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Apr 2026 US Bilateral MoUs for Health and Global Fund’s GC8: A Primer for Advocates +
Why the U.S. MoUs are relevant for GC8 planning and how will USG bilateral aid shape the impact of GC8 grants?
At the end of 2025, the U.S. government (USG) outlined a new vision of its role in global health in its America First Global Health Strategy. It went on to translate this vision at the country-level through Memorandums of Understanding (MoUs), blueprints for 5-year commitments to health funding by both the U.S. and implementing governments. Countries will need to fight the three diseases with fewer resources in 2027–29 as the Global Fund and U.S. cuts come into action. Global Fund and USG planning cycles are currently overlapping. Global Fund planning processes have never taken place in an environment of such limited transparency from the U.S. side.
Read the full brief here, with a summary of key features of the MoUs, how these are crucial in the context of GC8 planning, and core asks to push to CCM representatives, Ministries of Health and parliamentarians.
Related GFAN Resources:
If you have access to your country’s MoU, take a look at our Helpful U.S. MoU Reading Guide
En quoi les protocoles d’accord américains sont-ils pertinents pour la planification de la GC8 et comment l’aide bilatérale du gouvernement américain influencera-t-elle l’impact des subventions de la GC8 ?
Fin 2025, le gouvernement américain a défini une nouvelle vision de son rôle dans la santé mondiale dans sa stratégie « America First Global Health Strategy ». Il a ensuite traduit cette vision au niveau national par le biais de protocoles d’accord (MoU), qui constituent des plans d’action pour des engagements quinquennaux en matière de financement de la santé de la part à la fois des États-Unis et des gouvernements chargés de la mise en œuvre. Les pays devront lutter contre ces trois maladies avec moins de ressources en 2027–2029, à mesure que les coupes budgétaires du Fonds mondial et des États-Unis entreront en vigueur. Les cycles de planification du Fonds mondial et du gouvernement américain se chevauchent actuellement. Les processus de planification du Fonds mondial ne se sont jamais déroulés dans un contexte où la transparence de la part des États-Unis était aussi limitée.
Lisez la note d’information complète ici, qui présente un résumé des principales caractéristiques des protocoles d’accord, explique en quoi ceux-ci sont cruciaux dans le contexte de la planification de la 8e Assemblée générale du Fonds mondial (GC8), et énonce les principales demandes à adresser aux représentants des Mécanismes de coordination de pays (CCM), aux ministères de la Santé et aux parlementaires.
Nos outils:
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Dec 2025 GFAN Brief – Malaria control is key to strong and resilient health systems +
[Français ci-dessous]—This brief aims to highlight the importance of malaria control to make UHC possible in endemic countries, and the crucial role that the Global Fund plays in funding malaria program in the most vulnerable countries.It shows how, prior to the scaling up of malaria investments in the early 2000s, malaria routinely caused the majority of outpatients visits and inpatients admissions in endemic areas. And that, within years of the arrival of the Global Fund and the scaling up of funding, rates could be drastically lowered, to the point where malaria is today: a disease among many, rather than the overwhelming burden it had been. The other side of the coin is that as soon as interventions slow down and control slips, the disease can surge back rapidly.Une résurgence du paludisme menacerait des systèmes de santé tout entierLes dividendes cachés des investissements contre le paludismeCe rapport vise à souligner l’importance de la lutte contre le paludisme pour rendre possible la couverture sanitaire universelle dans les pays endémiques, ainsi que le rôle crucial que joue le Fonds mondial dans le financement des programmes de lutte contre le paludisme dans les pays les plus vulnérables.Il montre comment, avant l’augmentation des investissements dans la lutte contre le paludisme au début des années 2000, cette maladie était régulièrement à l’origine de la majorité des consultations externes et des hospitalisations dans les zones endémiques. Et que, quelques années après l’arrivée du Fonds mondial et l’augmentation des financements, les taux ont pu être considérablement réduits, au point que le paludisme est aujourd’hui une maladie parmi tant d’autres, plutôt que le fardeau écrasant qu’il était auparavant. Le revers de la médaille, c’est que dès que les interventions ralentissent et que le contrôle faiblit, la maladie peut rapidement resurgir. -
May 2024 Technical and Advocacy Brief on AMR and HIV, TB and Malaria +
In September 2024, the United Nations will hold the second High Level Meeting on Antimicrobial Resistance (AMR). AMR is a vast and technical issue, often discussed as an R&D problem for rich countries. In fact, the majority of the burden of AMR is in low and middle income countries, where issues of access to quality diagnostics and treatment have created the perfect storm for resistance to emerge and spread. We need advocates with experience in community-led programs and advocacy to help reframe the AMR debate as an access and rights issue.
To support you, GFAN, with help from Results UK, Aidsfondet and LHL International, has put together this brief to:
- Get you up to speed on AMR and its links to HIV, TB and Malaria.
- Give you talking points to enter discussions with AMR advocates productively.
- Highlight the role of mechanisms taking a less medicalized approach in fighting AMR, in particular the Global Fund.
Find the brief here.
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Dec 2023 GFAN Global Fund Board Meeting 50 Report +
Our report on the 50th Global Fund Board Meeting, held from November 14th to 16th, provide and extensive summary of the discussion held at the Board. Some of our key takeaways from the discussions inside and outside of the Board Meeting room are below. To read the full report, click here.
Some thoughts about the Board Meeting
New Board Format
The Board Meeting agenda was built around a pre-day of updates on technical and governance issues, a first day dedicated to further updates from the Executive director and the Secretariat covering the three diseases and contributory objectives, with no decision points, and only then two days for the board to make decisions.
We liked this structure, which gave all in the room time to absorb context and helped clarify positions and build consensus across delegations before it came time to take decisions. It felt intentional and natural, and we hope to see it continue.
Informal mini board retreat
The Board Member and Alternates were scheduled for a day of informal board retreat immediately after the closure of the Board Meeting itself – GFAN was not invited to attend and though Board members were openly discussing their priorities for the retreat throughout the meeting, the exact agenda was not shared with us. The Members and Alternates seemed to want to focus discussions on governance (the proposal for a new voting seat on the Board for the African Union put forward by some delegations) and sustainability (see below).
Sustainability, Co-financing and Transition review
A proposal was put to the Board and the Secretariat for a review, opening the door to an eventual revision, of the Sustainability, Co-financing and Transition (STC) policy of the Global Fund. The proposal seemed motivated primarily by better tools to promote country ownership and providing donor with a clear “off-ramp” in the face of rising demand from the most vulnerable countries. The request was not only received positively, with a number of participants noting that the type of changes suggested to the STC policy could really be accommodated within its current iteration.
Trade-offs
Linked to the STC discussions, “tradeoffs” really felt like the theme of the meeting. In the face of stagnating funding for GC7, limited prospects for improvements in GC8, and increased demand (see polycrisis below), the Secretariat, TRP, technical partners, and all delegations focused a lot of their interventions around resource allocation, what to prioritize and implicitly what to roll back.
Tradeoffs were discussed in particular with regard to innovation and coverage (buying new more expensive tools or cheaper, less effective ones), in terms of types of programs (prevention vs. diagnostics vs. treatment), and in terms of mandate (should certain thematic be relinquished in favor of other partners, and how should emerging issues be integrated without spreading the partnership thin?).
From our perspective, these discussions are essential to make sure there is transparency on what is prioritized and what is not, but the other side of that equation – how to increase the size if the pie so we do not have to trade one intervention for another or chase efficiencies all the way to US$2.3 more billions – was not featured enough throughout the meeting.
FGHI
The Future of Global Health Initiative was mentioned repeatedly throughout the Board Meeting by different delegations both among donor and implementing constituencies. References to FGHI were made to support calls for greater country ownership, and for greater collaboration and coordination across GHIs; these same calls were also made under the slogan “One Plan, One Budget, One Report”.
Polycrisis
Though some indicators were thankfully promising, the underlying tone for the meeting was one of concern if not gloom, encapsulated by the word “polycrisis” which creeped its way into a number of intervention (if the topic interests you this is a good newsletter and this is a good twitter account). The facets of the crisis of everything that were most discussed were climate change and its first, second and third order effects on health (i.e. respectively hotter temperatures, spread of vectors, and malnutrition, inequalities and poverty), the worsening of international tensions and ongoing conflicts (i.e. Ukraine and, though it was not mentioned directly as often, the ongoing Hamas/Israel conflict), the rise of resistance in Malaria to both insecticide and artemisinin, and a global anti-rights movement that made itself felt most starkly and most recently in Uganda.
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Nov 2023 GFAN Guide to Global Fund Board Meetings +
Please find here our guide to the Global Fund Board Meetings – the delegations, the structures, etc.
Updated November 2023.
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Sep 2023 #2023TBHLM Affected Communities and Civil Society Coordination Hub Statement on the Political Declaration +
The leaders assembled for the United Nations High Level Meeting (TB HLM) has adopted its political declaration with no objection at the opening of the TB HLM on September 22, 2023.
The Affected Communities and Civil Society Coordination Hub has released the following statement regarding the adoption of the political declaration. Find the full statement here.
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Mar 2023 GFAN TBHLM Scorecard +
World leaders committed in 2018 in New York to a set of targets, to put us on track to end TB by 2030. They also agreed to reconvene 5 years later to assess progress on their commitments.
Our 2018 TB HLM scorecard assesses our progress against the 2018 targets; you can download it:
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Mar 2023 Catalytic Investments in GC7 +
Our brief on the Global Fund’s Catalytic Investments – what they are, and where they stand at the beginning of Grant Cycle 7.
Download our brief: Catalytic Investments 101
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Dec 2022 GFAN Pledging Conference Pre-Meeting Report +
On September 16th & 17th 2022 GFAN held a pre-meeting ahead of the Global Fund Pledging Conference held on September 21st. More 90 participants joined in person or virtually.
The meeting had two main overarching components. One focused on the short-term objective of the pledging conference scheduled to take place on 21 September, just four days after the GFAN meeting ended, also in New York City: how to support the Global Fund’s efforts to get donors to pledge a total of at least $18 billion for the 2023–2025 funding cycle. Many of these discussions centred on finding ways to successfully influence key donor decision-makers to announce contributions before or at the pledging conference that were at least 30% larger than committed for the 6th replenishment. The second component explored longer-term issues and priorities, including:
- the network’s possible future role in pandemic preparedness and response (PPR) activities and advocacy, including the newly launched Financial Intermediary Fund (FIF) for Pandemic Prevention, Preparedness and Response;
- entry points for influencing Global Fund policies and decisions over the rest of 2022 and beyond, including at committee and Board meetings where discussions will take place on implementing the new Global Fund Strategy and deciding how to spend the money raised for the next funding cycle; and
- upcoming high-level global meetings of importance to HIV, TB, and malaria responses, including on TB and universal health coverage (UHC).
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Nov 2022 GFAN Report on the 48th Global Fund Board Meeting +
The Global Fund’s 48th Board meeting took place from the 15th to the 17th of November 2022; it was the first full in-person Board Meeting to take place since 2020.
You can find some of the documents submitted to the Board by the Secretariat here (you need to click on the + sign under Board Meeting Documents to see the full list). The complete list of decision points has already been uploaded, as well as a participants’ list, but at the time of writing no other document is available on the website.
A de-brief call from the Board Meeting was held with the Communities and two NGO Delegations on November 30th and you can access the recording and materials from that call here.
