the gc8 funding cycle: financial decisions with severe human consequences

The next three-year budget cycle (2027-2029) of the Global Fund, known as GC8, targets malaria, HIV, and tuberculosis. Grant applications, based on national health priorities, close at the end of July. Currently, North Kivu—a province grappling with an ongoing armed conflict—appears unlikely to be included in malaria prevention and treatment programs. These funds directly determine access to care in some of the most vulnerable areas.

“For years, the Global Fund has been a lifeline for North Kivu, providing most available malaria treatments. If funding is cut, the situation will turn catastrophic. Malaria is preventable and treatable. In 2026, no one should still be dying from it or suffering severe complications,” warns Stéphane Doyon, MSF’s medical coordinator.

The exclusion would come at a time when North Kivu is already battling multiple crises. The local health system, already fragile, could be overwhelmed by the ongoing Ebola outbreak. The similar early symptoms of malaria and Ebola complicate diagnosis, delay treatment, and strain already overburdened health facilities.

armed conflict and soaring malaria cases

“North Kivu is among the provinces hardest hit by armed conflict. Repeated displacement, food insecurity, and barriers to healthcare expose communities to malaria and increase the risk of severe illness,” explains Stéphane Doyon of MSF. Fighting between government-backed armed groups and the AFC/M23 has forced civilians into forests or remote areas—ideal breeding grounds for mosquitoes and devoid of medical infrastructure. The risk of malaria exposure is alarmingly high in these areas.

In 2025, malaria accounted for 48% to 58% of medical consultations in health zones like Bambo, Kibirizi, and Rutshuru, where MSF operates. In these areas alone:

• Over 255,000 uncomplicated malaria cases and 26,000 severe cases were treated by MSF, the Ministry of Health, and partners.
• 165,560 patients received care in MSF-supported facilities.

malnutrition: a deadly multiplier in a strained health system

Malnutrition is a growing concern in MSF-supported clinics. When combined with malaria, it dramatically increases the risk of complications and death, particularly among children under five.

shortages and shrinking malaria prevention efforts

Essential malaria prevention measures have already been scaled back. In areas historically covered by the Global Fund, no distribution of insecticide-treated mosquito nets has occurred since June 2023. Between July and December 2025, no malaria treatments or diagnostic tests reached North Kivu due to logistical hurdles.

To address these gaps, MSF has had to procure medications and rapid tests for multiple health centers. Our teams have provided:

• 53% of treatments for uncomplicated malaria;
• 35% of treatments for severe malaria in Kibirizi, Bambo, and Rutshuru—where MSF works alongside the Ministry of Health and partners.

Such ad hoc measures are unsustainable across a province as vast and crisis-stricken as North Kivu.

msf’s urgent appeal for fair funding allocation

With the grant cycle nearing its close, MSF is urging the Global Fund and DRC authorities to immediately reinstate North Kivu in the GC8 programming. The organization also calls on the Congolese Ministry of Health to ensure resources are allocated based solely on disease burden and civilian vulnerability, not political or logistical convenience.