In a significant development for global health, two of the world's leading organisations, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Gavi vaccine alliance, are in discussions to merge some operational functions. This strategic move aims to combat a severe financing crunch.
A Response to Aid Budget Pull-Backs
While discussions about more efficient collaboration have been ongoing for several years, a substantial pullback on government-funded aid budgets, notably initiated by the Trump administration, has lent a new urgency to these talks. Peter Sands, CEO of the Global Fund, articulated the gravity of the situation, saying the crisis is an “impetus to think hard about the shape and structure of the global health ecosystem.”
A Working Group Takes Shape
Last autumn, Gavi and the Global Fund established a dedicated working group to explore deeper collaboration and potential function mergers. This previously unreported initiative also includes the World Bank’s Global Financing Facility for women and girls. Sania Nishtar, CEO of Gavi, emphasised that the goal isn't to combine the entire structures of these colossal organisations but rather "to work better at the country level”.
Streamlining Aid Delivery
Speaking during the World Health Organisation's annual meeting in Geneva, where budget cuts and efficiencies were prominent on the agenda, Nishtar provided a tangible example of the potential benefits. In Nigeria, Gavi assists local health officials with measles and rubella vaccines for children, while the Global Fund supports providing bed nets to their parents to prevent malaria. Historically, these groups might have operated with separate desks, supply chains, data, staff, logistics, guidelines, and even warehouses. This duplication, Nishtar highlighted, can and should be improved.
The collaboration has also been spurred by the joint effort to roll out the malaria vaccine, led by Gavi, alongside other malaria tools such as preventive drugs, which the Global Fund manages.
The Financial Landscape and Donor Demands
Both organisations are currently in critical fundraising periods. The Global Fund seeks to raise $18 billion for its work from 2027 to 2029, while Gavi aims for $9 billion for 2026 to 2030. Donors, who have played a crucial role in enabling these groups to save millions of lives since their inception in the early 2000s, are actively pushing for greater efficiencies as they consider their pledges.
In response to these pressures, a Gavi spokesperson confirmed initiating a voluntary departure scheme among its 650 staff and consultants, alongside efforts to streamline operations. With approximately 1,200 staff, the Global Fund declined to comment on potential staff reductions.
Prominent figures like Bill Gates, a significant global health funder through his foundation, have been actively engaging with governments to underscore the indispensable role played by these two organisations.