“Being realistic does not mean being defeatist.”Peter Sands
Executive Director of the Global Fund
These words from Peter Sands, Executive Director of the Global Fund, echoed powerfully across the room as we gathered in Geneva from May 7 to 9, 2025, for what many of us fear may be the most pivotal, and possibly final, board meeting for communities this year.
It was our second time attending a Global Fund Board Meeting as members of the Communities Delegation (Priscilla) and the Developing Country NGO Delegation (Faith). And it was, by far, the heaviest. Emotional. Intense. Alarming. There were no polished smiles or empty optimism when we walked out.
We came together, not just to speak, but to stand—to uphold a promise that the Global Fund has carried for over two decades: to put communities at the centre.
This isn’t just a slogan. It’s been a commitment that people most affected by HIV, TB, and malaria would not just receive services, but shape them. It means that community voices matter in funding, policy, and protection.
But lately, that promise feels fragile.
The crisis we didn’t want to see coming
Over the past few months, we’ve seen attacks on health systems from left to right. Just as we’ve started to rebuild from the COVID-19 pandemic, we're now seeing funding cuts that threaten to unravel years, if not decades, of progress.
The Global Fund, which has saved over 65 million lives and supports programs in more than 120 countries, is facing significant financial strain. And as always, the first to feel the impact aren’t policymakers. It’s not high-level consultants or fancy offices that get slashed. It’s community services.
It's HIV testing in rural villages. It’s peer-led support groups for adolescent girls. It’s access to condoms, TB diagnostics, and malaria nets. It’s real people. Real needs.
In the lead-up to the board meeting, the Secretariat issued reprioritisation letters to Country Coordinating Mechanisms (CCMs) and Principal Recipients (PR), urging them to slow spending on what they termed “non-essential” services.
But for many countries, the interpretation was devastating. The message—whether intended or not—resulted in the termination of vital community services, including community-led monitoring and youth peer support.
We’re not being dramatic when we say: this could cost lives.
“We are here to keep the promise of a world where preventable diseases, or the place of birth, does not decide one's fate,”Bience Gawanas
Vice-Chair of the Board
[From left: Trilaterals with Communities, Developing and Developed Country NGOs, and Communities Delegation having lunch]
Reprioritisation: The technical and the tangible
Reprioritisation is being positioned as a “mathematical formula” designed to proportionately reduce unspent and uncommitted funds under Grant Cycle 7 (GC7). The idea is to preserve life-saving services across HIV, TB, and malaria, and to prioritise those most disproportionately affected.
But who decides what’s life-saving? Who defines what’s “non-essential”? And where are young people in these conversations?
At the Board Meeting, our delegations jointly called for the protection of community systems and human rights in every step of the reprioritisation process; full participation of communities in CCMs, including civil society and youth, and transparency in defining essential services, with a commitment to equity at the core.
Because here’s the truth: when budgets get slashed, it’s community interventions that get sacrificed first. If communities were truly central, why are we the first to be cut and the last to be heard?
But more importantly, this moment demands more than participation from young people as it requires bold leadership. Youth-led and youth-serving programs have long been the backbone of community responses, yet they’re often the first to be cut. As countries begin the grant reprioritisation process, young people must step forward to help define which services should be preserved and engage with PR’s and CCMs to ensure that our needs are not sidelined.
This is what we’re up against. Real lives. Real people. We simply cannot feel fatigued. We’ve come too far to let this be the end of the road. At the board meeting, delegates from communities and developing countries didn’t mince words. They reminded the room and the world that without stable funding, the Global Fund will be forced to scale back life-saving interventions or worse, become a procurement organisation.
A call to action to young people: Be proactive, stay connected
As countries move forward with grant reprioritisation, young people have a vital role to play. We know the programs that make a difference in our lives, whether it’s access to HIV testing, peer support, or safe spaces for young key populations. That’s why we must engage meaningfully in discussions at national and community levels, particularly within CCMs and with PR’s.
This can feel overwhelming, but no one has to navigate it alone. There are youth-led networks, civil society groups, and partners who are ready to collaborate and share tools for advocacy. By staying informed, connected, and proactive, we can help protect the services that matter most and ensure that young people are not left behind in this new phase of funding decisions.
The Global Fund is aiming to raise USD 18 billion in its 8th Replenishment, but not all donors are convinced. They're calling it "donor fatigue." But let’s be clear: this isn’t just about dollars. This is about lives.
It’s the pregnant girl who walks miles to a clinic only to find it closed. It’s about the young man forced to stop treatment because his meds ran out. The queer teen criminalised out of reach of services: the mosquito net that never arrived and the child who never woke up.
This isn’t fatigue. This is abandonment. And we won’t let donor fatigue become an excuse for lost lives. The 8th Replenishment isn’t just a financial ask; it’s a test of global will, equity, and humanity. We must all choose: retreat from our commitments, or recommit with courage.