GC8 cycle: financial decisions with dire human consequences

The GC8 represents the next three-year budget cycle (2027-2029) of the Global Fund aimed at combating malaria, HIV, and tuberculosis. Grant applications, based on each country’s priorities, close at the end of July. Currently, North Kivu—a province grappling with armed conflict—appears unlikely to be included in malaria funding allocations. These financial decisions directly determine healthcare access in the most vulnerable areas.

« For years, the Global Fund has been a lifeline for North Kivu residents battling malaria. Without its support for prevention and treatment, the situation will become catastrophic. This is a preventable and treatable disease. In 2026, it is unacceptable for people to continue dying or developing severe complications », warns Stéphane Doyon, MSF’s malaria program manager.

The exclusion of North Kivu comes as the province faces multiple crises. Its already fragile health system is struggling under the weight of a worsening Ebola outbreak. The overlapping symptoms of malaria and Ebola further strain already overwhelmed health facilities, delaying diagnosis and treatment.

Armed conflict and malaria surge in North Kivu

« North Kivu is one of the provinces hardest hit by armed conflict. Repeated population displacements, food insecurity, and limited healthcare access have increased malaria exposure and severe case risks », explains Stéphane Doyon. Fighting between government-backed armed groups and the AFC/M23 has forced civilians into forests and remote areas—ideal breeding grounds for mosquitoes but devoid of medical infrastructure.

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:

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

Malnutrition: a deadly multiplier in a fragile health landscape

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

Dwindling prevention efforts and drug shortages

Essential malaria prevention measures have already been scaled back in some areas. In districts historically covered by the Global Fund, no long-lasting insecticidal net distributions have 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 shortages, MSF has had to procure medications and rapid tests for multiple health centers. Our teams have:

• Provided 53% of treatments for uncomplicated malaria;
• Managed 35% of severe malaria cases in Kibirizi, Bambo, and Rutshuru—working alongside the Ministry of Health and partners.

This stopgap approach is unsustainable for a province as vast as North Kivu.

MSF’s urgent call for equitable funding allocation

With the Global Fund’s grant cycle deadline looming, MSF urges immediate reintegration of North Kivu into the GC8 funding framework. We also call on the Congolese Ministry of Health to ensure resource allocation is driven solely by disease burden and civilian vulnerability—not political or logistical constraints.