South African President Cyril Ramaphosa and United Kingdom Prime Minister Keir Starmer called for reform of the global health architecture as they addressed the Eighth Global Fund replenishment in Johannesburg on 21 November 2025:
“We are not done yet… As part of our commitment to the Lusaka Agenda… we need to work smarter and much more efficiently, we need to eliminate waste and duplication and we need to reduce the fragmentation of the global health financing system.” (Video here.)
– Cyril Ramaphosa, President of South Africa
In his opening remarks at the replenishment event, UK Prime Minister Keir Starmer also underscored the need for reform:
“We have got to reform the global health system….so every penny, every rand, every cent that we invest has the greatest possible impact…Institutions have multiplied, there are too many silos, health systems have become fragmented. I really welcome the Global Fund’s commitment to reform, putting countries back in the lead, strengthening national health systems and keeping communities at its heart. And to working ever more closely with multilateral partners like Gavi and key regional bodies like the African Union.”
– Keir Starmer, Prime Minister of the United Kingdom