The Global Fund’s Sixth Replenishment Conference: a challenge for France, a challenge for global health

The Lancet
Oct 05, 2019 Volume 394Number 10205p1205-1296


The Global Fund’s Sixth Replenishment Conference: a challenge for France, a challenge for global health
Stéphanie Tchiombiano, Jean-François Delfraissy, François Dabis on behalf of Santé mondiale 2030
… The Global Fund has been supported by unprecedented financial mobilisation for health—US$41·6 billion since its inception. It has had a leading role in the progress achieved in the fight against AIDS, tuberculosis, and malaria, with 32 million lives saved through the Global Fund partnership by the end of 2018.2 The Global Fund has transformed the approach to international development assistance, creating a new ecosystem for global health based on multisectoral governance,3 civil society participation,4 country ownership, and independent evaluation mechanisms.

In a context of stagnating development assistance for health for at least the past 5 years,5
it is imperative that the Global Fund’s Sixth Replenishment Conference provides a clear and positive signal and initiates a new dynamic, including by refocusing on the trajectory of eliminating the three target diseases. The replenishment is also a time for donor and recipient countries to rethink the Global Fund’s approach so that it increases investment in strengthening health systems and becomes more inclusive and more able to adapt to each context.

The Sixth Replenishment Conference in Lyon is a time to reposition France on the global health agenda. The success of the event will depend on the level of global financial commitment. Given the unmet needs and the possibility of fulfilling them with additional resources, the minimum $14 billion6 expected for replenishment is not acceptable and a more ambitious target should be set. The success of the replenishment will also rely on the increased diversity of donors and stakeholders, moving from a Global Fund mainly financed by G7 countries to a truly multilateral Global Fund. Finally, the debate on enlarging the scope and priorities of the Global Fund within the current and future global health agenda should be at the centre of the international debate…