Global Fund Replenishment and Pharma's Progress on U.S. Onshoring Efforts
November 28, 2025
Editors' Note
Last Friday, world leaders met for the Global Fund's Eighth Replenishment Summit in Johannesburg, South Africa, to raise money for health systems and sustain the fight against AIDS, tuberculosis, and malaria. The summit's fundraising fell nearly $7 billion below its target of $18 billion, but the United States still pledged $4.6 billion—the largest single donation by any country. That amount, however, is $1.4 billion less than the last replenishment cycle and reflects an overall lower commitment from other countries including Canada, Germany, and the United Kingdom.
To lead this week's edition, CFR Senior Fellow Prashant Yadav and Research Associate Elena Every explain how the United States' renewed commitment is a positive sign for global health and how it could complement the country's America First Global Health Strategy.
Next, Yadav and Research Associate Chloe Searchinger assess drug makers' commitments to onshore manufacturing to the United States following the threat of the Trump administration's tariffs. They present two indicators to gauge the materiality and saliency of the $480 billion pledges.
To wrap up, researcher Samantha Nyakundi explores why Cameroon has recorded more than 130,000 zero-dose children—kids who have not received any routine vaccinations—since 2019, and what separates hesitant families from those who lack access to vaccines.
Until next week! —Nsikan Akpan, Managing Editor, and Caroline Kantis, Associate Editor
Researcher Samantha Nyakundi explores why some children remain unvaccinated in Cameroon and what distinguishes vaccine-hesitant from historically unreached groups
