The Global Fund in the era of SDGs: time to rethink?

In the context of stagnating development assistance for health, the sixth Replenishment Conference of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, held on Oct 9–10, 2019, in Lyon, France, was a success. Pledges from donors for the next 3 years reached the minimum US$14 billion target that was needed to contribute to saving 16 million additional lives. Yet, although there have been positive synergies between vertical programmes for each of the three pandemics, as well as between those programmes and other components of health-care systems, the effective contribution of the Global Fund towards strengthening health-care systems has remained low. Only in a few exceptional cases (namely Rwanda and Ethiopia) has the Global Fund directly contributed to improvements in financing the pathway towards universal health coverage.