Post-55th Board Meeting Statement
The brief compiles the positions and reflections shared by the Developed Country NGO Delegation and does not represent the views held by the Global Fund Secretariat or the Global Fund Board as a whole.
Overview
The Developed Country NGO Delegation attended the 55th Global Fund (GF) Board meeting from 8-10 July, 2026 in Geneva, Switzerland. The following Decision Points and papers were discussed at the meeting. The official Board decisions can be accessed by following this link. In addition to participating in the Board meeting, our Delegation submitted a statement in advance for consideration by all Board constituencies and the Secretariat, met with various constituencies, including the Implementers’ Group meeting, and different divisions of the Secretariat. Our Board Member (BM) and Alternate Board Member (ABM) also participated in a Board Retreat on 6-7 July, 2026.
The key discussions on the Board agenda included consideration of an updated procurement policy and a new pre-financing procurement mechanism for countries that cannot purchase health products upfront; updates to the Risk Appetite Framework; next steps in considering proposed changes to the Evaluation function at the Global Fund; various reports including by the Office of the Inspector General; and preparations for a decision on the 2027 operating budget at the 56th Board meeting. A brief update from the Executive Director Nomination Committee and an overview of the next steps in the selection process were presented. The Global Fund’s role in an evolving global health ecosystem, GF governance effectiveness, and general strategy considerations as we approach the end period of the current GF strategy were among the overarching themes during the week’s discussions.
Our Delegation attended the Board meeting with goals to i) learn more about the trends surfacing from the first tranche of funding requests in Grant Cycle 8 (GC8)’s Window 1; ii) advocate for more detailed planning and support for countries transitioning from Global Fund funding in the next few years in GC8 and GC9; iii) ensure that Community, Rights and Gender related programs are prominent and integrated into Global Fund grant-making and sufficiently budgeted for within operating expenses to meet Board approved and established performance indicators; and iv) encourage that co-financing requirements, as part of countries’ funding agreements, are moved to grants’ second and third year to give more time for countries to put essential HIV, TB and Malaria (HTM) service delivery onto national budgets.
Grant Cycle 8 Early Observations
Our Delegation approved strategic shifts for GC8 at the previous 54th Board meeting, which focus on strengths that sustain grant financing in resource limited settings, catalyze scientific innovations, and set grant cycle-specific transition pathways for countries. We emphasized that the GF’s strong governance model has been instrumental to its successful track record when compared to other global health initiatives (GHIs). We recognize difficult trade-off decisions must be made during a period of diminished funding, yet we will not accept reduced governance roles in the name of operational or governance “efficiencies”.
Implementing CSOs support service integration, country ownership, and value for money. However, these objectives should not be pursued at the expense of service continuity, civil society leadership, human rights programming, strong governance, community accountability, or realistic implementation capacity.
In our constituency statement prior to the meeting and during our interventions at the table, we shared early observations from Window 1 GC8 funding requests, based on our Delegation members’ and their implementing partners’ experiences. More consolidated implementation arrangements, greater integration of programs across disease components and RSSH, fewer Principal Recipients (PRs), and stronger alignment with government-led systems – irrespective of preferences articulated by CCMs or the country governments – are among the trends we’ve seen and raised during the meeting. We are increasingly worried that civil society and community-led implementers are pushed into narrower delivery or subcontracting roles, which reduces their influence in program design, resource allocation, performance management, and accountability. This is a real risk for key population programming, community-led monitoring (CLM) and demand generation activities for new innovations (e.g., lenacapavir, TB near-point-of-care molecular testing, etc.). Furthermore, human rights, gender and community systems appear in grant narratives but remain underfunded, weakly operationalized, or exposed to reprogramming efforts later.
We also noted that shared costs are no longer treated as a separate budget line or as a general overhead allocation. Essential functions, such as office management, human resources, finance, and procurement, may no longer be recoverable unless they can be clearly linked to direct grant implementation. For country offices and civil society partners, this creates a potential financial cliff as smaller local organizations may have less flexibility to absorb unrecoverable costs and less capacity to manage more complex documentation requirements.
Looking at the accelerated timelines and the importance of having managed transitions, we called on the Secretariat to formulate detailed plans, guidance, and support for the countries transitioning away from GF grants – more transitions than have occurred in the GF’s history. The Technical Review Panel (TRP) is essential and must be included in the strategic planning and guidance. We also encouraged additional exploration in the areas that the Secretariat views as rising risks in the gaps in technical capacity emerging from the resource constraints and closure of organizations.
OPEX Considerations
Community systems strengthening (CSS) were repeatedly referenced as essential to sustainability, equity, transition and impact but the mitigation plans and risk framework did not give CSS the same level of visibility, protection or operational visibility as biomedical commodities and market-shaping themes. We noted at the Board table and in our side meetings, that in a constrained and/or lower OPEX environment, the risk is that CSS becomes everyone’s stated priority but not an operationally protected function.
We asked for and received clarification from the Secretariat that the proposal to finance Country Coordinating Mechanism (CCM) costs through its Asset and Liability Management (ALM) is a change in funding source rather than a reduction in support. This item will be discussed and decided upon this Fall. (The ALM is the financial framework used to balance the GF’s Sources of Funds [donor pledges] against its Uses of Funds [grant disbursements and operating costs] over the duration of an allocation period). This move would be a fundamental change in how CCMs are budgeted for and funded, and we asked for clarity on how the technical assistance supporting CCM effectiveness would be financed under this new approach. We also requested additional reassurance regarding the long-term resilience of this approach, particularly considering foreign exchange uncertainty.
Risk Appetite Framework Decision Point
Our Delegation approved the updated Risk Appetite Framework Decision Point but raised a few questions about how the taxonomy for Program Risk would be reported on, noting the expansive thematic scope within the Risk Appetite statement. We also raised concerns that the Board is asked to own more of the trade-offs and accept lower levels of assurance in lower priority areas – presented as a structural shift that appears to accept a higher and more constant level of risk as opposed to a mitigation approach to risk that could conceivably be considered temporary.
We suggested elevating the transition risks, which require more urgency, attention, and actionable steps taken across GC8 grant-making to mitigate – given how rapidly accelerated the transition timelines are – similar points were made by other constituencies. We inquired about policies around contingency planning when stockout risks occur, and about public financial management (PFM) and country readiness to fully shift programs ‘onto national budgets’ within the selected countries and across the GF portfolio.
And noting how several Board documents referenced the use of AI technology to improve efficiencies, we asked for an update on the GF’s AI security framework, and how this would be considered within the Risk Appetite Framework.
Non-Global Fund Financed Procurement Mechanism (NGFPM) Decision Point
Our Delegation approved the Non-Global Fund Financed Procurement Mechanism (NGFPM) Decision Point and the friendly amendment, which directed the Secretariat to return to the Strategy Committee in October 2026 to further articulate safeguards within the operational framework to achieve value-for-money, protect against market distortions and supplier concentration, support oversight and reporting on the the policy’s implementation, and for the Strategy Committee to provide input on addressing the associated risks. We viewed the potential, inter-operability, and strengths for regional collaboration and supported the overall direction of travel, in that the new policy responds thoughtfully to a changing global environment. We noted with appreciation the distinction between the upstream role of other actors, such as Unitaid on innovation, and the downstream lead role of the GF. Through our interventions, we also emphasized that the procurement mechanism must guarantee affordable access to quality-assured health products. Our Delegation remains conscious of the risk of the fight against AIDS, TB and Malaria becoming overly focused on commodities, at the expense of the community work and programs that actually ensure lifesaving products reach people. While we approved this Decision Point, we emphasized that success would need to continue to be measured not simply by procurement volumes, healthy markets, and country choice and ownership, but also by equitable access and the health outcomes that are achieved through them.
We welcomed and raised a procurement paper shared by the Communities Delegation ahead of the Board meeting, as well as the additional guardrails that had been incorporated into the policy since Strategy Committee discussions and the friendly amendment.
And finally, we – along with other constituencies – supported the suggestion from the Private Foundations and Private Sector Delegations to establish a right-sized market-shaping working group (with oversight in the Strategy and Audit and Finance Committees) to address the increasing responsibilities conferred on the GF, as it becomes a larger actor in this space. We shared concerns with other constituencies about the function of supply forecasting across the market-shaping ecosystem and worries about the possibilities of more failed tenders, therefore leading to supply disruptions and stock-outs. In this way, the GF’s role to work more intentionally and collaboratively with the right partners, institutions, and civil society to ensure supply could be an area of focus for such a working group.
The OIG is preparing a review in 18-24 months on the approved Non-Global Fund Financing Procurement Mechanism.
Governance Effectiveness
Our Delegation supported making governance more focused, more strategic and better aligned with where the Board adds the greatest value, while distinguishing between making governance more effective and the assumption that making the governance workload lighter makes it more effective.
Governance effectiveness should be determined by whether governance continues to strengthen the Partnership, improve decision-making, and maintain confidence among countries, communities, donors, and partners. Simplifying governance should ensure we are removing process rather than participation. We should preserve the diversity of voices that makes our decisions stronger and ensure we are responding agilely and effectively in these unprecedented times.
During our interventions that were significantly shortened due to time constraints, we amplified the Youth Council statement calling for strengthened youth representation across the governance structure, and we encouraged Board constituencies to examine our own delegation rules and approaches to find fit-for-purpose ways to ensure diverse youth perspectives continue to inform GF priorities. We also noted general support for potentially streamlining legacy issues or agenda items that no longer need to take up so much space or time in our governance agendas, but that such consideration of reprioritizing governance-facing agenda items and/or reporting should itself be an open and transparent process that involves the right level of governance oversight. Moreover, we emphasized equity of access – that is, enabling equity that lifts participation and representation up rather than pushes down. When planning for the 55th Board meeting, there had been mixed communications around reducing delegation sizes, and our Delegation alongside Developing Country NGO and Communities Delegations voiced concerns to the Board Leadership and Coordinating Group about how all these decisions were made, communicated, and attributed prior to the Board meeting. Meaningful inclusion may have costs but if we are sincere about the value of the Partnership and the multi-stakeholder model, then our approach to equity and cost must be significantly more nuanced than a balance sheet.
Throughout the week, we provided a few specific suggestions for improving governance effectiveness at Board meetings:
- Highlight the big themes and discussions around the main Decision Points up for Board approval in a clear and consistent way.
- Delink other items from the main Board meeting agenda items, which could be discussed in different types of sessions.
- Encourage other formats and inter-sessional Board touch points and a strong Board / Committee work plan to help our constituencies focus.
- Consider different approaches to presenting information in the Board documents and how we share our positions in the constituency statements. Set up the Board documents / presentations to better encourage dialogue and deliberation, rather than formal statements.
- Establish Board-initiated and Board-led sessions (with only minimal Secretariat-enabling support) where we can have designated space to discuss Board matters and responsibilities among ourselves.
We expect these conversations to continue over the coming months and, in general, our position has been and will likely remain that governance should provide the framework that helps us navigate changes in the global health landscape, while preserving the principles that have underpinned the Global Fund’s success. If some part of the governance is broken or not working as efficiently as it could, we have to ask if it should be fixed or replaced – but that conversation should be deliberate, transparent, and inclusive.
Executive Director Nomination Committee Update
The Executive Director Nomination Committee (EDNC), with representation among the Board constituencies and membership approved by the Board, oversees the selection of the next Global Fund Executive Director. Following the review of applications, shortlisting candidates, and holding interviews, the EDNC will present a shortlist of 4-5 candidates to the Board. BMs and ABMs are expected to meet the shortlisted candidates at a Board retreat on 1-2 October, 2026. There is a 3.5 week period for constituency engagement, which includes structured calls for Board constituencies to engage with each shortlisted candidate. The next Executive Director will be appointed at the 56th Board meeting, held on 28-30 October, 2026, and expected to start in Q1 2027.
The new Board Leadership, Erna Solberg and Javier Hourcade Bellocq, will start their three-year term once the ED has been appointed at the next Board meeting.
Global Health Ecosystem including Gavi Update
The changing global health ecosystem and the Global Fund’s role within it were prevalent themes and discussions during the Board retreat, at the Board meeting, and at a pre-Board day panel. Our Alternate Board Member spoke about the civil society perspectives on global health ecosystem reform, as part of her separate work with the Health Architecture Reimagined Civil Society organizations (HEAR-CSO) group.
We welcomed the clear recognition in the Board paper that no single institution can address today’s health challenges alone, we noted appreciation for how it was framed as an ongoing discussion rather than a final blueprint. It has been our Delegation’s position that greater collaboration, clearer roles, and stronger alignment across GHIs will all be important as countries face increasing financial pressures and more complex health needs.
The Board paper provided and sought input from Board constituencies on three interlinked pathways for considering the Global Fund’s role, positioning, and evolution and solicited advice and strategic guidance on the relative importance of each. The pathways proposed were:
- Pathway 1: Evolving to better deliver our mission
- Pathway 2: Delivering synergies with other partners
- Pathway 3: Contributing to system-wide transformations
Regarding the three proposed pathways, we considered all approaches to be important, but to mainly focus on the first two – the GF’s own evolutions and specific synergies with partners like Gavi. The GF should contribute to system-wide transformation through Pathway 3, but our Delegation does not think the investment of time and energy in this area should outstrip the other two pathways.
We noted that relevant to Pathways 1 and 2, most CSOs are less concerned with whether institutions or boards merge, but whether reforms and transformations shift power, trust, and enable and sustain effective implementation. We highlighted that reforms to drive practical partnerships need to ensure that communities and CSOs are engaged as co-designers, co-implementers, and meaningfully involved to achieve the objectives of the ecosystem reform conversations.
The Board paper also shared updates on several years of practical collaborations to reduce duplications already underway with Gavi. In particular, on the proposed partnership with Gavi in joint TB work, we endorsed this area as deserving time and expertise. We noted important nuances in the paper around the other prevention tools that are needed alongside a TB vaccine; the novelty of a vaccine cannot come at the expense of other proven prevention strategies and noted this is especially important given the poor, off-track performance of the prevention KPI in the Strategic Performance Report. While many TB high-burden countries are facing – or have already begun – transitions from both Gavi and GF, we noted how important getting this relationship with Gavi on TB right is at this moment of integration and transition, which is featured so heavily in GC8 and GC9. The relationship with Gavi on TB is the right focus and a test of what is feasible in other areas and collaborations with other institutions.
Evaluation and Learning Function
Our Delegation generally supported but had some reservations about the proposed approach in the Board paper for a new evidence and learning model aimed at generating more rapid, relevant, and cost-effective evidence and learnings. We agree with other constituencies that the new approach should sync with the governance calendar and help inform Board decisions. In our input, we emphasized the continued valuable role of the TRP, such as in rapid reviews.
We appreciated that the presentation recognized that balance between independence and institutional insight will vary depending on the evaluation / learning work product’s purpose, audience, and potential impact on future programming decisions. The new model would need to ensure that general accountability is built in because, despite the best efforts, it is often difficult to truly take into account internal conflicts and biases. We urged the consideration of a decision-making structure that includes input from outside the Secretariat when external validation of a decision regarding independence, conflict, or bias would provide valuable assurances.
To note, most of the evaluation and learning functions at the Secretariat over the years have been separate but complementary to the OIG’s work. And while the new model is still being decided, our Delegation is pleased to see that the OIG is working on a strategic review on transition right now.
About the Developed Country NGO Delegation
The Developed Country NGO Delegation is one of twenty voting Delegations to the Global Fund Board. It plays a critical role in the development and evolution of organizational strategy, the funding model, the work of the Secretariat and policy. Delegation members are representatives of civil society organizations based in countries not eligible for the Global Fund grants. For more details on the Delegation, please visit our website, www.developedngo.org and on the Global Fund, please visit www.theglobalfund.org
For more information, please contact the Developed Country NGO Delegation at: developedcountryngo@gmail.com.
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