New York, NY, November 24, 2025 — Global public and private sector donors pledged over $11 billion at last week’s 8th Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria in Johannesburg, South Africa. In the current political and economic context, these pledges represent a recognition of the pivotal role of the Global Fund in saving lives and building health systems. But they fall well-short of the $18 billion goal.
At a time when HIV, TB and malaria science is delivering as never before, with long-acting injectable HIV prevention options, new malaria drugs and vaccines and improved TB treatments entering the market — and a potential TB vaccine in late-stage trials — funding must meet the moment to deliver life-saving new technology with speed, scale and equity. Ensuring highly effective innovations reach those who need them most requires resources. Universal access to effective health technologies is an achievable goal, with robust investment in expert institutions, national public health systems, and aligned private enterprise.
“This moment is a historic opportunity to save lives and meet major milestones against all three epidemics. With political will and commitment, proper investment in the Global Fund will be instrumental in maintaining progress and building on success,” said AVAC Executive Director Mitchell Warren.
The US pledge of $4.6 billion over three years is a decrease from the $6 billion commitment in the previous replenishment cycle. But the US did reaffirm its 1:2 match, with the US continuing to contribute 1/3 of the total to the Global Fund, hopefully motivating other funders to step-up. Now, the US Congress must appropriate funding to fully meet the new US pledge, with language codifying the 1:2 match. Congress must also ensure funds appropriated for the previous replenishment, including $1.47 billion in matched funds, are distributed.
Communities with the greatest burden of disease, which have already suffered program cuts, service disruptions and the loss of many trusted local partner organizations, and include marginalized key populations, are at even greater risk now. AVAC joins affected communities and civil society to call on all stakeholders to recommit to solidarity, transparency and global health security. Achieving this requires national governments, foundations, the private sector and civil society to develop new financial tools for sustainable, country-owned and community-led public health systems. One critical step is closing the remaining gap to reach the Global Fund goal and ensure that donors who have yet to step forward to do so with ambitious, robust pledges.
“The impact of this current shortfall will be needless death and disease. Modeling suggests up to 22 million preventable deaths by 2030 if global health funding from all sources continues to decline. Millions of lives have been saved thanks to the Global Fund, and shrinking resources threaten these achievements and risk squandering the opportunities of recent scientific advances,” said AVAC Director of Policy Advocacy Suraj Madoori.
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About AVAC
AVAC is an international non-profit organization that provides an independent voice and leverages global partnerships to accelerate ethical development and equitable delivery of effective HIV prevention options, as part of a comprehensive and integrated pathway to global health equity. Follow AVAC on Bluesky and Instagram. Find more at www.avac.org and www.prepwatch.org.