Cuts and disruptions in international health funding are beginning to reverse progress against HIV, tuberculosis and malaria, with prevention programmes scaled back, tuberculosis services disrupted and malaria campaigns delayed, the Global Fund said on Wednesday.
The warning comes as countries face increasing pressure to maintain essential health services amid declining external financing, conflict, displacement and growing humanitarian needs.
The Global Fund’s 2026 Results Report shows that despite these pressures, countries and communities continued to protect key services in 2025.
Some 26.9 million people were receiving antiretroviral treatment for HIV in Global Fund-supported countries, up from 25.6 million in 2024. About 7.4 million people received tuberculosis treatment, while 196 million insecticide-treated mosquito nets were distributed, compared with 162 million in 2024.
Since 2002, the Global Fund partnership says it has helped save 72 million lives.
But the report also highlights areas where progress is being lost.
HIV prevention services were among the hardest hit. The number of people receiving pre-exposure prophylaxis, or PrEP, in countries where the Global Fund invests fell from 1.4 million in 2024 to 1.1 million in 2025.
Treatment coverage remained more stable. In 2025, 87% of people living with HIV in Global Fund-supported countries knew their status, 80% were receiving antiretroviral therapy and 74% had achieved viral suppression.
Tuberculosis programmes also experienced disruptions to case finding, diagnosis and treatment.
In 2025, 7.4 million people were treated for TB in Global Fund-supported countries, including 115,000 people with drug-resistant TB. Globally, an estimated 10.7 million people developed TB in 2024 and more than 1.2 million died.
Malaria programmes faced a combination of funding shortages, conflict, climate change and growing insecticide resistance.
The Global Fund supported the distribution of 196 million insecticide-treated mosquito nets in 2025. Yet malaria killed an estimated 610,000 people globally in 2024.
The report says the greatest burden is concentrated in some of the world’s most difficult settings. Fragile and conflict-affected countries account for about 63% of global malaria cases, while countries experiencing acute or prolonged crises account for about a quarter of global TB cases.
The Global Fund is investing US$5.3 billion between 2024 and 2026 in challenging operating environments, representing 38% of its total investments.
It is also putting more money into health systems, with approximately US$5.9 billion being invested in health and community systems during the same period. This is a 43% increase from the previous grant cycle and the largest such investment in the organisation’s history.
The money supports laboratories, disease surveillance, medical oxygen, supply chains, community health workers and primary healthcare.
The importance of these investments is being demonstrated by the ongoing Ebola outbreak in the Democratic Republic of Congo.
The Global Fund has mobilised US$6.4 million from existing grants and approved another US$4.6 million in emergency funding to support Ebola surveillance, laboratory diagnosis, contact tracing, case management and infection prevention and control.
At the same time, the report points to new technologies that could help countries achieve more with limited resources.
Lenacapavir, a long-acting HIV prevention tool, was first delivered to Global Fund-supported early-adopter countries at the end of 2025, with wider scale-up in 2026. AI-enabled digital X-rays are being introduced in more than 20 countries to support TB detection.
For malaria, dual active-ingredient insecticide-treated mosquito nets are being scaled up. In areas affected by insecticide resistance, the nets have the potential to reduce malaria cases by up to 45% compared with standard nets.
Peter Sands, executive director of the Global Fund, said the 2025 results demonstrated what countries could achieve when they lead their health responses while partners adapt to their priorities.
The report comes at a time when countries are being encouraged to take greater responsibility for financing their health systems.
The Global Fund says its next phase will place greater emphasis on domestic co-financing, resource mobilisation, integration of health programmes into national systems and the sustainability of community health systems.
For countries that have relied heavily on external financing to fight HIV, TB and malaria, the developments underline the challenge of maintaining gains as international funding comes under pressure.
The Global Fund said sustained international investment would remain important even as countries increase domestic financing and move towards greater self-reliance.
