This is a difficult time to be a health advocate. Even more so if you are a young person whose health and future are still being debated.
It’s frustrating, honestly, at times disheartening, to see years of work pushing for people’s health and well-being being deprioritised. But this is the reality we are navigating. This is my reality and the reality shared by many young people living with and affected by HIV.
From March 3 to 5, I joined advocates, civil society leaders, and partners in Nairobi, Kenya, for the Global Fund Advocates Network (GFAN) Annual Meeting. The aim was to reflect on where we are and prepare for what comes next. From the very beginning, there was a shared sense that the road ahead would not be easy.
There was a sense of tension in the room that was unmistakably noticeable.
Many of us have witnessed firsthand the shifting global health landscape, particularly following changes in the United States foreign aid funding. At the same time, ongoing conflicts, rising insecurity, geopolitical tensions, and widening inequality are reshaping global priorities. In many contexts, global health is no longer treated as an urgent crisis. Funding is shrinking, and attention is shifting elsewhere.
And while these competing priorities are real, the result is an imbalance, one that is already affecting how governments view development assistance, solidarity, and responsibility in global health.
To be honest, there was a shared concern: what happens when health equity is no longer seen as a political priority?
As official development assistance becomes increasingly constrained, competition for resources is intensifying. In this environment, global health advocates are being pushed to do more with less—and to argue more convincingly than ever before that investments in HIV, tuberculosis, malaria, and health systems are not optional, but essential.
[From left to right: Yolanda from Developing NGO, Priscilla from Communities, and Katy from Developed NGO delegations in a briefing session]
During a briefing on the 54th Global Fund Board Meeting, representatives from the Developing Country NGO, Developed Country NGO, and Communities delegations reflected on how the Global Fund is adapting to this shifting context.
There was a clear emphasis on transitioning, integrating, and strengthening community systems, but also on something broader: positioning.
A recurring message throughout the discussion was that the Global Fund must engage more strategically within wider global health and political conversations. This means aligning more closely with country priorities, strengthening relationships with governments, and ensuring that new political leaders quickly understand the value of Global Fund investments.
Because increasingly, technical solutions alone are not enough. Navigating political ecosystems is just as critical. At the same time, there is growing pressure to demonstrate value for money. With limited resources available, every investment must show a clear, measurable impact.
[From left to right: Photos taken of the GFAN team engaging recipients of care at Deaf Empowerment Kenya Youth Health Centre in Machakos County]
One of the most powerful moments of the meeting was a field visit to a youth health centre led by Deaf Empowerment Kenya in Machakos County.
Established in 2022 with Global Fund support and in collaboration with the Ministry of Health, the centre is a one-stop wellness hub providing youth-friendly services, from SRHR and HIV testing to mental health support, family planning, and GBV services.
What stood out wasn’t just the services themselves, but how they were delivered.
With an accessible triage and reception system, the centre supports around 200 walk-in clients each month and reaches over 1,000 young people through outreach. Speaking with both the staff and young clients, you could feel the impact; this was not just service delivery, but dignity, trust, and care in action. This was a reminder of what could be achieved if responses to HIV were well-funded and resourced.
[From left to right: Priscilla leading a session at the GFAN meeting; Priscilla with Bella, Y+ Global Board Member for Asia]
Back in the meeting rooms, conversations turned to advocacy, specifically, how we communicate in an increasingly sensitive political environment.
There was strong agreement on the need for careful, sometimes neutral messaging when engaging with governments. Advocacy that is perceived as overly political can risk relationships with key donors and decision-makers. The recent 8th replenishment campaign report reinforced this, highlighting the importance of balancing credibility with urgency, especially when speaking about communities facing criminalisation.
Y+ Global’s Board Member for Asia, Bella Aubree, raised important concerns about how these political shifts are affecting communities on the ground.
As Grant Cycle 8 approaches, there have been strong calls for greater transparency in the selection of Principal Recipients and for Country Coordinating Mechanisms (CCMs) to prioritise accountability and inclusivity. These structures will play a critical role in ensuring that programmes remain grounded in the realities of the communities they are meant to serve.
Perhaps the most worrying conversations centred on the continued marginalisation of key and vulnerable populations. We must be cautious.
The expansion of restrictive policies and shrinking civic space risk undoing years of progress. If civil society continues to be constrained, our ability to reach those most affected by HIV, tuberculosis, and malaria will be severely compromised.
As I left the meeting, I kept coming back to one feeling: tension, but also determination.
There is no denying that we are entering a more complex and constrained global health landscape. But there was also a shared understanding that this moment calls for something more.
Stronger collaboration. Smarter advocacy. And a renewed commitment to ensuring that no one is left behind.