L’Initiative is a French instrument that complements the work of the Global Fund. It aims to accelerate the fight against major pandemics and help countries improve access to high-quality healthcare services.
At the turn of the new millennium, the international community launched a remarkable wave of solidarity to fight the world’s major pandemics, establishing the Global Fund to Fight AIDS, Tuberculosis and Malaria. France is one of its founding members and a major contributor to this partnership, both operationally and financially.
In 2011, France created L’Initiative in response to the difficulties that certain countries, particularly French-speaking ones, were having in accessing Global Fund grants. The French Ministry for Europe and Foreign Affairs devolved implementation to Expertise France, the government agency for international technical cooperation. L’Initiative is a unique tool that supports France’s global health ambitions. Every year, it receives a proportion of France’s contribution to the Global Fund.
L’Initiative carries a clear ambition: to contribute to eliminating the AIDS, tuberculosis and malaria pandemics by 2030, through equitable access to quality, integrated, people-centered health services.
Concretely, L’Initiative’s action is structured around four missions:
We pursue this ambition by mobilizing three channels of intervention:
We mobilize experts, most often local or regional, through thematic envelopes and resident expertise arrangements deployed according to needs on the ground – to durably strengthen the capacities of organizations and stakeholders engaged in the fight against pandemics.
We support projects that complement Global Fund grants and are co-designed with national partners. These initiatives have strong catalytic potential to advance health practices and policies, while fostering innovation and the sustainability of interventions.
We support institutions and civil society through hybrid interventions combining funding, technical assistance and tailored support, to address under-invested challenges – notably through a civil society support mechanism, an emergency fund, and training and health workforce strengthening initiatives.
Within these countries, L’Initiative engages a diverse range of stakeholders involved in the response to the three pandemics: national coordinating mechanisms, Global Fund grant recipients, as well as public administrations, research institutes, civil society organizations and private sector actors.
Particular attention is paid to French-speaking Africa, making sub-Saharan Africa the program’s priority intervention area. This priority is accompanied by a stronger focus on the most vulnerable countries as well as those affected by crises and conflict — with at least 60% of support dedicated to them.
The eligible countries* for the 2026-2028 cycle are:
Benin, Myanmar, Burundi, Cambodia, Cameroon, Comoros, Congo, Côte d’Ivoire, Djibouti, Ethiopia, Ghana, Guinea, Haiti, Laos, Lebanon, Liberia, Madagascar, Mauritania, Central African Republic, Democratic Republic of the Congo, Rwanda, Senegal, Chad, Thailand, Togo, Tunisia, Ukraine, Vietnam.
* Countries that were eligible during the previous cycle but no longer are continue to benefit from monitoring of ongoing commitments.
Global health is going through a period of major strain: shrinking funding, multiplying crises, weakened health systems and shrinking civic space. In this context, preserving the progress made against HIV/AIDS, tuberculosis and malaria requires concentrating efforts on the most vulnerable countries, stakeholders and populations.
L’Initiative’s 2026-2028 strategy responds to this new reality by prioritizing interventions where they can have the greatest impact. This new framework for action, drawing on fifteen years of experience delivering effective, equitable and sustainable responses, is fully aligned with the orientations of France’s 2023-2027 global health strategy — notably in support of equitable, resilient and people-centered health systems, disease prevention and control, and the mobilization of research, expertise and international partnerships.
L’Initiative’s strategy is thus structured around four priority areas of action:
Strengthening the skills, practices and working conditions of health personnel to durably improve the quality of, and access to, health services.
Reducing inequalities in access to health services, with particular attention to key and vulnerable populations, gender equality and respect for human rights.
Strengthening the role and capacities of communities and civil society organizations — key actors in the pandemic response, working closest to populations — in access to care, prevention and support.
Supporting research, experimentation and knowledge production, and fostering the dissemination and scale-up of proven solutions.