US Investment in Global Programs

The Global Fund was established in 2002 to support preventing and treating HIV, Tuberculosis (TB), and malaria. The program brings together government, civil society, health workers, and the private sector to end these epidemics by procuring medication, strengthening health systems and helping countries take the fight into their own hands. Since the program began, it has saved 70 million lives and reduced the combined death rate from AIDS, TB, and Malaria by 63%.

This map shows the Global Fund’s return on investment to US businesses. Specifically, it details the amount of money made by US companies, by congressional district, as a result of Global Fund investments.

Below we answer questions about the Global Fund and explain how this program provides a return on investment for US businesses.

Who pays for the Global Fund? How much does the US contribute?

The Global Fund receives around 94% of its funding from donor governments, and 6% from the private sector. More than 80 countries – and the European Union – have made or pledged resources to the Global Fund, including a number of African countries. The Global Fund raises funds through three-year commitments, or “replenishments.” Throughout 2025, the Global Fund is raising money for its 8th replenishment, with the goal of raising $18 billion from all donors for the three years. A fully funded Global Fund would save another 23 million lives and prevent 400 million infections between 2027 and 2029.

The US helped establish the Global Fund in 2002. Thanks to a provision enacted by Congress, every one dollar invested by the US has had to be matched by two dollars from all other donors. If other donors don’t step up, the US will reduce its contribution proportionally, so American taxpayers never have to bail out other countries for failing to deliver. For the last replenishment cycle in 2022, the US pledged $6 billion to the Global Fund. However, Congress has long been the leading voice for US investment in the Global Fund, and the contribution is subject to appropriations. In FY 2023, Congress appropriated $2 billion to the Global Fund, followed by $1.65 billion in both FY 2024 and FY 2025.

How does the Global Fund support US global health programs abroad, such as PEPFAR and PMI?

US investments in the Global Fund improve the efficiency of US bilateral programs (with which it closely coordinates to avoid duplication) including the President’s Emergency Plan for HIV/AIDS Relief (PEPFAR), the President’s Malaria Initiative (PMI), and US efforts to address TB around the world. The Global Fund accelerates the work of those programs by bringing in additional donor funding, making medications and other health products more affordable and accessible, and filling in gaps where US programs don’t operate, such as conflict zones like Ukraine, Sudan and Haiti.

At every level of governance, policymaking, and program implementation, there is close collaboration between the Global Fund and the bilateral US health programs. The US has a permanent seat on the Global Fund’s board, provides technical advice to the Global Fund, contributes to program design at the country level, and coordinates implementation on the ground.

How is the Global Fund different from other global health programs like PEPFAR and PMI?

Though the Global Fund and the US bilateral programs share a similar goal of ending the HIV, TB, and malaria epidemics, they use different – but complementary – models to achieve this. PEPFAR and PMI implement their programs through US Government agencies like USAID, CDC, and DOD to support testing, prevention, and care/treatment programs. In many cases, these programs work directly with partner governments to strengthen their responses to these epidemics.

The Global Fund is a financing mechanism that mobilizes global donor commitments – both public and private – to maximize the funding and value-for-money for HIV, TB and malaria programs. Its distinguishing features are the scale of its investment capacity and the breadth of its funding sources. It provides 28% of international financing for HIV programs, 76% of all financing for tuberculosis programs and 62% of all financing for malaria programs. That scale allows it to leverage its buying power to make medical commodities more affordable, ensuring U.S. taxpayer dollars are used efficiently and increasing the accessibility of products globally. Unlike PEPFAR and PMI, it has no staff on the ground; rather it funds networks of local health experts, community groups and national health ministries to tackle diseases in a far greater number of countries.

The Global Fund focuses on financing prevention and treatment resources. For HIV, it provides medications to mothers living with HIV to keep them alive and prevent transmission to their babies, in addition to testing for vulnerable populations. For TB, the Global Fund provides treatment for drug-resistant TB, and supports additional services for TB patients living with HIV. For malaria, the Global Fund provides testing services, distributes mosquito nets, supports spraying anti-mosquito insecticides, and provides both seasonal malaria chemoprevention to children and preventive therapy for pregnant women.

Where does the Global Fund work?

The Global Fund works in more than 120 low- and lower- middle income countries. 30% of these countries are considered challenging operating environments, which include conflict zones and otherwise unstable or fragile states. Countries that receive Global Fund resources are required to meet certain eligibility requirements – this ensures resources are being distributed to places where need is greatest, and where local governments are committed to promoting impact. These programs are designed and implemented by local actors (including government agencies, civil society and faith-based organizations), maximizing efficiency and effectiveness and requiring no in-country Global Fund staff. The Global Fund also requires countries to co-invest themselves in these programs and to take progressively more responsibility for funding and managing their own health systems.

How does the Global Fund support US industry?

The Global Fund procures extensively from US companies—at least $3.5 billion in the last fifteen years. These include game-changing American innovations including advanced mosquito nets treated with insecticides that also reduce the fertility of any mosquito that survives. The Global Fund works directly with manufacturers to bring new technologies to market while using its buying power to get the best possible prices.

By reducing the burden of the deadliest diseases, the Global Fund helps open access to emerging markets for US firms. Every $1 invested by the private sector in the fight against these diseases results in $19 in health gains and economic returns globally.