Germany commits €1B to Global Fund as aid cuts shape World Health Summit

Even as this year’s World Health Summit opened Sunday with a focus on reimagining the global health architecture, some health leaders emphasized the devastation caused by the dramatic aid cuts over the past months. “We’re seeing that aid tumbling very fast and that suddenness is costing lives,” said UNAIDS Executive Director Winnie Byanyima during one session. “Aid needs to stay there to keep as a scaffolding, as a transition.” Against that backdrop, the announcement by Germany’s minister for economic cooperation and development, Reem Alabali Radovan, that the country would commit €1 billion over the next three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria was met with relief. Though this is a €300 million cut from Germany’s 2022 commitment, Lisa Ditlmann, ONE’s Germany director, said the minister “is sending an important signal with her commitment — also to other donor countries, some of which are making drastic cuts in development cooperation.” The Global Fund is looking to raise $18 billion for its funding cycle between 2026 and 2028. Its major replenishment summit is scheduled for next month in South Africa. But Peter Sands, the fund’s executive director, welcomed Germany’s early pledge. “Germany’s latest commitment sends a powerful signal of global solidarity and sets a strong foundation,” he said. The pledge came at the end of a day of discussions, though, built around a recognition that solidarity is fraying. Indeed, the theme of this year’s WHS is: “Taking Responsibility for Health in a Fragmenting World.” With bilateral and multilateral aid on the decline, much of the first day’s focus was on what model the world should be transitioning to to preserve the gains in life expectancy earned over the past decades. Leaders from Africa and other parts of the global south were eager to lead those discussions. “We are talking about a number of components,” said Dr. Jean Kaseya, who heads the Africa Centres for Disease Control and Prevention. “Financing, local production, data sovereignty. We are saying Africa is ready. We don’t want to be invited. We are a cocreator.” This is in keeping with the Accra Reset, which emerged out of an August meeting convened in Ghana’s capital to chart a new path toward financing health systems. Continental leaders committed to national ownership of health system priorities and more equitable cooperation. "The Accra Reset’s basic tenet is that Africa and all partners are equal co-authors, co-creating solutions on the ground to reimagine a new global health architecture centered on sovereignty and solidarity,” Lee Abdelfadil, who is a member of the technical subcommittee that is coordinating the Accra Reset, told Devex. That vision spread beyond both Africa and health to development more broadly during a meeting on the sidelines of the U.N. General Assembly in September. And the Accra Reset and, particularly, its focus on sovereignty, are looking to build momentum in Berlin this week. “This is a great forum for advancing the Accra Reset agenda, debating it, finding solutions, and recruiting enthusiastic individuals to the cause,” Abdelfadil said. “We need to think it through and all be comfortable with where we are going together.” Even as European leaders at the conference lined up behind this vision, they also expressed interest in supporting tools that might help make health care more affordable and farther reaching. That included evangelizing for artificial intelligence. “Under fiscal pressure, there is also opportunity,” said Neils Annen, the BMZ state secretary. AI could help health systems “work more efficiently and make the most of limited resources.” Kaseya and others cautioned, though, that the advent of AI would need to come with new regulatory frameworks, security measures, and infrastructure to ensure that it didn’t create further divides in who has access to services.