Global Fund Contributions to Health Security: Mapping Synergies between Vertical Disease Programs and Capacities for Preventing, Detecting, and Responding to Public Health Emergencies

Background: The Global Fund to Fight AIDS, Tuberculosis and Malaria is a robust vertical global health program. Other work has discussed potential synergies between various global health initiatives, but the extent to which investments from vertical programs support health security has not been investigated. We, therefore, endeavored to quantify the extent to which the budgets of this vertical program support health security. Methods: We examined budgets from the Global Fund for work in 10 countries from 2014–2020. Using the International Health Regulations Joint External Evaluation (JEE) Tool as a framework, we mapped budget items to health security capacities. We blinded researchers who independently reviewed each budget and mapped items to the JEE. We then unblinded the researchers and reviewed the budgets again until a consensus was reached regarding if an item supported health security directly, indirectly, or not at all. Findings: The budgets totaled USD 6,927,284,966, and USD 2,562,063,054 (37·0%) of this mapped to JEE capacities. USD 1,330,942,712 (19·2%) mapped directly to JEE capacities and USD 1,231,120,342 (17·8%) mapped indirectly. Laboratory systems, antimicrobial resistance, and the deployment of medical countermeasures and personnel received the greatest amount of overall budgetary support, while laboratory systems, antimicrobial resistance, and workforce development received the greatest amount of direct budgetary support. Interpretation: Over one-third of the Global Fund’s work supports health security and the Global Fund has budgeted more than USD 2,500,000,000 for activities that support health security in these 10 countries since 2014. Funding Statement: This work was funded by Resolve to Save Lives: An Initiative of Vital Strategies. Declaration of Interests: The authors have no competing interests to declare. Ethics Approval Statement: Not required.