GFO Issue 462, Article Number: 4
ABSTRACT
This article summarizes the key points from the Risk Management Report and the Chief Risk Officer's Annual Opinion, which were discussed during the 53rd Board meeting of the Global Fund, held from May 7 to 9, 2025, in Geneva, along with feedback from stakeholders.
The Global Fund stands at a pivotal juncture, facing an external environment marked by unprecedented volatility, disruption, and complexity. The latest Risk Management Report and the Chief Risk Officer's Annual Opinion, as well as robust discussions among Board members, Secretariat, and partners, reveal a consensus: the risk landscape is fundamentally shifting, and the organization must adapt rapidly to sustain its mission and impact. This article synthesizes the key findings, concerns and strategic priorities from the deliberations that appear to have emerged from the Global Fund's 53rd Board meeting on 7-9 May 2025, providing an overview of how the Global Fund is responding and preparing for this new era of risk.
A risk landscape heightened by multidimensional instability
The Global Fund’s risk profile is now driven largely by external factors that are both acute and unpredictable. Geopolitical instability, economic shocks, climate-related disasters, and the evolving global health architecture are converging to create a highly dynamic operating context (Figure 1). Board members and Secretariat leaders alike emphasized that these external disruptions are not only increasing in frequency and severity but are also interacting in ways that amplify their impact on program delivery, financing, and partnership models.
Key external risks include:
- Geopolitical conflicts and economic volatility: These have direct consequences for funding flows, program implementation, and supply chains, leading to delays, increased costs, and operational uncertainty.
- Global health financing uncertainty: Funding gaps threaten the sustainability of essential HIV, TB, and malaria programs, with the risk of reversing hard-won gains.
- Climate change and environmental shocks: These exacerbate disease burdens and disrupt health system resilience.
- Evolving global health partnerships: Shifts in the architecture of global health require the Fund to adapt its collaborative models, ensuring resilience even when traditional partners face their own crises.
These factors significantly increase the inherent risk, exposing the Fund to greater risks. One passage in the report makes this very clear:
“At the end of 2024, the Organization’s risk profile continues to show a high level of risk, with 10 out of 22 rated as High or Very High, and 14 showing an increasing direction of travel (compared to 12 in Q3 2024). Notably, there are two key changes to residual risks for Q4- 2024: the Program Quality - Malaria risk has escalated to Very High, meanwhile, the Grant- Related Fraud & Fiduciary risk reached the residual risk of Moderate aligned with the Board adjusted risk appetite timelines of December 2024.”
In fact, while the organization had previously seen risk levels generally declining, the current context is one of rising risks and diminishing resources to manage them.The report particularly emphasizes that in the face of growing uncertainty, inertia itself constitutes a major risk; the Global Fund must remain agile and responsive, capable of anticipating and swiftly addressing emerging threats.
Figure 1: Organizational risk profile as of Q4 2024
Source: Global Fund
In fact, while the organization had previously seen risk levels generally declining, the current context is one of rising risks and diminishing resources to manage them.
While the Global Fund has made substantial progress against HIV, tuberculosis, and malaria over the past two decades, the report clearly warns of threats to these achievements. Reduced resource availability could reverse gains, intensifying challenges such as increasing drug resistance, limited access to diagnostics and treatments, and systemic barriers linked to human rights and gender inequalities.
The report particularly emphasizes that in the face of growing uncertainty; inertia itself constitutes a major risk. The Global Fund must remain agile and responsive, capable of anticipating and swiftly addressing emerging threats.
Strengthening risk culture and systems
Adapting to this new risk environment requires not only external vigilance but also internal transformation. The Secretariat’s forward-looking analysis outlined several priorities:
- Promoting a risk-aware culture: Systematic training and capacity-building are being scaled up for Secretariat teams, implementers, and Local Fund Agents (LFAs) to ensure early detection of emerging risks and informed decision-making.
- Enhancing risk analytics: The development and deployment of advanced risk analysis tools, including an Integrated Risk Management module, are supporting more rigorous, data-driven decisions.
- Streamlining processes and controls: Simplification and prioritization of operational processes are being pursued to maximize the impact of limited resources, without compromising essential controls or the gains made in risk management maturity.
The Secretariat also acknowledged the need for continuous review and recalibration of risk management frameworks, ensuring they remain relevant and responsive to fast-changing realities.
A central theme in Board and committee discussions was the balance between risk-taking and risk mitigation. The Global Fund’s risk appetite framework, approved by the Board, guides the organization in making explicit trade-offs between fiduciary risks and programmatic impact. However, several key risks-particularly those related to program quality for TB and malaria, and in-country supply chains-remain above target levels and are unlikely to reach moderate risk soon.
Board members and stakeholders raised critical questions:
- Are we catching the right signals early enough to inform timely action?
- Is the current balance between risk-taking and risk mitigation optimal for achieving impact?
- Should the risk appetite be recalibrated considering new realities, especially in conflict zones or fragile contexts where some risks may have to be accepted to maintain life-saving interventions?
The Secretariat signaled plans to review risk management documents and frameworks, inviting input from Board members and constituencies to ensure that risk considerations remain central to all decisions.
In fact, three major priorities clearly emerge from the report for 2025:
- Proactive adaptation of country risk management frameworks, to effectively address emerging threats.
- Revision of the risk appetite framework, ensuring its relevance and alignment with the current context.
- Strengthening the assurance model, better targeting controls on the most critical risks.
More broadly, the success of the Global Fund is closely linked to its partnerships with governments, international technical agencies and, above all, local communities. Effective risk management is increasingly dependent on the leadership and engagement of in-country actors-Principal Recipients, Sub-Recipients, Country Coordinating Mechanisms, and communities. The Global Fund is investing in:
- Real-time risk monitoring and early warning systems: Community-led monitoring is being integrated into formal risk assessments, providing early signals on programmatic issues and enabling rapid response.
- Support for sustainable transitions and domestic financing: Accelerated transitions must be carefully managed to avoid service disruptions, especially for vulnerable populations. Practical tools, such as financing data platforms that translate donor costs into national costs, are being deployed to support countries in planning for sustainability.
- Flexibility in grant implementation: In contexts where standard financial and procurement systems are not feasible, the Fund is exploring more flexible arrangements that balance accountability with operational realities.
Stakeholders emphasized that investments in prevention, community systems, and human rights-based programming must be treated as non-negotiable elements of risk mitigation, even in times of constrained funding.
The Audit and Finance Committee, along with other Board committees, stressed the need for:
- Clearer guidance and updated risk frameworks to navigate the shifting landscape.
- Enhanced scenario planning and workforce management to address funding and operational uncertainties.
- Prioritization and simplification: Recognizing that attempting to address every risk may dilute impact, the Fund must focus on its comparative advantages and ensure that essential services are protected, even amid funding cuts and program reprioritization.
Partners and Stakeholders called for the explicit incorporation of civic space and equity considerations into risk frameworks, and for continued transparency and accountability in all risk management processes.
Conclusion: Trade-offs and resource allocation
A recurring concern among Board members was the challenge of making difficult trade-offs in resource allocation. With multiple risks trending upwards and limited ability to initiate new funding in the short term, the organization is operating above its Board-approved risk appetite in several areas. This reality necessitates explicit, evidence-based trade-offs, particularly between programmatic priorities and fiduciary controls.
For example, in high-burden, conflict-affected regions, the Fund may have to accept higher fiduciary risks to ensure continued delivery of life-saving interventions. Similarly, the need to streamline processes and reduce administrative burdens must be balanced against the imperative to maintain robust oversight and accountability.
In fact, the consensus across the partnership is clear: the Global Fund must continue to adapt, innovate, and collaborate to navigate this volatile environment. Key priorities for the coming years include:
- Continuous monitoring and recalibration of risk management approaches: Ensuring that frameworks and tools remain fit for purpose and responsive to emerging threats.
- Making explicit, evidence-based trade-offs: Prioritizing interventions that offer the greatest impact, while safeguarding the needs of the most vulnerable.
- Strengthening partnerships with governments, donors, and civil society: To ensure sustainable progress and avoid reversal of hard-won gains.
- Investing in workforce and capacity: Sustaining critical capacities within the Secretariat and among partners is essential for delivering on the Fund’s mission.
All in all, the Global Fund’s ability to deliver on its mission in this new era of risk will depend on its agility, resilience, and commitment to prioritizing the most impactful interventions. As the risk environment evolves, too must the organization’s approaches to risk management, partnership, and resource allocation. The coming years will test the partnership’s capacity to adapt, but they also offer opportunities to strengthen systems, reinforce the foundation for future success, and ensure that the Global Fund remains a vital force in the fight against HIV, TB, and malaria.
The organization must build upon its past successes while remaining willing to revisit its models and practices to stay relevant and effective in a profoundly changing global environment. It is a clear call to action for the Board and all Global Fund partners, ensuring that the fight against HIV, tuberculosis, and malaria maintains its vital momentum.
The Global Fund stands at a pivotal juncture, facing an external environment marked by unprecedented volatility, disruption, and complexity. The latest Risk Management Report and the Chief Risk Officer's Annual Opinion, as well as robust discussions among Board members, Secretariat, and partners, reveal a consensus: the risk landscape is fundamentally shifting, and the organization must adapt rapidly to sustain its mission and impact. This article synthesizes the key findings, concerns and strategic priorities from the deliberations that appear to have emerged from the Global Fund's 53rd Board meeting on 7-9 May 2025, providing an overview of how the Global Fund is responding and preparing for this new era of risk.
A risk landscape heightened by multidimensional instability
The Global Fund’s risk profile is now driven largely by external factors that are both acute and unpredictable. Geopolitical instability, economic shocks, climate-related disasters, and the evolving global health architecture are converging to create a highly dynamic operating context (Figure 1). Board members and Secretariat leaders alike emphasized that these external disruptions are not only increasing in frequency and severity but are also interacting in ways that amplify their impact on program delivery, financing, and partnership models.
Key external risks include:
- Geopolitical conflicts and economic volatility: These have direct consequences for funding flows, program implementation, and supply chains, leading to delays, increased costs, and operational uncertainty.
- Global health financing uncertainty: Funding gaps threaten the sustainability of essential HIV, TB, and malaria programs, with the risk of reversing hard-won gains.
- Climate change and environmental shocks: These exacerbate disease burdens and disrupt health system resilience.
- Evolving global health partnerships: Shifts in the architecture of global health require the Fund to adapt its collaborative models, ensuring resilience even when traditional partners face their own crises.
These factors significantly increase the inherent risk, exposing the Fund to greater risks. One passage in the report makes this very clear:
“At the end of 2024, the Organization’s risk profile continues to show a high level of risk, with 10 out of 22 rated as High or Very High, and 14 showing an increasing direction of travel (compared to 12 in Q3 2024). Notably, there are two key changes to residual risks for Q4- 2024: the Program Quality - Malaria risk has escalated to Very High, meanwhile, the Grant- Related Fraud & Fiduciary risk reached the residual risk of Moderate aligned with the Board adjusted risk appetite timelines of December 2024.”
In fact, while the organization had previously seen risk levels generally declining, the current context is one of rising risks and diminishing resources to manage them.The report particularly emphasizes that in the face of growing uncertainty, inertia itself constitutes a major risk; the Global Fund must remain agile and responsive, capable of anticipating and swiftly addressing emerging threats.
Figure 1: Organizational risk profile as of Q4 2024
Source: Global Fund
In fact, while the organization had previously seen risk levels generally declining, the current context is one of rising risks and diminishing resources to manage them.
While the Global Fund has made substantial progress against HIV, tuberculosis, and malaria over the past two decades, the report clearly warns of threats to these achievements. Reduced resource availability could reverse gains, intensifying challenges such as increasing drug resistance, limited access to diagnostics and treatments, and systemic barriers linked to human rights and gender inequalities.
The report particularly emphasizes that in the face of growing uncertainty; inertia itself constitutes a major risk. The Global Fund must remain agile and responsive, capable of anticipating and swiftly addressing emerging threats.
Strengthening risk culture and systems
Adapting to this new risk environment requires not only external vigilance but also internal transformation. The Secretariat’s forward-looking analysis outlined several priorities:
- Promoting a risk-aware culture: Systematic training and capacity-building are being scaled up for Secretariat teams, implementers, and Local Fund Agents (LFAs) to ensure early detection of emerging risks and informed decision-making.
- Enhancing risk analytics: The development and deployment of advanced risk analysis tools, including an Integrated Risk Management module, are supporting more rigorous, data-driven decisions.
- Streamlining processes and controls: Simplification and prioritization of operational processes are being pursued to maximize the impact of limited resources, without compromising essential controls or the gains made in risk management maturity.
The Secretariat also acknowledged the need for continuous review and recalibration of risk management frameworks, ensuring they remain relevant and responsive to fast-changing realities.
A central theme in Board and committee discussions was the balance between risk-taking and risk mitigation. The Global Fund’s risk appetite framework, approved by the Board, guides the organization in making explicit trade-offs between fiduciary risks and programmatic impact. However, several key risks-particularly those related to program quality for TB and malaria, and in-country supply chains-remain above target levels and are unlikely to reach moderate risk soon.
Board members and stakeholders raised critical questions:
- Are we catching the right signals early enough to inform timely action?
- Is the current balance between risk-taking and risk mitigation optimal for achieving impact?
- Should the risk appetite be recalibrated considering new realities, especially in conflict zones or fragile contexts where some risks may have to be accepted to maintain life-saving interventions?
The Secretariat signaled plans to review risk management documents and frameworks, inviting input from Board members and constituencies to ensure that risk considerations remain central to all decisions.
In fact, three major priorities clearly emerge from the report for 2025:
- Proactive adaptation of country risk management frameworks, to effectively address emerging threats.
- Revision of the risk appetite framework, ensuring its relevance and alignment with the current context.
- Strengthening the assurance model, better targeting controls on the most critical risks.
More broadly, the success of the Global Fund is closely linked to its partnerships with governments, international technical agencies and, above all, local communities. Effective risk management is increasingly dependent on the leadership and engagement of in-country actors-Principal Recipients, Sub-Recipients, Country Coordinating Mechanisms, and communities. The Global Fund is investing in:
- Real-time risk monitoring and early warning systems: Community-led monitoring is being integrated into formal risk assessments, providing early signals on programmatic issues and enabling rapid response.
- Support for sustainable transitions and domestic financing: Accelerated transitions must be carefully managed to avoid service disruptions, especially for vulnerable populations. Practical tools, such as financing data platforms that translate donor costs into national costs, are being deployed to support countries in planning for sustainability.
- Flexibility in grant implementation: In contexts where standard financial and procurement systems are not feasible, the Fund is exploring more flexible arrangements that balance accountability with operational realities.
Stakeholders emphasized that investments in prevention, community systems, and human rights-based programming must be treated as non-negotiable elements of risk mitigation, even in times of constrained funding.
The Audit and Finance Committee, along with other Board committees, stressed the need for:
- Clearer guidance and updated risk frameworks to navigate the shifting landscape.
- Enhanced scenario planning and workforce management to address funding and operational uncertainties.
- Prioritization and simplification: Recognizing that attempting to address every risk may dilute impact, the Fund must focus on its comparative advantages and ensure that essential services are protected, even amid funding cuts and program reprioritization.
Partners and Stakeholders called for the explicit incorporation of civic space and equity considerations into risk frameworks, and for continued transparency and accountability in all risk management processes.
Conclusion: Trade-offs and resource allocation
A recurring concern among Board members was the challenge of making difficult trade-offs in resource allocation. With multiple risks trending upwards and limited ability to initiate new funding in the short term, the organization is operating above its Board-approved risk appetite in several areas. This reality necessitates explicit, evidence-based trade-offs, particularly between programmatic priorities and fiduciary controls.
For example, in high-burden, conflict-affected regions, the Fund may have to accept higher fiduciary risks to ensure continued delivery of life-saving interventions. Similarly, the need to streamline processes and reduce administrative burdens must be balanced against the imperative to maintain robust oversight and accountability.
In fact, the consensus across the partnership is clear: the Global Fund must continue to adapt, innovate, and collaborate to navigate this volatile environment. Key priorities for the coming years include:
- Continuous monitoring and recalibration of risk management approaches: Ensuring that frameworks and tools remain fit for purpose and responsive to emerging threats.
- Making explicit, evidence-based trade-offs: Prioritizing interventions that offer the greatest impact, while safeguarding the needs of the most vulnerable.
- Strengthening partnerships with governments, donors, and civil society: To ensure sustainable progress and avoid reversal of hard-won gains.
- Investing in workforce and capacity: Sustaining critical capacities within the Secretariat and among partners is essential for delivering on the Fund’s mission.
All in all, the Global Fund’s ability to deliver on its mission in this new era of risk will depend on its agility, resilience, and commitment to prioritizing the most impactful interventions. As the risk environment evolves, too must the organization’s approaches to risk management, partnership, and resource allocation. The coming years will test the partnership’s capacity to adapt, but they also offer opportunities to strengthen systems, reinforce the foundation for future success, and ensure that the Global Fund remains a vital force in the fight against HIV, TB, and malaria.
The organization must build upon its past successes while remaining willing to revisit its models and practices to stay relevant and effective in a profoundly changing global environment. It is a clear call to action for the Board and all Global Fund partners, ensuring that the fight against HIV, tuberculosis, and malaria maintains its vital momentum.
