From pledges to impact: tracking the Global Fund's 8th Replenishment

Introduction

Since its establishment in 2002, the Global Fund partnership has helped to save 70 million lives and reduce combined death rates from HIV/AIDS, tuberculosis, and malaria by 63%. As the Global Fund looks to its 8^th Replenishment, global progress against these three diseases is at risk. Declining international support for development and multilateralism, as well as interconnected crises affecting country financing and ownership, mean that major risks threaten the global health progress made in the past two decades.

Multilateral funding plays an essential role in strengthening the impact of global health ODA, particularly when resources are limited. The return on donor investment to the Global Fund is substantial: according to the Global Fund, each dollar the organization has invested in fighting HIV/AIDS, tuberculosis, and malaria generates an estimated US$19 in health and economic benefits. For its 8^th Replenishment, the Global Fund estimates that it needs US$18 billion between 2027 and 2029 to save 23 million lives, cut overall mortality rates by another 64% compared to 2023, and prevent approximately 400 million infections. According to the Global Fund, the US$18 billion investment could yield returns worth US$323 billion between 2027 and 2029.

The Global Fund held its Eighth Replenishment Summit on November 21, 2025, in Johannesburg, South Africa, co-hosted by the governments of South Africa and the UK on the margins of the G20 Leaders' Summit, securing US$11.3 billion in pledges.

This Donor Tracker Commentary examines funding and pledges to the Global Fund as part of Donor Tracker's new series examining donor pledges, budget allocations, and disbursements to the multilateral system.

The article was updated following the November 21 pledging conference.

Historical funding

Funding asks, pledges, outstanding balances, and top donors

The Global Fund's replenishment ask to donors has fluctuated significantly, falling from a high of US$20 billion as a full funding 'headline' ask during the 3^rd Replenishment to US$13 billion in the 5^th Replenishment. The 8^th Replenishment target is US$18 billion, matching the 7^th Replenishment ask. Although the Global Fund did not reach its target in 2022, remaining resources from its COVID-19 response mechanism, for which the Global Fund opened funding windows in 2020 and 2021, enabled investment of approximately US$18 billion during the 2023-2025 period. Raising US$18 billion in the 8^th Replenishment would therefore allow the Global Fund to maintain current support levels worldwide. Though total pledges at the summit did not meet the US$18 million goal, several key donors have yet to pledge and outcomes were generally considered strong.

Historically, donor pledges have fulfilled anywhere between 50% and 133% of the Global Fund's official replenishment asks, though these extremes were spurred by the global financial recession and additional funding from the COVID-19 Response Mechanism, respectively. Outside of these years, fulfillment rates have ranged from 82% to 93%, a relatively strong track record for the organization's ambitious targets.

Pledges donors make to the Global Fund are often subject to ongoing parliamentary or congressional approval. Some donors, including France, the US, and Australia, set aside certain amounts of their pledges for individual management or technical assistance, which appear as outstanding balances in Global Fund data reporting despite pledge totals being effectively met through a combination of contributions and set-asides. However, payment delays and defaults due to economic and political challenges in donors also contribute to unconverted pledging. Including set-asides, across replenishments, a total of 8.5% of all pledges have not been converted. While the proportion of set-asides to actual unconverted pledges is not publicly disclosed, addressing delays and defaults caused by macroeconomic conditions is an ongoing concern for the Global Fund.

The Global Fund's contributor base is relatively narrow, with the largest seven donors providing an average of 82% of the funding across the last three replenishments. Since the founding of the Global Fund, the US, France, the UK, Germany, Japan, the Gates Foundation, and the EUI have been top donors, with the US the largest contributor by a significant margin.

Replenishment outlook

The development budgets of the six largest public donors to the Global Fund are expected to have declined by an average of 38% between the beginning of the 7^th Replenishment in 2023 and the beginning of the 8^th in 2026.

A risk exists that the trend will continue, with potential impact on contributions to the Global Fund. France has eliminated key mechanisms for multilateral funding that traditionally contribute to the Global Fund, complicating the budget source for France's contributions to the 8^th Replenishment. The UK, though still a significant donor, recently lowered its target ODA/:abbrGNI from 0.5% to 0.3% until fiscal conditions improve, putting pressure on the distribution of funds from the development budget.

What current commitments tell us about the 8^th Replenishment

Of the historical largest donors, the UK and Germany made advance pledges ahead of the November 2025 conference. Germany, emphasizing its historical role as a leading donor to the Global Fund, pledged an early EUR1 billion (US$1.1 billion) to the Global Fund through 2027, representing a EUR200 million (US$232 million) cut from the previous replenishment. However, a previously planned cut of EUR350 million (US$407 million), as set out in a draft budget for the BMZ, was reduced to EUR100 million (US$166 million) following successful advocacy from local global health advocates. The UK's early pledge to the 8^th Replenishment (GBP850 million, US$1.1 billion) is 15% below its pledge to the 7^th Replenishment (GBP1 billion, US$1.3 billion) however, given the expected 38% real-term drop in the UK's ODA between 2023 and 2026, the pledge demonstrates relative prioritization of the UK's Global Fund contribution.

Of the seven donors covered by the Donor Tracker that have made early pledges, only Germany and the UK have decreased funding. Denmark and Spain have increased pledges compared to the 7^th Replenishment, and Switzerland, Australia, and Norway have maintained funding levels.

At the summit, partners from more than 30 countries pledged support to save lives and strengthen systems for health, marking the first replenishment held on African soil. The summit demonstrated global solidarity despite fiscal tightening, conflict, and global uncertainty, though total pledges fell short of the ambitious target set in the Investment Case and several key donors, including the EUI and Japan, have yet to confirm their pledges, though the US made a significant pledge of US$4.6 billion amid uncertainty about whether the US would contribute at all, following the Trump administration's dismantling of the country's foreign assistance infrastructure and withdrawal from many multilateral commitments.

Fluctuations in donor disbursement patterns

Country charts below show how these early pledges relate to historical donor disbursements. While countries pledge over a three-year cycle, they disburse annually and not always evenly. Looking at OECD data reporting shows that funding can be highly variable from year to year. While donors surged funding during the height of the COVID-19 pandemic in 2021, typically, disbursements are not tied to a fixed contribution schedule and can drop precipitously in the face of other funding needs or constrained funding environments. Some donors, like Australia, have irregular payment schedules to adapt to different funding demands for global health commitments, causing annual funding to the Global Fund to vary significantly. Others, like Denmark, tend to disburse more evenly, though even these markets may see one-off yearly drops in funding.

The Global Fund's replenishment model provides a strong approach to managing fluctuations in yearly funding, and the Global Fund is proactive in establishing formal contribution agreements to maintain a steady funding stream, though risks to pledge fulfillment still exist in difficult funding environments.

Conclusion

The Global Fund partnership faces a decisive moment. Interconnected crises, including conflict, poverty, climate change, and economic uncertainty, are jeopardizing the remarkable progress that the world has made against HIV/AIDS:abbrTB, and malaria over the past two decades.

The US$18 billion target represents not only the continuation of the Global Fund's work saving lives from HIV/AIDS:abbrTB, and malaria, but also a test of multilateral cooperation in an era of fiscal consolidation. In a changing donor landscape, taking a close look at both donor commitments and pledge fulfillments will help advocates calibrate their work and spot which sectors and instruments are at risk of significant funding shortfalls.

The Donor Tracker will be launching an analysis of key donor pledging and funding to prominent multilateral organizations in the coming months, empowering the development community to leverage data and collective knowledge during key moments of advocacy.