The United States pledged $4.6 billion to the Global Fund during its eighth Replenishment Summit in Johannesburg, marking a reduction from its previous $6 billion pledge but signaling continued engagement in multilateral global health efforts. Overall, the Global Fund has raised $11.4 billion of its $18 billion target for the next three years, although several key donors, including France, Japan, and the European Commission, have yet to make their commitments.
South African President Cyril Ramaphosa, co-host of the Replenishment, emphasized the importance of resilient health systems, local production of medicines, diagnostics, and therapeutics, and sustainable financing to support vulnerable populations. He noted that access to health services is critical for national prosperity and achieving global health equity. UK Prime Minister Keir Starmer, the other co-host, highlighted the historic significance of this being the first Replenishment jointly hosted by countries from the Global North and South, and underscored the Global Fund’s achievements, including saving over 70 million lives and reducing combined death rates of HIV, tuberculosis, and malaria by nearly two-thirds.
The Summit also addressed ongoing global health challenges, with Starmer noting that malaria continues to kill a child under five every minute, HIV affects thousands of adolescent girls weekly, tuberculosis remains the deadliest infectious disease, and antimicrobial resistance threatens previous progress. He praised increased private sector involvement and reforms that empower countries to lead their own health programs more effectively.
US Under Secretary Jeremy Lewin announced the American pledge via video, describing the Global Fund as a critical partner in advancing the country’s “America First” global health strategy. While the US has reviewed and adjusted many multilateral commitments, Lewin emphasized that the pledge reflects the nation’s continued leadership and commitment to global health. The US pledge is structured as a 1:2 commitment, requiring that every dollar from the US be matched by at least two dollars from other donors.
Other notable contributions include Germany’s €1 billion pledge, Canada’s CAD$1.02 billion, the Netherlands’ €195.2 million, Norway’s $200 million, Italy’s €150 million, Ireland’s €72 million, and the Bill & Melinda Gates Foundation’s $912 million. These combined contributions are expected to sustain and expand programs addressing HIV, tuberculosis, malaria, and related health challenges, while reinforcing global partnerships in public health.
