Every chapter in history contains a moment that tests humanity’s collective resolve; a time when the world must decide whether to look inward or act together for the common good.
In an era defined by global interdependence, where the effects of political decisions and climate change transcend borders, our future depends on how well we unite to avert crises and safeguard both lives and livelihoods.
The eighth replenishment summit of the Global Fund to Fight Aids, Tuberculosis and Malaria is one of these pivotal moments. Since its establishment in 2002 the fund has been one of the most powerful expressions of multilateralism in action, having saved 70-million lives and halving global deaths from HIV/Aids, tuberculosis and malaria.
Behind these numbers are real people — HIV-positive mothers whose children were born healthy thanks to antiretroviral therapy, children who sleep safely under mosquito nets, and families no longer devastated by tuberculosis.
Yet progress is not inevitable. In recent years the world has faced compounding crises that continue to test the resilience of our health systems. Funding for health and development has come under intense scrutiny, trust in public health institutions is waning, and the rise of nationalism and protectionism have strained the spirit of collective responsibility that once underpinned global health and co-operation.
These pressures threaten to reverse hard-won gains and push us farther away from attaining the global goals to end Aids, TB and malaria by 2030. With so much at stake, now is not the time to retreat into our national or political cocoons. Instead, we must double down on efforts to deepen our service to humanity.
This is especially critical at a time when widening inequality and a crippling debt crisis have left millions facing food insecurity and struggling to access affordable health care, while many low- to middle-income nations are forced to spend more repaying loans than investing in education or health.
According to the Global Inequality Report about 3.4-billion people around the world live in countries that spend more on repaying debt than on education or health, exposing them to preventable diseases and poverty.
We cannot afford to stop
The convergence of the Global Fund replenishment and the G20 meetings in SA has been an opportunity to put health at the centre of the global agenda. That this gathering has taken place on African soil is especially significant given the continent’s extraordinary resilience in the face of widespread funding cuts for essential health programmes.
This has been a decisive moment; an opportunity to reinforce our commitment to invest in stronger, more equitable health systems by putting our money where it matters — in institutions and causes whose impact goes beyond fighting disease to strengthening the foundation for inclusive and sustainable country-led development.
Global Fund investments are deliberately designed to align with and advance national health plans, unlocking domestic capacities and complementing domestic resource investments to support countries on their pathways to self-reliance. Across the continent, African countries are demonstrating what national ownership and partnership can achieve.
In 2023 the number of people receiving antiretroviral therapy in SA reached more than 5.8-million. Today the country has one of the world’s largest HIV treatment programmes, with over 6,1-million on this life-saving treatment. The UK, for its part, has long been a leading global health champion, a founding donor to the Global Fund and a steadfast advocate for partnership, innovation, transparency and accountability.
Together, our two nations have deepened co-operation for decades, from groundbreaking HIV research and access to medicines, to joint work in strengthening laboratories, surveillance, and public health infrastructure.
In SA and across the world the Global Fund supports laboratories, data systems, health workers and community networks that form the backbone of resilient health systems. For every cent invested the return in lives saved, productivity gained and economies developed is extraordinary and meaningful.
By cohosting this replenishment we have sent a clear message to the world: global health is a shared responsibility and the Global Fund remains one of the most effective investments in global health. As the challenges we face evolve, replenishing the Global Fund is not just an act of generosity; it is an act of strategic foresight and a powerful reaffirmation of the power of multilateralism in action.
It reminds us that global health security cannot be achieved in isolation, but only through the collective resolve of nations working together toward a common purpose. By investing now, we not only strengthen our defences against future pandemics, but also safeguard development gains across education, gender equality and economic growth.
History will judge us not by the scale of our pledges, but by our resolve to do what’s right. Imploring governments to sustain and increase their contributions is therefore more than a call for money; it is a call for sustained momentum to finish what we started. We cannot stop at almost.
And so we invite every partner, nation, and citizen of the world to join us in this effort. The Global Fund has given the world a blueprint for what is possible when we act together. We owe it to ourselves to build on that legacy.
• Dr Motsoaledi is SA health minister, and Phillipson is British high commissioner to SA.
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