LAUSR

Introduction: The Global Fund to Fight AIDS, TB, and Malaria (the Global Fund) pivoted investments to support countries in their response to the COVID-19 pandemic. Recently, the Global Fund's Board approved global pandemic preparedness and response as part of their new six-year strategy from 2023-2028. Methods: Prior research estimated that US$124 billion is required, globally, to build sufficient country-level capacity for health security, with US$76 billion needed over an initial three-year period. Action-based cost estimates generated from that research were coded as directly, indirectly, or unrelated to systems strengthening efforts applicable to HIV, TB, and/or malaria. Results: Of approximately US$76 billion needed for country level capacity-building over the next three-year allocation period, we estimate that US$66 billion is needed in Global Fund-eligible countries, and over one-third relates directly or indirectly (US$6 billion and US$21 billion, respectively) to health systems strengthening efforts applicable to HIV, TB, and/or malaria disease programs currently supported by the Global Fund. Among these investments, cost drivers include financing for surveillance and laboratory systems, to combat antimicrobial resistance, and for training, capacity-building, and ongoing support for the healthcare and public health workforce. Conclusion: This work highlights a potential strategic role for the Global Fund to contribute to health security while remaining aligned with its core mission. It demonstrates the value of action-based costing estimates to inform strategic investment planning in pandemic preparedness.