Doctors Without Borders (MSF) has warned that global efforts to combat HIV/AIDS, tuberculosis (TB), and malaria are at serious risk due to drastic reductions in international health funding. In January, the United States, historically the largest contributor to global health programs, announced a suspension and review of all international aid. As a result, nearly $3 billion of the $6 billion USD pledged to the Global Fund for 2023–2025 remains unfulfilled, with key donor countries yet to confirm commitments for the Global Fund’s next three-year cycle due in November.
Anele Yawa, General Secretary of South Africa’s Treatment Action Campaign (TAC), stressed the critical nature of this funding: “It would be a mortal blow should the Global Fund not meet its replenishment targets. History will judge us harshly if we stay silent.” MSF emphasizes that the Global Fund is essential in supporting fragile health systems across Africa, Asia, Latin America, and beyond, providing funding for medications, diagnostic tests, healthcare workers, and disease prevention programs. Without timely contributions, decades of progress in reducing illness and death could be undone.
Antonio Flores, MSF Senior HIV/TB Advisor, highlighted the human impact: “In Honduras, abrupt PEPFAR cuts halted HIV prevention and care programs. Patients lost access to PrEP overnight, and health workers lost their jobs. We’re now seeing patients return with advanced opportunistic infections.” MSF notes that reduced funding threatens not only ongoing programs but also promising innovations, such as injectable PrEP in Malawi, where sex workers face HIV prevalence rates nearing 60 percent.
TB remains a major threat, causing an estimated 1.5 million deaths annually. In Sudan, MSF has observed TB testing equipment left unused due to a shortage of trained staff, while research on drug-resistant TB in Belarus has stalled due to unfulfilled funding. Malaria continues to be the leading cause of death among children under five in endemic regions. MSF teams in the Central African Republic, South Sudan, and the Democratic Republic of the Congo report shortages of diagnostic tests and medications, as well as understaffed facilities, putting children at deadly risk.
Joseph Wato, President of COFIS-CSU Cameroon, highlighted the stakes: “If the 8th replenishment does not go ahead, it would jeopardize decades of progress, leading to a resurgence of malaria cases and unnecessary loss of lives.” MSF underscores that domestic resource mobilization alone cannot replace international support in many countries, leaving patients unable to afford critical care.
The organization’s report, Deadly Gaps, documents the consequences of funding cuts, including program shutdowns, weakened treatment adherence, rising unexplained deaths, and broader social impacts such as food insecurity and psychosocial breakdown.
MSF urges key donor countries to maintain and scale up their commitments to the Global Fund, emphasizing that the fight against HIV, TB, and malaria is a global, generational challenge that is far from over. Sustained international support remains critical to prevent the reversal of hard-won gains and save millions of lives worldwide.
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