The next Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria will step into the role as the global campaign to end malaria reaches an inflection point. 

Malaria remains a leading cause of death for children worldwide, particularly in sub-Saharan Africa.  Both the malaria-causing parasites and the mosquitoes that carry them are increasingly able to evade existing tests, treatments, and preventive tools.  This is a precarious situation made worse by the invasive, insecticide-resistant Anopheles stephensi mosquito that is spreading with alarming speed across sub-Saharan Africa.

Despite malaria’s stubborn persistence, however, we are experiencing an unprecedented period of rapid innovation that can make eliminating the disease feasible in our lifetime.  A growing number of new anti-malarial tools and technologies, many invented in the United States, are becoming available just when they are needed most.  

The Global Fund’s next leader will have a critical opportunity to make smart investments at the right moment in the tools and innovations needed to stay ahead of resistance and accelerate progress toward eliminating the disease. 

Here are five practical recommendations for the Fund’s next Executive Director: 

1. Unlock More Funding Against Malaria

The next Executive Director will need to convince the Global Fund’s Board of Directors to address the organization’s chronic underfunding of malaria — an issue which the current Executive Director has consistently raised, including at the July 2026 Board Meeting.  The Fund’s allocation formula  disadvantages the disease (and tuberculosis) relative to HIV/AIDS.  Malaria has received about 32 percent of total resources in previous funding cycles.  And the disease bore the largest brunt of the cuts required by financial shortfalls in the current period (Grant Cycle 7), even though the Fund’s Board approved limited flexibility in the formula to protect grants for malaria in the lowest-income countries with the highest disease burdens.  Indications are that the Fund’s Grant Cycle 8, which starts in 2027, will not make up this deficit.  

In addition, several countries are slated to transition out of the Global Fund’s financing for malaria, and even more are scheduled to see their malaria grants sunset in the coming Grant Cycle 9.  These transitions are warranted, but they will need careful management.  When funding declines, malaria can — and will — resurge much faster than slower-onset diseases like HIV or tuberculosis.  The Fund’s next Executive Director would be wise to work with the organization’s Board to set aside funding for surge capacity to protect hard-won gains.  At the same time, he or she will have an opportunity to propose a new allocation formula to the Fund’s Board that can finally rectify longstanding structural issues with the assignment of resources across the three diseases. 

2. Look to Philanthropy for New Sources of Revenue, but with Flexibility 

While internal adjustments at the Global Fund are needed, the reality is that dwindling resources for health from public donors is a permanent trend.  Given this constrained financial landscape, the Fund’s next Executive Director will need to find new sources of revenue beyond traditional government partners.  Philanthropic organizations should top his or her prospect list. 

The good news is that private philanthropies have shown an interest in funding malaria, because their algorithms show reducing the impact of the disease is one of the most cost-effective investments available.  GiveWell is reportedly exploring a potential partnership that could generate an additional $2-3 billion for malaria through a mechanism called the “Malaria Impact Accelerator.”  This follows the August announcement from Coefficient Giving that it teamed up with GiveWell to make its largest grant to date to the Against Malaria Foundation in support of a campaign to distribute bed nets in the Democratic Republic of the Congo.  Because private philanthropies can earmark donations to the Global Fund in a way that public donors cannot, they can provide new dedicated funding streams for malaria at a time when traditional sources are not keeping pace.  

The new Executive Director should consider how to direct any additional resources to scale up multiple malaria-related tools and technologies that have the potential to accelerate progress quickly.  Bed nets have long been the gold standard in preventing malaria, but we need a layered, micro-targeted combination of them — and every other tool in the toolbox, tailored at the local level — to get to the finish line.  We must stay ahead of the growing threat of resistance and grapple with the truth that nets do not break the chain of transmission fed by large numbers of asymptomatic people who carry malaria parasites in their blood, but escape detection because they do not get sick.  

3. Invest Smartly — and Quickly — in New Anti-Malarial Tools and Technologies

We have seen more innovation against malaria in the last 18 months than in the last 30 years.  With an impending wave of new malaria-related interventions on the horizon — from new drugs to vaccines to diagnostic tools enabled by artificial intelligence — the next Executive Director will need to get creative to deploy these solutions to high-burden areas at scale, and with speed and precision.  He or she must understand that these breakthrough tools will be more expensive than current ones, at least at first, but that they will save money over time.  The widely lauded framework by which the Global Fund and the U.S. Government are deploying Gilead Sciences’ lenacapavir to prevent HIV, which relies on sales in high-income countries to deliver the drug below cost in low-and middle-income countries, will not be applicable for most new malaria-related innovations that do not have a market in developed nations.   Even this year’s tripartite arrangement between the U.S. Department of State, the Global Fund, and SC Johnson to distribute 60 million Guardian^tm spatial repellent to help improve protection against malaria for families in sub-Saharan Africa is not an analogue, because private sales of the product should produce enough revenue to subsidize distributions to vulnerable households.

Luckily, the new Executive Director has a model to emulate.  Beginning in 2018, the Global Fund, the U.S. President’s Malaria Initiative, UNITAID, the Gates Foundation, and MedAccess formed the New Nets Project to provide market-shaping financing to bring down the price of next-generation insecticide-treated bed nets (ITNs) while making their production commercially viable.  The deployment of 56 million dual-active-ingredient ITNs) through the consortium prevented an estimated 13 million malaria cases in sub-Saharan Africa.  

The Fund’s next leader should build on this legacy and find new ways to ensure life-saving interventions reach those who need them as quickly as possible, while preserving incentives for manufacturers to continue to innovate.  The first opportunity to do so will be with Novartis’ ganaplacide/ lumefantrine (Gan-Lum), which, pending approval by stringent regulatory authorities, is set to become the first novel antimalarial drug to hit the market in over 25 years. 

4. Start Early to Get Procurement Planning Right

The next head of the Global Fund will have to navigate a new way of working with the U.S. Government.  The State Department is turning to the Global Fund’s pooled-procurement facility to purchase anti-malarial drugs, ITNs, and other supplies to implement the Memoranda of Understanding signed with national governments under the America First Global Health Strategy, This is a departure from how the U.S. Government has managed the procurement and delivery of these tools over the last 20 years.

Planning for all contingencies is imperative, given the lead time required to manufacture, ship, and deploy malaria-related commodities, especially ITNs.  When cases of malaria surge, nets do not appear magically overnight.  On the contrary, the planning and forecasting for distributing ITNs to households and pregnant women at the household level must happen as much as 12 to 18 months in advance.  These campaigns are complex and logistically challenging and, because malaria is seasonal in many countries in sub-Saharan Africa, the timing must be precise.  If the correct delivery window is missed, the most vulnerable people are left to survive a rainy season without the protection of a net, or without accurate tests or effective drugs.  There is no room for error, even during this time of transition.  

5. Coordinate Closely with Gavi on the Distribution of Vaccines Against Malaria 

Only five years ago, the World Health Organization recommended the first-ever vaccine against malaria for global use.  Yet already the governments of 25 African countries have introduced vaccines for malaria into their routine immunization schedules and delivered more than 50 million doses with financing from Gavi, the Vaccine Alliance.  As demand continues to grow and with new vaccine candidates in development, the Global Fund’s next leader should deepen collaboration with Gavi to coordinate the rollout of malaria vaccines alongside other interventions, both geographically and technically.  By streamlining the deployment of all antimalarial tools, we can maximize impact and save lives.