Presented by Organisation of African First Ladies for Development
Every global health conference I’ve been to this year has had sessions on innovative financing — no surprise given the U.S. funding cuts and anticipated declines in global health ODA overall.
But most of these ideas aren’t entirely new. Many have been borrowed from other sectors, are simply retooled versions of existing mechanisms, or reflect funding models that parts of the global health ecosystem have been using for years.
Take the United Nations Population Fund’s Match Fund, which provides $2 worth of commodities for every $1 a country spends on reproductive health products. I first wrote about the fund back in 2023, but Emma Foster, policy adviser for the agency’s Supplies Partnership’s technical division, tells me much has changed since then.
Governments have put in an extra $33 million of their own money through the matching model — and some are going well beyond what they originally pledged. Take Madagascar: Despite being a low-income country, it spent more than $9 million on contraceptives in 2024 alone. So even with a 21% budget cut looming for UNFPA’s Supplies Partnership program in 2026, the agency says it plans to channel a portion of its remaining resources into scaling up this model.
The Match Fund’s early success has sparked interest in adapting the model for other priorities. With support from the Gates Foundation, UNFPA and UNICEF rolled out the Maternal, Newborn and Child Health Accelerator pilot in early 2025. It follows the same basic principles — verifying orders upfront and ensuring product quality — but introduces some changes. It uses a 1:1 match. So if a government buys $100 of oxytocin, for example, UNFPA can match that by purchasing $100 worth of heat-stable carbetocin, another key drug for preventing postpartum hemorrhage.
The pilot wraps up at the end of this year. After that, UNFPA and its partners will dig into the data to see whether it actually boosted domestic spending — and whether it helped countries procure more quality-assured maternal and newborn health commodities.
Read: How UNFPA’s Match Fund spurs additional domestic funding (Pro)
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Matching funds like UNFPA’s are just one example of the kinds of financing tools the global health sector is looking to as it braces for continued donor cutbacks.
Another is the collaborative fund model used by The END Fund — the organization working to eliminate the most common neglected tropical diseases. Since 2012, it has pooled private capital from individuals, corporations, foundations, activist-philanthropists, and institutions, and then channeled that money to governments, nonprofits, and community groups. The fund works with them to cocreate grants, as my colleague Sara Jerving reports.
Tapping private capital has its advantages — it gives organizations more speed, agility, and flexibility, helping them respond faster to crises and jump on new opportunities. And the collaborative model aligns with growing calls for external funders to work more closely with government priorities and cut down on duplication.
The END Fund is also moving into cofinancing. In Oromia, Ethiopia’s most populous region, it now has a two-year agreement with the government in which both sides put in $1 million a year to tackle intestinal worms and trachoma.
Read: The END Fund — a collaborative fund approach to health integration (Pro)
Last week, we wrote about the opportunities to expand access to popular weight loss drugs in 2026 as patents for semaglutide — the main ingredient behind Ozempic and Wegovy — expire in places such as China and India.
A few days later, the World Health Organization issued recommendations stating these drugs may be used by adults for the long-term treatment of obesity.
The new guidance comes at a critical moment. Obesity has become a serious public health issue affecting more than 1 billion people globally, and it was associated with 3.7 million deaths in 2024 — a number that WHO projects will double by 2030.
However, WHO also warned that these weight loss drugs are “projected to reach fewer than 10% of those who could benefit by 2030,” even with the anticipated rapid production expansion of these medicines.
Read: WHO issues recommendations for weight-loss drugs to treat obesity
ICYMI: Ozempic generics are coming. But will low-income countries benefit?
As we further unpack the U.S. government’s “America First” global health strategy, a clear theme is emerging: Many African experts and organizations say this marks a sharp departure from previous U.S. approaches.
In her latest piece, Sara talked to leaders of African faith-based organizations — several of whom were invited by the State Department to weigh in on the bilateral health negotiations underway with their governments.
That’s not especially surprising — the “America First” global health strategy explicitly says it wants to work more closely with faith-based groups. And the leaders Sara spoke with see this engagement as a positive shift. They’re glad to be at the table, and they say it’s encouraging to have their role and capacity to deliver services formally recognized.
“In the past, maybe more of the focus was on how NGOs, or faith-based NGOs, get a carved out piece of funding, or how do they compete with others to be able to qualify to get funding?” said Doug Fountain, executive director at Christian Connections for International Health. “The emphasis has changed to how do we deliver on American ideas and strategies by working with local organizations?”
But big questions remain — including how, exactly, funding will reach faith-based groups once these negotiations wrap up.
“Calling people to the table for meetings to give their views doesn’t mean substantial engagement, and doesn’t mean resources trickling down to the people that are actually doing 30% to 70% of health care,” Nkatha Njeru, CEO of the Africa Christian Health Associations Platform, told Sara.
Read: State Dept taps African faith groups for bilateral health deal consults
+ Catch up on our reporting on The future of global health — a new series which explores the consequences of cuts to foreign aid and the search for a new path forward.
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There’s a lot of buzz right now around lenacapavir — the twice-yearly HIV prevention shot that many hope could be a game changer. But as experts keep reminding us, ending the HIV crisis will require a mix of interventions, not just one breakthrough product.
That mix is under real strain. UNAIDS’ latest report shows that this year’s funding cuts hit HIV prevention services the hardest, with steep drops in the number of people receiving pre-exposure prophylaxis, or PrEP, and male condoms in countries such as Burundi and Nigeria. Voluntary medical male circumcision — which can reduce a man’s risk of acquiring HIV from a female partner by about 60% — also took a major hit, falling 65% in Uganda and up to 88% in Botswana.
My colleague Andrew Green reports on the role U.S. funding cuts played in the sharp declines we’re now seeing in Botswana.
The President’s Emergency Plan for AIDS Relief, or PEPFAR, had been providing about $55 million a year to support the country’s HIV response — money that helped sustain local organizations such as the African Comprehensive HIV/AIDS Partnerships, which delivers HIV testing and treatment directly to people’s homes and works to convince men to undergo circumcision as a protective measure.
But that funding was interrupted early in the year when the Trump administration froze all U.S. foreign aid. By August, many organizations receiving PEPFAR support were issued termination notices. The administration has since cut funding for most of Botswana’s HIV prevention and community-based programs, keeping support only for services targeting pregnant or breastfeeding women.
Circumcision services are still free in government clinics, but without the community mobilizers who used to encourage men to come forward, the intervention has lost one of the key drivers of its success.
And the stakes are high. UNAIDS warns that if HIV prevention services continue to falter, the world could see an additional 3.9 million new infections over the next five years.
Read: US retreat stalls Botswana’s HIV prevention outreach
ICYMI: HIV prevention services hit hardest by funding cuts, UNAIDS warns
+ This reporting is part of The Aid Report, Devex’s new editorial and data project tracking how U.S. foreign aid cuts are reshaping programs and services on the ground. This editorially independent project is funded by the Gates Foundation. If your organization has data or examples of how programs and people are being affected by the U.S. foreign aid cuts, please email editor Kelli Rogers at kelli.rogers@devex.com. You can also reach Kelli securely on Signal or fill out this short survey.
282 million
—That’s the number of new malaria cases recorded in 2024 — about 9 million more than the 273 million reported in 2023.
The rise was driven in large part by increases in several countries — including Ethiopia, Madagascar, and Yemen — according to WHO’s latest World Malaria Report, released today.
WHO officials point to a mix of factors behind the surge: growing drug and insecticide resistance, conflict, climate change and extreme weather, and chronic underfunding. And with donor budgets tightening, they warn the situation could easily worsen.
“We can't predict what will happen as such. But the point is, if there is no good coverage in terms of preventive tools [and] treatment, it means that the actual situation might be worse,” Dr. Daniel Ngamije, WHO director for malaria and NTDs, said during a press briefing ahead of the report’s launch.
The Ebola outbreak that began in September in the Democratic Republic of Congo has now been declared over by WHO and national health officials. [Reuters]
Despite the U.S. announcement that it plans to withdraw from the U.N. health agency, WHO chief Tedros Adhanom Ghebreyesus says he’s been in regular communication with the U.S. health secretary, Robert F. Kennedy Jr. [Bloomberg]
The CDC panel in charge of U.S. vaccine recommendations will discuss and vote on whether to delay the administration of the hepatitis B vaccine to newborns shortly after birth. [U.S. News]