On September 29, 2025, we held the fourth session of our Quo Vadis, Global Health? Fireside Chat series, bringing together experts and community voices to discuss one pressing question: What does “life saving” really mean in global health?

In times of fiscal austerity and competing crises, the risk is that programs are cut back to the bare minimum of emergency response. But as our speakers stressed, saving lives is not only about keeping people alive in the short term, it also means preventing infections, ensuring long-term treatment, and sustaining strong, community-based systems that reach those most at risk.

Dr. Tania Rödiger-Vorwerk (BMZ) highlighted Germany’s commitment to human rights, gender equality, and access for key and vulnerable populations as non-negotiable principles in Global Fund investments. She underlined the need for efficient use of resources, better coordination, and a gradual push toward domestic financing, while recognizing that many fragile contexts are not ready to carry the costs alone.

Ganna Dovbakh (Eurasian Harm Reduction Association, EHRA) spoke powerfully from the perspective of communities of people who use drugs in Eastern Europe and Central Asia. She warned of shrinking civic space, anti-rights backlash, and funding cuts that threaten decades of harm reduction work, from overdose prevention and opioid agonist treatment to HIV and hepatitis services. Stable core funding for community services and modest advocacy support are vital to keep people safe and bring evidence to policymakers.

From a humanitarian angle, Tess Hewett (MSF Belgium) stressed that short-term emergency aid cannot replace long-term system support. When development funding disappears, humanitarian actors face unsustainable pressure to fill the gaps — a costly and temporary fix that leaves people behind. She called for maintaining a focus on people in need, using data to target support, and fostering humanitarian–development collaboration rather than shifting the burden onto patients or fragile governments.

The discussion made clear that:

• Protecting access for key and vulnerable populations is non-negotiable; current budget cuts threaten essential prevention, treatment, and community-based services.
• The Global Fund remains indispensable for sustaining progress against HIV, tuberculosis, and malaria and must be successfully replenished to avoid backsliding.
• Civil society plays a central role — both in delivering services to hard-to-reach groups and in shaping public opinion and political will.
• While domestic financing is an important long-term objective, many countries lack the capacity to fund health services on their own; the principle of “leave no one behind” must guide global support.
• Life-saving interventions form the first line of defense for global health security, protecting both vulnerable communities and global stability.

One message came through strongly: fully funding the Global Fund is essential to protect hard-won gains against HIV, TB and malaria and to maintain global health security. Cuts made now will cost more later, in lives, stability, and resources.

We were honored to have:

• Ganna Dovbakh, Executive Director, Eurasian Harm Reduction Association (EHRA)
• Dr. Tania Rödiger-Vorwerk, Deputy Director General Global Health, Resilience, Equality of Opportunity (BMZ)
• Tess Hewett, Global Fund Focal Point & Health Policy Advisor, MSF Belgium

Moderation: Peter Wiessner (Action against AIDS Germany) & Tanja Siebenbrodt (DSW)

The discussion underscored that fully funding the Global Fund and safeguarding UNAIDS’ role remain essential to protect hard-won progress and strengthen health systems.

Watch the full recording here: