GFO Issue 463, Article Number: 4
ABSTRACT
The article highlights civil society deliberations during a virtual meeting held on 20 May 2025. During the meeting, civil society organizations were concerned about a recent shift in funding by the Global Fund caused by delays in donor disbursements. Specifically, they expressed their concerns about the lack of clear direction and sudden pauses of programs that are critical in the fight against HIV, tuberculosis, and malaria. Many said that vital community services were being paused without adequate explanation or input. While the Global Fund committed to improving communication and engagement, activists argued that essential services should be protected, not cut.
The Global Fund has entered what its executive director called a "perfect storm of challenges," prompting widespread concern and uncertainty among civil society organizations and implementing partners. With development assistance declining, donor disbursements delayed, and geopolitical instability growing, the Fund has begun a process of reprioritization and reprogramming that could result in life-saving services being scaled back unless countries and communities act quickly and decisively.
During a high-stakes virtual meeting on 20 May 2025, attended by over 250 participants, civil society leaders, community advocates, and Global Fund officials discussed the implications of recent decisions made at the 53rd Global Fund Board meeting. This convening was part of a series of discussions aimed at clarifying confusing directives and abrupt program pauses that followed the meeting. Throughout the forum, community leaders expressed deep concern about unclear communication, unrealistic timelines, and inadequate inclusion of affected stakeholders. Many warned that hard-won progress in the fight against HIV, tuberculosis, and malaria could be lost. A consistent message emerged: the Global Fund’s budget adjustments must not come at the cost of essential community-led services.
"Reprioritization should not come at the expense of community-led interventions," said Philip Nyakwana, civil society co-lead on Kenya’s Country Coordinating Mechanism (CCM). "Some implementers have stopped activities altogether because the instructions were unclear. People are already suffering."
"We were left behind": confusion and concern on the ground
Many community members said they were blindsided by the Global Fund’s sudden call for countries to pause or slow down certain activities. Instructions were sent by letters and emails to Principal Recipients (PRs), but not always through formal CCM channels.
"The information did not come directly through the CCM," Nyakwana explained. "The PRs passed it on to sub-recipients without any strategic or concrete guidance. Some implementers just stopped activities outright."
This has led to sudden service interruptions and uncertainty in community-led programs. "Some activities that enable community engagement have been paused or canceled," he added. "Are people expected to attend meetings without support? To join virtually without resources?"
Nyakwana warned against confusing rhetorical support for communities with meaningful inclusion. "There is a disconnect," he said. "It’s one thing to say ‘communities should be involved,’ but how are we being supported to actually participate?"
"Let’s not mop the floor with the tap open"
Maurine Murenga, from the Global Fund’s Community Delegation, offered a detailed explanation of the rationale and implications behind the funding adjustments. She noted that while some services are being paused temporarily, new - though reduced - funding envelopes will be issued by mid-June. Countries will then have just two weeks to submit revised programs.
"This is not a routine event," Murenga said. "It’s a mid-cycle adjustment because not all Seventh Replenishment pledges have translated into actual cash."
She emphasized the importance of protecting both medical commodities such as ARVs and TB medications, and the interventions that ensure people can access them. "We can’t just focus on treatment and ignore prevention," she said. "That would be like mopping the floor while the tap is still running."
Murenga expressed concern that many of the programs already paused - such as community-led monitoring (CLM), behavior change communication, advocacy, and community system strengthening - are often among the first to be cut.
"CLM is not a luxury," she said. "We advocated for its inclusion as a life-saving service because it helps ensure people are actually receiving care."
"We’re already seeing damage": the cost of silence and exclusion
Community leaders expressed frustration that the reprioritization guidance has led to over-interpretation and premature program cuts in some countries.
"We’ve seen some countries categorize CLM as just a survey - and suspend it," Murenga said. "But CLM is about accountability. It’s about ensuring services reach the people who need them."
Nyakwana echoed this concern, warning that premature cuts are already harming communities. "Even before the Global Fund has released the new envelopes, some implementers have halted community interventions," he said. "We are seeing real consequences on the ground."
He also flagged the extremely tight timeframe. "We’re told we’ll have two weeks once the revised envelopes arrive. But how can we coordinate everything - especially in dual-track systems involving both government and civil society PRs - in such a short window?"
"This is a chance to re-strategize"
Despite the challenges, community actors are organizing proactively. Murenga urged community members to prepare "cheat sheets" with options for various levels of budget cuts in advance of receiving the new envelopes.
"Let’s plan what we keep if we’re told to cut by 15%, or 20%, or 30%," she said. "We need to agree in advance on our priorities."
She encouraged detailed budget analysis and greater transparency. "In some countries, PRs conceal administrative budgets," she noted. "We need to scrutinize every budget line to ensure that what remains are the components that save lives."
Nyakwana agreed, calling for a participatory approach rooted in equity and sustainability. "We must unpack current funding - what’s in the budgets, who benefits, and where savings can be made without hurting the community."
He added that prevention programs, systems strengthening, and efforts to address access barriers must be recognized as life-saving. "It’s not just about the medicine. It’s about who gets it, and how."
Global Fund pledges transparency but warns of tough choices
In response to community concerns, Anna Maalsen, Manager of Community Engagement, Key Populations and CRG at the Global Fund, acknowledged the challenges and promised greater transparency and inclusion.
"We’ve heard community feedback loud and clear," Maalsen said. "We are putting mechanisms in place to ensure communities are informed, included, and supported."
Maalsen outlined several commitments to improve transparency and participation. All members of Country Coordinating Mechanisms - not just chairs - will be informed when changes to funding envelopes are communicated, ensuring that all stakeholders receive timely information.
Additionally, a mandatory two-week consultation period will follow the release of revised allocations, expected in mid-June. CCMs will be encouraged to hold review meetings, and Secretariat budgets may be used to support this engagement - which is essential for enabling community participation.
To track decision-making and its impact on community-led programs, new templates will be introduced. These will help assess whether cuts disproportionately affect civil society implementers or shift responsibilities to PRs. A community engagement satisfaction survey will also be conducted to evaluate the quality and inclusiveness of the process.
Maalsen emphasized that community-led monitoring and prevention efforts remain both eligible and critical. "We’re not saying these programs should stop. We’re saying: don’t expand them right now, but protect what’s already in place."
"Being realistic doesn’t mean being defeatist"
Even as they brace for difficult choices, community advocates remain committed.
"We’re not defeatist," said Murenga. "We’re realistic. But we must defend the space we’ve earned and the programs that save lives."
Nyakwana concluded with a warning: "If we deprioritize community engagement now, we’ll be back in a year or two doing emergency damage control."
The message from communities is clear: they are ready to collaborate with the Global Fund - but not to be sidelined. With lives on the line, there’s no room for shortcuts or silence.
The Global Fund has entered what its executive director called a "perfect storm of challenges," prompting widespread concern and uncertainty among civil society organizations and implementing partners. With development assistance declining, donor disbursements delayed, and geopolitical instability growing, the Fund has begun a process of reprioritization and reprogramming that could result in life-saving services being scaled back unless countries and communities act quickly and decisively.
During a high-stakes virtual meeting on 20 May 2025, attended by over 250 participants, civil society leaders, community advocates, and Global Fund officials discussed the implications of recent decisions made at the 53rd Global Fund Board meeting. This convening was part of a series of discussions aimed at clarifying confusing directives and abrupt program pauses that followed the meeting. Throughout the forum, community leaders expressed deep concern about unclear communication, unrealistic timelines, and inadequate inclusion of affected stakeholders. Many warned that hard-won progress in the fight against HIV, tuberculosis, and malaria could be lost. A consistent message emerged: the Global Fund’s budget adjustments must not come at the cost of essential community-led services.
"Reprioritization should not come at the expense of community-led interventions," said Philip Nyakwana, civil society co-lead on Kenya’s Country Coordinating Mechanism (CCM). "Some implementers have stopped activities altogether because the instructions were unclear. People are already suffering."
"We were left behind": confusion and concern on the ground
Many community members said they were blindsided by the Global Fund’s sudden call for countries to pause or slow down certain activities. Instructions were sent by letters and emails to Principal Recipients (PRs), but not always through formal CCM channels.
"The information did not come directly through the CCM," Nyakwana explained. "The PRs passed it on to sub-recipients without any strategic or concrete guidance. Some implementers just stopped activities outright."
This has led to sudden service interruptions and uncertainty in community-led programs. "Some activities that enable community engagement have been paused or canceled," he added. "Are people expected to attend meetings without support? To join virtually without resources?"
Nyakwana warned against confusing rhetorical support for communities with meaningful inclusion. "There is a disconnect," he said. "It’s one thing to say ‘communities should be involved,’ but how are we being supported to actually participate?"
"Let’s not mop the floor with the tap open"
Maurine Murenga, from the Global Fund’s Community Delegation, offered a detailed explanation of the rationale and implications behind the funding adjustments. She noted that while some services are being paused temporarily, new - though reduced - funding envelopes will be issued by mid-June. Countries will then have just two weeks to submit revised programs.
"This is not a routine event," Murenga said. "It’s a mid-cycle adjustment because not all Seventh Replenishment pledges have translated into actual cash."
She emphasized the importance of protecting both medical commodities such as ARVs and TB medications, and the interventions that ensure people can access them. "We can’t just focus on treatment and ignore prevention," she said. "That would be like mopping the floor while the tap is still running."
Murenga expressed concern that many of the programs already paused - such as community-led monitoring (CLM), behavior change communication, advocacy, and community system strengthening - are often among the first to be cut.
"CLM is not a luxury," she said. "We advocated for its inclusion as a life-saving service because it helps ensure people are actually receiving care."
"We’re already seeing damage": the cost of silence and exclusion
Community leaders expressed frustration that the reprioritization guidance has led to over-interpretation and premature program cuts in some countries.
"We’ve seen some countries categorize CLM as just a survey - and suspend it," Murenga said. "But CLM is about accountability. It’s about ensuring services reach the people who need them."
Nyakwana echoed this concern, warning that premature cuts are already harming communities. "Even before the Global Fund has released the new envelopes, some implementers have halted community interventions," he said. "We are seeing real consequences on the ground."
He also flagged the extremely tight timeframe. "We’re told we’ll have two weeks once the revised envelopes arrive. But how can we coordinate everything - especially in dual-track systems involving both government and civil society PRs - in such a short window?"
"This is a chance to re-strategize"
Despite the challenges, community actors are organizing proactively. Murenga urged community members to prepare "cheat sheets" with options for various levels of budget cuts in advance of receiving the new envelopes.
"Let’s plan what we keep if we’re told to cut by 15%, or 20%, or 30%," she said. "We need to agree in advance on our priorities."
She encouraged detailed budget analysis and greater transparency. "In some countries, PRs conceal administrative budgets," she noted. "We need to scrutinize every budget line to ensure that what remains are the components that save lives."
Nyakwana agreed, calling for a participatory approach rooted in equity and sustainability. "We must unpack current funding - what’s in the budgets, who benefits, and where savings can be made without hurting the community."
He added that prevention programs, systems strengthening, and efforts to address access barriers must be recognized as life-saving. "It’s not just about the medicine. It’s about who gets it, and how."
Global Fund pledges transparency but warns of tough choices
In response to community concerns, Anna Maalsen, Manager of Community Engagement, Key Populations and CRG at the Global Fund, acknowledged the challenges and promised greater transparency and inclusion.
"We’ve heard community feedback loud and clear," Maalsen said. "We are putting mechanisms in place to ensure communities are informed, included, and supported."
Maalsen outlined several commitments to improve transparency and participation. All members of Country Coordinating Mechanisms - not just chairs - will be informed when changes to funding envelopes are communicated, ensuring that all stakeholders receive timely information.
Additionally, a mandatory two-week consultation period will follow the release of revised allocations, expected in mid-June. CCMs will be encouraged to hold review meetings, and Secretariat budgets may be used to support this engagement - which is essential for enabling community participation.
To track decision-making and its impact on community-led programs, new templates will be introduced. These will help assess whether cuts disproportionately affect civil society implementers or shift responsibilities to PRs. A community engagement satisfaction survey will also be conducted to evaluate the quality and inclusiveness of the process.
Maalsen emphasized that community-led monitoring and prevention efforts remain both eligible and critical. "We’re not saying these programs should stop. We’re saying: don’t expand them right now, but protect what’s already in place."
"Being realistic doesn’t mean being defeatist"
Even as they brace for difficult choices, community advocates remain committed.
"We’re not defeatist," said Murenga. "We’re realistic. But we must defend the space we’ve earned and the programs that save lives."
Nyakwana concluded with a warning: "If we deprioritize community engagement now, we’ll be back in a year or two doing emergency damage control."
The message from communities is clear: they are ready to collaborate with the Global Fund - but not to be sidelined. With lives on the line, there’s no room for shortcuts or silence.
