Policy Updates

On November 27, 2025, Australia announced AUD48 million (US$32 million) to support Pacific Island countries in managing increasing HIV infections through technical assistance, disease surveillance, and co-investment in national public health responses.

Minister for Foreign Affairs Penny Wong, Minister for Pacific Island Affairs Pat Conroy, and Minister for International Development Anne Aly jointly announced the program ahead of World AIDS Day on December 1. The officials stated that rising rates of HIV and co-infections like tuberculosis are placing increased pressure on Pacific health systems, societies, and economies, and they reaffirmed Australia's support to ending the global AIDS epidemic by 2030.

The funding will assist Pacific governments to contain the spread of HIV by sharing Australian knowledge and expertise and investing in community-led responses. The announcement complemented broader and longstanding Australian support to strengthen national health systems in the region and beyond.

The program will focus on partnering with Pacific countries to reduce HIV transmission and support people living with HIV. Australia has committed to co-investing with Pacific partners to strengthen nationally led HIV responses and advance resilient health systems capable of responding effectively to HIV.

On November 25, 2025, the US State Department approved a grant of up to US$150 million over three years to Zipline International Inc., an American robotics and autonomous drone delivery company, to expand healthcare operations in Rwanda, Ghana, Nigeria, Kenya, and Côte d'Ivoire, potentially reaching 15,000 health facilities and providing 100 million people with access to blood and medications.

The grant marked one of the first major US global health funding announcements since the Trump administration's foreign assistance freeze, dismantling of USAID, and release of its 'America First' global health strategy. US Undersecretary of State for Foreign Assistance, Humanitarian Affairs, and Religious Freedom Jeremy Lewin characterized the partnership as an example of innovative, results-driven partnership at the core of the America First foreign assistance agenda.

The funding was structured on a pay-for-performance basis, with initial payments unlocked when participating governments signed contracts committing to pay for ongoing logistics services. The five governments committed to pay up to US$400 million in utilization fees. Rwanda, where Zipline began operations in 2016, is expected to be the first to sign.

On November 21, 2025, the US pledged US$4.6 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria for 2026-2029 at the 8^th Replenishment pledging event in Johannesburg, South Africa.

The Global Fund reached US$11.3 billion of its US$18 billion target, with the US maintaining its matching pledge ratio requiring the Global Fund to secure US$2 from other donors for every US$1 contributed.

The pledge represented a modest decline from the US$6 billion the US committed in the previous funding cycle. Undersecretary of State for Foreign Assistance, Humanitarian Affairs and Religious Freedom Jeremy Lewin announced the pledge in a video message, noting the reduction was to account for needed reforms and efficiencies. Lewin praised Executive Director Peter Sands' leadership and the organization's track record, stating the Global Fund would play a role in America's new vision for global health engagement.

The pledge came amid uncertainty about whether the US would contribute at all, following the Trump administration's dismantling of the country's foreign assistance infrastructure and withdrawal from many multilateral commitments.

On November 21, 2025The Global Fund held its Eighth Replenishment Summit, in Johannesburg, South Africa, co-hosted by the governments of South Africa and the UK on the margins of the G20 Leaders' Summit, securing US$11.3 billion in pledges to sustain the fight against AIDS, tuberculosis, and malaria.

Partners from more than 30 countries pledged support to save lives and strengthen systems for health, marking the first replenishment held on African soil. The summit demonstrated global solidarity despite fiscal tightening, conflict, and global uncertainty, though total pledges fell short of the ambitious target set in the Investment Case and several donors had yet to confirm their pledges.

The US, the Global Fund's largest donor, committed US$4.6 billion. The UK pledged GBP850 million (US$1.1 billion), while Germany confirmed EUR1 billion (US$1.2 billion) and Canada pledged CAD1.02 billion (US$723 million). France noted that its support remained unchanged. Spain increased its pledge to EUR145 million (US$167 million), Italy pledged EUR150 million (US$173 million), the Netherlands contributed EUR146 million (US$169 million), and additional pledges came from many other donors. South Africa committed US$37 million, including US$10 million from the private sector. African countries made solidarity commitments totaling US$52 million. G20 member states reached US$9 billion in commitments.

Within the private sector, the Gates Foundation pledged US$912 million, the Children's Investment Fund Foundation pledged US$135 million, and (RED) committed US$75 million. Overall, private sector support reached US$1.3 billion.

The UK pledged GBP850 million (US$1.1 billion) to the Global Fund on November 11, 2025, ahead of the 8^th replenishment summit on November 21, 2025, representing a 15% reduction from the UK's previous GBP1 billion (US$1.3 billion) pledge in 2022.

The UK will co-host the Global Fund's 8^th replenishment summit with South Africa on November 21, 2025. The pledge marked the first time in Global Fund history that a host country reduced its contribution.

Chair of the International Development Committee Sarah Champion expressed disappointment with the GBP150 million (US$197 million) reduction. Champion stated that reducing the UK's commitment was short-sighted and risked undermining the UK's reputation as a global health leader. Champion noted that cuts of this scale would have real impact and result in avoidable harm, urging ministers to take seriously the commitments the UK makes to vulnerable populations.

On October 13, 2025, following the declaration of a national HIV emergency in PNG in June 2025, the Australian government announced it would nearly triple its annual HIV development funding to the country to almost AUD10 million (US$6 million) for the 2025/2026 financial year.

The announcement was made by Assistant Minister for Pacific Island Affairs Nita Green during a visit to the newly renovated St Therese HIV clinic in Port Moresby. The increased funding will focus on prevention through awareness campaigns, increased testing, and expanded access to prevention measures. The support will also fund youth-led education programs and tailored services for women and girls, who are disproportionately affected by the virus.

Minister for Foreign Affairs Penny Wong stated that the support reflects the close partnership between the two countries and the need to work together to safeguard the region. The new funding complements Australia’s ongoing support for regional partners like UNAIDS, Health Equity Matters, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Minister for Pacific Island Affairs Pat Conroy and Green reiterated Australia's commitment to working with PNG to improve health outcomes and respond to the HIV situation with urgency.

On October 12, 2025, at the World Health Summit in Berlin, Germany Development Minister Reem Alabali-Radovan announced a pledge of EUR1 billion (US$1.2 billion) to the Global Fund.

Alabali-Radovan stated that the pledge demonstrates Germany's continued engagement in global health protection despite domestic budget constraints.

The contribution is part of to the Global Fund’s current replenishment round, which began in February 2025 and will conclude at the G20 summit in South Africa in late November 2025. Since its establishment in 2002, the Fund has saved an estimated 70 million lives.

Germany's pledge includes EUR100 million (US$117 million) in the form of Debt to Health Swaps, which are subject to budgetary approval.

Dutch Minister for Foreign Trade and Development Aukje De Vries informed Parliament on October 7, 2025, that the Netherlands would reduce global health funding from EUR448 million (US$522 million) in 2025 to EUR384 million (US$447 million) in 2026, cutting EUR31 million (US$36 million) annually in core contributions to multilateral health organizations while maintaining funding to WHO.

De Vries explained in a letter that total core contributions to six multilateral health organizations would decrease to EUR142 million (US$165 million) in 2026. The EUR31 million (US$36 million) annual reduction would be divided equally among UNFPA, UNAIDS, the Global Financing Facility, Gavi, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Core contributions to WHO remained at current levels to safeguard its coordinating role amid declining donor funding.

The letter fulfilled a commitment made by Minister of Foreign Affairs David van Weel to Member of Parliament Danielle Hirsch to explain effects of cuts on SRHR policy. De Vries stated that the government could not calculate specific effects on SRHR because services are integrated into broad basic health care, but noted that long-term commitments to UNFPA Supplies for contraception availability and the International Planned Parenthood Federation, which provides SRHR services in over 145 countries, would not be affected.

On September 25^th, 2025, during UNGA80 in New York, the Government of Norway committed NOK55 million (US$5.5 million) to the UNFPA Supplies Partnership for 2025, to expand access to contraceptives and maternal health supplies in 54 countries.

The new funding is intended to help avert an estimated 378,000 unintended pregnancies, more than 1,000 maternal deaths, and more than 6,000 child deaths. Norwegian Minister of International Development Åsmund Grøver Aukrust stated that Norway is committed to protecting sexual and reproductive rights and ensuring access to vital health services as a prerequisite for sustainable development.

The investment will leverage the UNFPA Supplies Partnership’s Match Fund, which encourages countries to increase their own spending on reproductive health. This has led to a fivefold increase in domestic spending on contraceptives since 2020.

On September 18, 2025, the US Department of State, under the leadership of Secretary of State Marco Rubio, released its America First Global Health Strategy, a comprehensive plan to align US global health programs with American national interests, security, and prosperity.

While the plan reaffirms commitment to goals for HIV/AIDS, malaria, and TB, the strategy marks a significant pivot from previous administrations, failing to mention previous administration and historically bipartisan priorities, including maternal and child health, routine immunizations, nutrition, and family planning. The document frames global health as a tool to counter Chinese influence, particularly in Africa.

The strategy is built on three pillars:

• "Making America safer" by improving disease surveillance and outbreak response;
• "Making America stronger" by shifting to bilateral agreements with partner countries; and
• "Making America more prosperous" by protecting the US economy from pandemics and promoting American health products.

The plan outlines a move away from NGO-led program delivery toward direct, multi-year bilateral agreements with recipient governments. The agreements will require co-investment from partner countries and will be tied to performance benchmarks. The US administration aims to finalize the deals with the 87 countries that received US health funding in FY2023 by the end of 2025, which is a timeline seen as highly challenging by global health experts, particularly in light of severe cuts to government global health staff.

The strategy justifies the shift by targeting “inefficient and wasteful” spending, asserting that 60% of current funding goes to overhead and program management rather than frontline services.

Critics raised concerns that the new model poses significant challenges, highlighting that a purely bilateral approach is seen as insufficient to tackle transnational threats, which require the broad, multilateral cooperation offered by institutions like the WHO. Another point of concern highlighted by health experts is the reduced funding for program management and technical assistance, which could weaken the detailed data collection and reporting that have historically allowed for close congressional oversight.