On Friday, Johannesburg will become the nerve centre of a world confronted by old epidemics and new uncertainties. Leaders from every region—presidents, prime ministers, ministers of finance, heads of multilateral agencies, global health advocates and private sector champions—will converge on South Africa’s commercial capital for the Global Fund’s 8th Replenishment Summit, a meeting that many believe may determine whether the world marches forward or slips backward in the fight against AIDS, tuberculosis (TB) and malaria.
The timing of the summit could not be more symbolic. It will unfold alongside the G20 Leaders Summit, creating a two-tier stage where economic and health decisions mingle, overlap and ultimately shape the contours of development for the next decade. The meeting will be jointly led by South Africa’s President Cyril Ramaphosa and UK Prime Minister Sir Keir Starmer—two leaders standing at opposite ends of the global health landscape, but united by a shared understanding: the world is running out of time to sustain progress against these epidemics.
The Global Fund, established in 2002, has been one of humanity’s most successful collective responses to disease. Its investments have saved more than 59 million lives, strengthened fragile health systems, and ensured that millions of people receive life-saving medicines and preventive care. But the ground has shifted. Progress is no longer guaranteed. In several regions, it is slowing, stalling, or reversing. HIV infections among young women remain distressingly high; TB, especially its drug-resistant strains, has resurged in many countries; malaria is spreading to new geographies as climate patterns change. The world, despite its scientific advances, is again vulnerable.
This is what gives Friday’s summit its urgency. According to Global Health Strategies (GHS), which released a statement ahead of the meeting, the replenishment offers “a major opportunity to mobilise fresh donor support” to keep these epidemics from reclaiming lives and livelihoods at devastating scale. And it will require boldness—not symbolic gestures, but concrete financial commitments from donor governments, the private sector, philanthropies, and implementing countries. South Africa and the UK have deliberately set the tone for this replenishment by anchoring it on five guiding principles: solidarity, sustainability, innovation, equity and reform. But these principles are more than thematic flourishes. Each captures a pressure point in the global health architecture.
Solidarity matters because pandemics and epidemics are borderless. Sustainability matters because global health gains collapse when domestic investments dry up. Innovation is critical in an era when mosquitoes develop insecticide resistance and TB bacteria outsmart older drugs. Equity is essential because diseases thrive in pockets of poverty, conflict and exclusion. And reform is necessary because global health financing itself must adapt to a world that is growing more complex and less predictable.
This replenishment also carries symbolic force because of where it is being held. South Africa’s role as co-host is deeply significant. The country has lived through the worst of the HIV pandemic and emerged as a champion of community-driven, treatment-focused programmes that transformed global thinking about HIV care. It knows what it means to fight—and win—against epidemics. The United Kingdom, on the other hand, is one of the Global Fund’s earliest and most consistent donors. A summit led jointly by these two nations sends a message: the fight against AIDS, TB and malaria is strongest when north and south act in concert.
Beyond the pledges, one of the centrepieces of the Johannesburg summit will be a renewed focus on building resilient and sustainable health systems. COVID-19 exposed the fragility of even the best-prepared countries, and in low- and middle-income nations the cracks were even deeper. The Global Fund has since become one of the most influential financiers of pandemic preparedness, supporting laboratory networks, supply chains, data systems, community health workers, oxygen capacity and disease surveillance. Discussions in Johannesburg are expected to emphasise that without stronger health systems, gains against AIDS, TB and malaria cannot be sustained. The future—marked by climate shifts, migration, conflict, antimicrobial resistance and unpredictable outbreaks—demands health systems that can withstand shocks and deliver care even under strain.
For Nigeria, a country whose health profile makes it one of the Global Fund’s highest-impact investment landscapes, the summit is far from an abstract diplomatic exercise. Nigeria carries the highest HIV burden in West Africa, one of the world’s largest TB caseloads and a malaria burden that strains households, health facilities and the national economy. For millions of Nigerians, Global Fund support translates directly to access to antiretroviral therapy, bed nets, diagnostics, preventive medicines, community outreach, supply chain support and strengthened health facilities. The outcomes of Friday’s summit will shape Nigeria’s disease response for years to come.
In the lead-up to the replenishment, the Global Fund and its partners have rallied around a resonant message: #StopAtNothing. It is a call to action grounded in the recognition that epidemics do not pause because the world is distracted by geopolitics or fiscal tightening. AIDS, TB and malaria remain relentless. Without sustained attention and sustained financing, they will reclaim ground the world spent two decades fighting to regain. Johannesburg will bring together ministers of finance who must weigh competing budget demands; civil society organisations whose community networks keep programmes alive; researchers pushing new tools to outpace evolving pathogens; philanthropic institutions and private sector actors exploring innovative financing models; and implementing countries seeking to deepen domestic ownership. The replenishment is not merely about money—it is about collective alignment, shared responsibility and political will. The world has witnessed what happens when health emergencies collide with unprepared systems: preventable deaths, economic collapses, social disruptions and widening inequality. The 8th Replenishment is an attempt to learn from those lessons—to invest now rather than pay far more later.
