Deadly Gaps - MSF warns the UK must not be the first co-host to fail the Global Fund ​ ​ 

For more than 20 years, the Global Fund has been the world's largest financial backer of efforts to tackle the deadliest diseases - HIV, tuberculosis (TB), and malaria - in the world’s poorest countries. Its grants have helped fund medications and diagnostic tests, health worker salaries, and sustain disease prevention efforts. ​ ​ 

The organisation has saved 70 million lives since its inception in 2002.

As co-host of the Global Fund replenishment summit this year, the UK carries the responsibility to ensure the fund remains fully financed. The UK is yet to announce its pledge for the next three-year funding cycle before the replenishment summit on 21 November. ​ 

Liz Harding, MSF’s Humanitarian Representative, said: "This is a pivotal moment for the Global Fund and for global health more broadly. No host has ever reduced its previous pledge – the UK must not be the first.” ​ ​ ​ ​ 

The UK’s previous pledge was £1billion over three years, however there are reports that this could be reduced to £800million. These potential cuts follow the Prime Minister Sir Keir Starmer’s decision to cut the UK’s Official Development Assistance from 0.5% to 0.3% of national income by 2027, just weeks after the sudden and devastating initial “freeze” to US aid in January. Global health funding is facing a crisis and needs the commitment of world leaders, now more than ever. ​ ​ ​ ​ 

MSF treats more than three million people with malaria and tens of thousands of HIV and TB patients every year and while our work is not financed by the Global Fund, we remain very concerned about the impact of potential cuts. They will have catastrophic consequences on health programmes globally and ultimately negatively impact patient care, affecting the most vulnerable groups more than any others. ​ 

These setbacks are particularly tragic given recent advances with new, transformative tools which bring us closer than ever to tackling these diseases. This includes injectable pre-exposure prophylaxis (PrEP) for HIV, which, if properly funded, could be groundbreaking in preventing HIV infection. Our teams are working alongside local organisations to provide injectable PrEP for people at high risk in key settings, yet scale-up has stalled due to reduced international funding. ​ 

Hundreds of community-based health organisations supported by the fund are currently being forced to scale back plans amidst financial uncertainty. For more than 20 years, its grants have helped fund medications and diagnostic tests, pay health workers' salaries, and sustain disease prevention efforts. Even the threat of cuts will result in greater illness and death. ​ 

Malaria remains the leading cause of death among children under five in endemic countries. Despite preventative tools like bed nets, seasonal malaria medicines and new vaccines, current gaps in access to treatment continue to cost lives. ​ 

Joseph Wato, President of the Coalition of Civil Society Organisations for Health Financing and Universal Health Coverage (OFIS-CSU) Cameroon, said: “The Global Fund has been instrumental in reducing the burden of malaria by expanding access to prevention, diagnostics and treatment, particularly in vulnerable communities in Africa who represent 95% of cases and death in the world. “Imagine hearing your unique child’s voice for the last time because of a preventable disease.” ​ 

MSF teams in Central African Republic, the Democratic Republic of Congo and South Sudan regularly see the consequences of under resourced clinics and witness the lack of access to rapid diagnostic tests and medications needed for treatment. ​ 

Our recent report, Deadly Gaps: Don’t turn away from saving lives, shows the burden inevitably falls on patients who cannot afford care. In Sudan, where war has disrupted access to basic services, supplies for HIV, TB, and malaria have run dangerously low. In South Kordofan, Sudan, HIV and TB medications are completely unavailable - the last known provision was a small donation from MSF in 2024. ​ 

Liz Harding emphasised: “This is a defining moment in global health. The UK has a clear responsibility to ensure the world does not step back from fighting these deadly diseases. The world is watching.” ​ ​