The UK Government has today announced an £850 million pledge to the Global Fund. Results UK is extremely disappointed that the UK has reduced its pledge by 15%, despite calls from civil society, parliamentarians and the international community to maintain its previous £1 billion commitment as a minimum. The UK is co-hosting the Global Fund’s replenishment summit meeting with the Government of South Africa on 21 November.
“The decision to reduce the UK’s contribution is deeply concerning and represents a serious setback in the fight to end AIDS, tuberculosis, and malaria,” said Kitty Arie, CEO of Results UK. “We recognise the difficult fiscal environment in which this pledge is made, but this does mark the first time in the Global Fund’s history that a host country has reduced its pledge – setting a worrying precedent for other donor governments and jeopardising the issues the UK Government has said are priorities: global health, strengthening pandemic preparedness and promoting global security. This decision takes us in a different direction – undermining decades of progress and weakening our ability to respond to future threats.”
At a time when the international community needs solidarity, cooperation and genuine partnership, the UK Government has decided to retreat, threatening decades of progress, weakening our collective capacity to respond to future health threats, and undermining the Global Fund’s efforts to end the three diseases.
Impact of funding cuts
In the seventh replenishment in 2022, the UK pledged £1 billion, representing a 30% cut from the previous funding round. Since 2020, the UK has cut its overall contribution to the Global Fund by 45%.
These reductions are the direct result of political choices, a shrinking Official Development Assistance (ODA) budget, and a growing prioritisation of defence spending over global health and development. The reduced ODA budget means less funding to combat global poverty, increasing the vulnerability of communities and reversing the gains made in public health outcomes in recent years.
These cuts will cost lives. A reduction of £150 million translates to over 255,000 preventable deaths and nearly six million avoidable infections over the next three years. Beyond the tragic human toll, these cuts will strain already fragile health systems, undermine economic stability in partner countries, and ultimately weaken the UK’s own trade and health security interests.
Implications for TB control
For two decades, Global Fund-supported programmes have diagnosed and treated over seven million people. The Global Fund accounts for 76% of all international financing for TB. TB remains the least funded of the three diseases within the Global Fund’s portfolio, receiving just 18% of total allocations, despite causing more deaths than HIV and malaria combined.
At the 52nd Global Fund Board meeting in 2024, board members agreed that TB funding would increase only if the full $18 billion replenishment target were achieved. This conditional approach was always politically short-sighted. It effectively linked the lives of millions of people with TB to the unpredictable outcome of donor contributions rather than to sustained, strategic investment.
The reduced UK pledge comes in the context of wider cuts to TB financing. The United States Agency for International Development was the largest bilateral donor in the fight to end TB, providing a quarter of all international donor financing for TB. The withdrawal of this funding is now reversing decades of progress on TB and risks worsening inequalities and destabilising the global TB response.
The impact of the loss of funding across the 30 high-burden TB countries has severely impacted screening, detection and diagnosis of TB. Loss of essential health workers and drug supply issues all risk increasing the transmission of drug resistance.
The reduced funding for the global TB response, increased displacement of people, humanitarian crises and armed conflicts all fuel the spread of infections. The rising rates of TB in the UK are indicative of a global trend. This is why it is crucial to support the Global Fund to control infectious diseases before they spread across borders and cause harm.
Broader implications for the future of global health financing
The Global Fund remains one of the few international mechanisms capable of delivering health interventions at scale while mobilising local expertise and championing equity as a cornerstone of community resilience. Its model, anchored in inclusivity and innovation, has empowered nations to confront some of the most devastating health crises of our time. Yet today, this very model is under strain.
The aftershocks of the seventh replenishment in 2022 continue to reverberate across the Global Fund partnership, driven by the United States’ failure to honour its 2022 pledge in full. The consequences have been felt directly at the country level through the reprioritisation process. It is both unjust and politically untenable that Country Coordinating Mechanisms – run by the people closest to the front-lines of public health – should shoulder the burden of shortfalls.
Replicating the same donor-dependent model every three years shows a failure to adapt to today’s geopolitical and economic realities. Global health cannot continue to rely on the goodwill of a few donors whose domestic politics dictate the fate of millions. It’s time for a new model for multilateral health financing if we are to achieve health equity and resilience.
The final replenishment summit will take place on 21 November in Johannesburg, South Africa. There is still time for donor countries to step up their contributions and lead the way to a more equitable future.
“It’s now more important than ever that the Prime Minister attend the Global Fund replenishment summit,” said Kitty Arie. “Other countries are looking to the UK and will expect him to be there – the UK must use its role as co-host to collaborate with partners to reach the $18 billion target.”