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Editorial
70 million lives, equivalent to the population of France, have been preserved over the past 23 years thanks to the mobilization of the international community united under the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Prevention campaigns, improved access to scientific innovations, and lower drug prices resulting from the Global Fund’s action have led to unprecedented progress in the fight against these three pandemics. In 2015, hopes of eradication even seemed within reach, as all countries across the globe had agreed—after years of historic progress—on a target: 2030.
Ten years later, optimism has given way to disillusionment. Recent cuts in official development assistance could result in over 10 million new HIV infections by 2030 and nearly 1.7 million additional deaths due to the resurgence of tuberculosis by 2035.
These alarming projections are not inevitable. Scientific advances have never offered more hope for a world free of AIDS, tuberculosis, and malaria—three diseases responsible for 2.5 million deaths in 2024..
Rarely has the ability of governments to demonstrate political will been so critical to the future of millions..
In 2025, donor countries to the Global Fund and their partners will have the opportunity to reaffirm their commitment to global health security and to future generations across all five continents, during the 8th Replenishment of the Global Fund.
The goal: to collectively mobilize 18 billion US dollars to save an additional 23 million lives by 2029. Reaching this target would also send a strong signal in support of multilateralism—currently under threat on many fronts.
Will France and the international community rise to the challenge? Explore the key issues of the 8th Replenishment in our special report.
Over the past 25 years, the international community has made remarkable progress in the fight against HIV/AIDS, tuberculosis, and malaria.
These advances are the result of joint efforts by international organizations—with the Global Fund at the forefront—as well as major bilateral initiatives such as PEPFAR and the U.S. President’s Malaria Initiative (PMI), along with governments that have invested heavily in prevention and access to treatment, while also working to sustainably strengthen health systems.
However, the gains of the past two decades are now facing multiple obstacles: the long-term impact of covid-19, drug resistance, economic and climate crises, armed conflicts, and now a funding shortfall—all are slowing progress toward eradication. In addition, gender inequalities continue to significantly hinder progress worldwide.
As a result, these three pandemics still cause 2.5 million deaths each year, although this represents a significant reduction compared to the 4.4 million deaths reported in 2000.
According to the latest available data, the HIV, tuberculosis, and malaria pandemics rank as the 10th, 8th, and 4th leading causes of death, respectively, in low-income countries.
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The consequences of reductions in Official Development Assistance
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The Global Fund to Fight AIDS, Tuberculosis and Malaria is an international partnership that mobilizes and invests resources to support local programs for prevention, treatment, and care in over 100 countries.
Established in 2002, its mission is to accelerate the eradication of these three infectious diseases by funding initiatives led by the countries themselves, in collaboration with civil society and affected communities. The Global Fund operates through a unique governance model in which all stakeholders—donor and recipient countries, civil society, UN agencies, the private sector, and affected communities—have an equal voice in decision-making.
As a financing platform, the Global Fund does not directly implement programs. Instead, it channels resources to the countries most affected, supporting local partners. Each grant is based on inclusive dialogue, measurable targets, and accountability mechanisms. The Global Fund focuses its support on one or two key programmatic priorities per country. This strategy aims to maximize impact and strengthen the integration of interventions into national health systems. A key performance indicator framework is used to assess outcomes—such as the number of people on treatment or mosquito nets distributed—in order to monitor progress in the fight against the three diseases.
Since its inception, the Global Fund has helped save 70 million lives and has contributed to a 63% reduction in the combined mortality rate from AIDS, tuberculosis, and malaria. In 15 sub-Saharan African countries, life expectancy has increased from 49 to 61 years, with more than half of this gain attributable to progress made in combating the three diseases.
To finance its activities for the 2027–2029 period, the Global Fund is organizing its 8th replenishment throughout 2025. The partnership aims to raise 18 billion dollars to save 23 million lives during this period, by reducing the number of deaths caused by AIDS, tuberculosis, and malaria to 920,000 by 2029, down from over 2.3 million in 2023 (and more than 4 million in 2005).
These investments will also generate a return on investment of 1 to 19, resulting in 323 billion dollars saved in hospital stays and outpatient consultations.
Some public and private donors have already announced their support for the Global Fund’s 8th replenishment. Norway, Spain, and Luxembourg have all increased their contributions compared to the previous period. Australia, Switzerland and Portugal have announced that they will maintain their current levels of contribution.
The pharmaceutical company Takeda was the first private sector partner to renew its support for the Global Fund, pledging approximately 2.3 million dollars for 2026–2028. It was followed by the Children’s Investment Fund Foundation (CIFF) (200 million dollars), the Gates Foundation (912 million dollars), (RED) (75 million dollars), Goodbye Malaria (5.5 million dollars), and the Johnson & Johnson Foundation (5 million dollars).
France has historically played a leading role in the global fight against HIV/AIDS, tuberculosis, and malaria, particularly through its commitment to the Global Fund. Since its establishment in 2002, France has been the largest European public contributor and the second-largest worldwide, with cumulative pledged donations totaling 9.5 billion euros. Since 2011, part of France’s contribution has funded L’Initiative, which supports the Global Fund’s activities by providing technical expertise to maximize the Fund’s impact on the ground.
This commitment forms part of a broader French strategy on global health, aimed at promoting universal access to healthcare, strengthening health systems, and supporting the global fight against pandemics.
On the occasion of the Global Fund’s 8th replenishment, many civil society actors are calling on France to demonstrate political will and urge it to maintain or even increase its commitment at least to the level of the previous replenishment, namely 1.6 billion euros. A contribution of this amount would enable the Global Fund to save 2 million lives between 2027 and 2029, prevent more than 35 million new infections or cases of the three diseases, and generate economic returns exceeding 28 billion dollars.
