Canada has pledged just over $1 billion over three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria, reaffirming its commitment to combating infectious diseases in the world’s poorest countries. The announcement came Friday at the G20 summit in Johannesburg, South Africa, though it represents a reduction from Canada’s previous contribution.

A Longstanding Partnership

Prime Minister Mark Carney’s personal representative at the G20 summit, Cindy Termorshuizen, made the announcement in Johannesburg ahead of Carney’s arrival at the summit. The commitment underscores Canada’s continued support for the multilateral health partnership, which it has backed since the Global Fund’s inception in 2002.

The new contribution is $190 million lower than Canada’s last contribution to the Global Fund, announced in 2022. That $1.21 billion contribution over three years represented a 30 per cent increase in Canada’s contribution at the time. The latest pledge, scheduled to run from 2027 until 2029, reflects the challenging fiscal environment facing many donor nations.

The Global Fund’s Life-Saving Work

The Global Fund represents one of the most successful public health partnerships in modern history. Over two decades of progress, the partnership has helped reduce the combined death rate from AIDS, tuberculosis and malaria by 63%. Since the Global Fund’s inception in 2002, 70 million lives have been saved through its programs.

The organization’s work encompasses multiple dimensions of disease control. The Global Fund helps fight diseases such as AIDS, tuberculosis and malaria, and its programs distribute mosquito nets to protect populations from malaria and provide medication and treatments to people living with HIV and tuberculosis.

Recent results demonstrate the scale and impact of these interventions. In 2024, 25.6 million people were on antiretroviral therapy for HIV, 7.4 million people with tuberculosis were treated, and 162 million insecticide-treated mosquito nets were distributed. These achievements represent record levels across multiple indicators.

Progress Against Three Deadly Diseases

The Global Fund’s impact on each of the three diseases has been substantial. For HIV, 88% of people living with HIV in Global Fund-supported countries knew their status, 79% were on antiretroviral therapy and 74% had a suppressed viral load in 2024 – the highest levels ever recorded for each indicator. Use of pre-exposure prophylaxis (PrEP) for HIV prevention surged, with 1.4 million people receiving PrEP in 2024 – a 325% increase from 2023.

On tuberculosis, working with governments, the private sector, health workers, civil society and communities, the Global Fund partnership reduced TB deaths by 40% between 2002 and 2023. Without these interventions, TB deaths would have been dramatically higher.

For malaria, the distribution of insecticide-treated nets has been a cornerstone strategy, protecting vulnerable populations across endemic regions. However, rising conflict, extreme weather events, and increasing resistance to antimalarial drugs and insecticides present ongoing challenges.

Strengthening Health Systems

Beyond direct disease interventions, the Global Fund invests heavily in building resilient health infrastructure. In 2024, a $2.7 billion investment was made to strengthen health and community systems, representing the largest such investment in the organization’s history.

In 2024, the Global Fund invested $2.7 billion in health systems and disease surveillance in more than 100 countries to help detect, track and contain new outbreaks, making the Global Fund the largest provider of external grants for reinforcing pandemic preparedness and response.

These systems-strengthening investments have benefits that extend beyond the three focal diseases, improving countries’ capacity to respond to other health challenges and building long-term sustainability.

A Critical Moment for Global Health Funding

Canada’s announcement comes amid concerns about declining international support for global health. Doctors Without Borders issued a notice that the Global Fund is in danger of not hitting its $25 billion CAD target to fund the next three years, noting it’s possible this fundraising cycle will fall billions of dollars below the last fundraising target of $21 billion CAD.

Tess Hewett, a Doctors Without Borders health policy adviser, stated: “We are seeing major traditional donors signalling deep cuts, even as the need for sustained investment grows. When funding falls short, it is the patients — those least able to afford care — who pay the price”.

Both Germany and the United Kingdom have also reduced their contributions. The United States, typically the fund’s largest donor, has not announced a contribution. The U.S. has historically been the Global Fund’s largest single donor, having provided approximately $26 billion between 2001 and 2024.

The Road Ahead

The eighth replenishment summit, being held alongside the G20 summit in Johannesburg, represents a pivotal moment for the Global Fund’s future. The organization estimates that adequate funding could save up to 23 million lives over the next funding cycle.

Canada’s announcement followed meetings between Prime Minister Carney and leaders in the United Arab Emirates, which concluded with a promise of $70 billion in investments in Canadian businesses. This diplomatic context highlights how international health commitments are often intertwined with broader economic and foreign policy objectives.

As the Global Fund enters a critical fundraising period, the question remains whether the international community will provide sufficient resources to maintain momentum against three diseases that continue to kill millions each year. The gap between the fundraising target and committed pledges suggests difficult conversations lie ahead about priorities, burden-sharing, and the long-term sustainability of global health financing.

Canada’s contribution, while reduced from previous levels, represents a continued commitment to multilateral health cooperation. However, the overall funding picture reveals the vulnerability of global health initiatives to competing priorities and fiscal pressures facing donor nations worldwide.