transformation preparedness to support sustainable progress within the fight against these three diseases.

To facilitate the implementation of this set of changes and contribute to a more streamlined, effective and sustainable response to global health, the Executive Board encouraged the Global Fund to proceed to support countries’ efforts to strengthen public financial management (PFM). The aim is to enable the implementation of credible, priority-driven health budgets, integrated disease programs, efficient flow of funds, effective budget execution and increased accountability.

Catalytic investment priorities in Grant Cycle 8 will concentrate on elements of the Global Fund strategy which are critically needed to speed up progress but will not be fully captured by country allocations. This includes human rights, gender equality, shaping the NextGen market to enable faster access to latest innovations, and tackling the impact of climate change on the health of the poorest and most vulnerable communities. The Catalytic Investment Priorities for Grant Cycle 8 also seek to leverage private sector contributions.

“These critical decisions set the stage for the Eighth Supplement and shape our approach to the next grant cycle,” said Lady Roslyn Morauta, Chair of the Global Fund Board. “By focusing on countries with the greatest needs, increasing their accountability and supporting sustainable financing, we strengthen our commitment to the millions of people whose lives depend on our work.”

“The sustainability levers we activate are essential to maximizing impact, protecting hard-won profits and ensuring the long-term success of Global Fund’s mission in the communities we serve,” said Peter Sands, executive director of Global Fund.

Additionally, the Board approved the Global Fund Secretariat’s 2025 operating expenditure budget (OPEX), set at USD 346 million, and approved adjustments to the chance appetite statements to consider domestic supply chain risk and grant fraud and fiduciary risk.

Continued efforts against the consequences of the climate crisis and the erosion of human rights

During wide-ranging discussions, Board members consistently emphasized the critical importance of maintaining investments in health systems and communities to support the fight against HIV, TB and malaria, enhance pandemic preparedness, and speed up the trail to universal health coverage (UHC).

Alerted by simultaneous discussions at COP29, they reiterated their concern concerning the growing health impacts of the climate crisis and called on the Global Fund to proceed to support countries in constructing resilient health systems and responding to climate-related disasters. The session with Malawi’s Minister of Health, Khumbize Chiponda, highlighted the challenges Malawi faces because of this of the increasing variety of climate-related events corresponding to droughts and cyclones, that are disrupting the delivery of health services to essentially the most vulnerable groups, which is a further driver of transmissible diseases man-made diseases corresponding to malaria and cholera.

At one other session, the Council reaffirmed its commitment to removing human rights and gender-related barriers to access to health care, including stigma and discrimination.

“The Global Fund Partnership must take decisive action to protect civic space and counter the global erosion of rights that, if ignored, could have devastating consequences for public health,” said Bience Gawanas, vice-chair of the board. “Communities are at the heart of everything we do. Every Global Fund program must continue to prioritize the needs of the most vulnerable – girls, women and other marginalized groups.”

Mobilization for a successful eighth replenishment

With just five years left to attain the Sustainable Development Goals, the Executive Board has called on the complete partnership to unite behind the important thing goal of ensuring the perfect possible end result for the Eighth Complement next yr.

“For both HIV and TB, we have great momentum, with the 2030 HIV target already visible and record numbers of people being successfully treated for TB; And with malaria, we are at risk of halting or even reversing progress, and we must act bolder to break the cycle of malaria transmission,” Sands said. “For all three diseases, innovative, revolutionary tools offer new opportunities and reasons for hope. The success of the Eighth Complement will determine the Global Fund’s ability to accelerate equitable access to such innovations and will set the pace of progress toward eliminating these three diseases as epidemics. In an increasingly divided world, the Global Fund partnership must unite as a beacon of global solidarity and humanity.”

“Partner countries, governments, civil society and communities look to donors with confidence and hope that the partnership will fulfill our responsibilities and ensure a successful Complement,” Morauta concluded.