U.S. steps back up as biggest donor to the Global Fund

Would the U.S. show up? That was the question being asked in the lead-up to the gathering of world leaders, held in November 2025, to pledge funds to the Global Fund to Fight AIDS, Tuberculosis and Malaria. The prevailing wisdom was that the U.S. wouldn’t be at the meeting, much less make a significant pledge.

At the start of 2025, the Administration had shut down virtually all global health programs. It was also withholding already-promised payments to the Global Fund.

The President’s budget for Fiscal Year 2026 proposed further slashing funding for the Global Fund. Historically, the U.S. has matched $1 for every $2 from other donors — the President’s budget also proposed cutting that rate in half, offering $1 for every $4.

We need the Global Fund more than ever

Communities worldwide are facing deadly gaps in healthcare since the U.S. massively reduced foreign assistance. This makes the Global Fund an even more important lifeline.

Since its founding, the Global Fund has been instrumental in saving more than 70 million lives by providing grants and support to countries with lower incomes to fight infectious diseases and strengthen their health systems. Its work is too important to give up.

So, together with a chorus of partners, we proved the conventional wisdom about U.S. support wrong.

• We got bipartisan members of Congress signing on to public letters re-enforcing the 1:2 match.
• We helped secure a Republican-led funding bill that fully funded the Global Fund.
• And when the White House was targeting the Global Fund for cuts, we got members of Congress speaking out.

And the U.S. showed up for the pledging conference. “Today the U.S. is announcing a $4.6 billion multiyear pledge to the Global Fund,” said a representative from the State Department. “It is at the same 2:1 legislative match as previous U.S. pledges.”

It was a stunning turnaround. Because of RESULTS’ advocacy and that of our partners and allies, more people across the planet will have access to lifesaving treatment for HIV, TB, and malaria.

Directly affected countries and communities are leading the way

Unfortunately, many government donors fell short of the needed commitments to the Global Fund. Some reduced their pledges, and some failed to pledge at all. We know that the White House’s actions this spring helped trigger this global wave of withdrawal.

Too much is on the line to accept this pull-back from the fight against the three preventable and treatable diseases.

Our fellow advocacy partners around the world aren’t letting up. They’re still pushing for new funding from Japan, France, the European Commission, and more.

Meanwhile, many countries in Asia and Africa stepped up their commitments. Nigeria, South Africa, Côte d’Ivoire, and others boosted their pledges to the Global Fund, as well as increasing their investments in their own national health systems.

Cecilia Senoo, who leads a community health and advocacy nonprofit in Ghana and sits on the board of the Global Fund, spoke to donors at the pledging summit. “We are not retreating, and you must not either,” she said.

The U.S. needs to keep its promises

While we’re proud to have secured the U.S. pledge, we must ensure that every dollar allocated is new investment.

In 2025, the Global Fund was forced to cut more than $1 billion in promised resources for countries’ health programs, jeopardizing lifesaving services across the planet. This marked the first time in its history that the partnership was forced to cut funds because of uncertainty from the U.S. and other donors.

There are currently nearly $2 billion in funds dedicated to the Global Fund sitting idle in the U.S. Treasury. These funds were previously pledged, already matched, and already appropriated. They need to be turned over. 

For years, we’ve worked with Congress to boost funding for high-impact programs like the Global Fund. This year, despite deep partisan divides, we got Republicans and Democrats to defend the Global Fund. Bipartisan legislation has paved the way for Congress to make good on the $4.6 billion commitment to the Global Fund, on top of the money already owed.

Normally, we could count on the money being spent once Congress set it aside. Not so anymore.

In 2026, we will push Congress to ensure the Administration allocates the money it already has, as well as making good on the new pledge. The pledge has the potential to save millions of lives while advancing the goal of defeating AIDS, TB, and malaria — so long as the U.S. keeps its promises.