Exclusive: State Department Shifts All U.S.-Funded Health Commodity Procurement to Global Fund’s Wambo Platform

Or: what happens when you don't go to the World Health Assembly and have some time on your hands

All US government health commodity procurement has shifted over to the Global Fund’s Wambo.org pooled procurement mechanism, as of May 15 2026, according to a Department of State démarche sent to embassies around the world on the same day.

Under the new arrangement, countries will order US-funded commodities using Wambo’s Non-Grant Financed Procurement” (NGFP) channel. The US will pay for the purchases by transferring money to the Global Fund under via a “funding agreement.”

The communique, which has not been previously reported, says that the current US supply chain contract, managed by Chemonics International, will “fulfill all outstanding purchase orders and complete all in-transit deliveries by September 2026.” The new arrangement “applies for the period during which the US government continues to finance commodity purchases…”

The contents of the communique are not surprising. State has previewed the shift to Wambo in public remarks; a contractor recently advertised a role to support procurement collaboration between the Department of State Bureau of Global Health Security and Diplomacy (GHSD) and Global Fund.

The idea is also solid. I’ve spoken to country and headquarters based USG staff, and to non-governmental procurement experts who all think the Wambo shift is sound. No one is sad to see the Chemonics era come to an end.

In other words, it’s a pretty good idea.¹

If you want to support country ownership of health programs, it’s a good idea to move away from a contract with a US-based company to procure and deliver other countries’ commodities, and towards the platform that most countries are already using to buy stuff with money from their Global Fund grants. This will make life simpler for some countries. The shift will also increase Global Fund purchasing power, as the volume of orders it processes increases.

The Non-Grant Financed Procurement Channel got good marks in the formal review conducted at the end of its pilot phase.² And the new approach addresses at least one of the challenges identified in that write-up, namely that Wambo does not have a buy now, pay later option. The US will handle the “pre-payment requirement” by giving the money directly to the Global Fund both resolves issues some countries had with a “pre-payment requirement.” Other wrinkles raised in the report, like lack of transparency about the selection process for inclusion of commodities and legislative or local procurement requirements that complicate Wambo use for some countries can also be ironed out.

So yes, it is a solid idea. Should we leave it at that and get on with what is, for many, including yours truly, a holiday weekend?

Not just yet. Because while the idea is solid, the execution is on-brand for Trump Era GHSD: short on details, blisteringly hasty and utterly blasé about timely, transparent public communication.

Alt text: A screenshot of a book cover. The title is ‘Enormous Changes at the Last Minute.” There is a painting, mostly in shades of green, of a woman with a wide-brimmed hat in a train carriage, reading. The author of the book is my hero, Grace Paley, who said, “The only recognizable feature of hope is action,” and who ferociously protected her right to be an activist and a mother and a writer. This is as good a title as any for the last year, but also for today, which I planned to spend much like the green-hatted woman, reading, until I opened my inbox. You can ferociously protect a lot. Sometimes the first day of the long weekend has to go.

GHSD can be congratulated on having a good idea and also be held accountable for ensuring that it is implemented responsibly and effectively. Accountability in this instance means looking closely at the resources put behind the wee talking point stashed below the heading, “IF RAISED—CONCERNS ABOUT LOSS OF IN-COUNTRY GHSC-PSM PRESENCE.” It reads, “The USG is committed to ensuring that in-country supply chain technical assistance continues under the new approach. Post should report any specific in-country capacity concerns to GHSD/PTSC for follow-up.”

The Chemonics contract covered far more than just buying, shipping and delivering commodities. It paid for in-country support for demand quantification, forecasting, storage, last-mile delivery, and a host of other activities. (I’ve said it once, I’ll say it again: read Alain Casseus to really, really understand.) The GHSC-PSM contract is ending on September 30th. It is completely unclear how the US will make good on its commitment to ensure that technical assistance continues; it’s also not clear that the US is committed to ensuring that services other than technical assistance like storage and delivery also continue. There is more silence than substance in this talking point—and if the continuity isn’t addressed, both by countries and by GHSD, the consequences will be lethal.

Then there’s the matter of timing. The State Department appears to be proceeding full speed ahead with closure of the Chemonics contract by the end date set under the Biden Administration: September 30 2026. As I’ve written about before, the justification for that contract extension was in order to facilitate an orderly transition from one procurement system to another. The memo, written by Dr. Atul Gawande, said that experience showed one year to 18 months of crossover was a good practice. As it stands now, there is four months of overlap between what’s left of GHSC-PSM and the new approach that went into effect on May 15th.³

Alt text: Highlighted excerpt from Atul Gawande’s memo explaining how to end a supply chain grant. This memo is not called “Make Enormous Changes at the Last Minute.”

Finally, there is the matter of transparency. As I covered in the last stack on this subject, at least one country-based expert has told me that the timelines are rushed but feasible as long as the information is public. The information is not public. This shift and the related timelines haven’t been shared with anyone I’ve spoken to today. That’s been true of every other timeline related to the supply chain closure shared to date. It is irresponsible and undermining of country ownership and planning to persist in this level of secrecy.

In addition to sharing these timelines, there must be clear, formal and firm communication that the funding transferred from the US government to the Global Fund under new approach will not in any way be considered part of the US government’s contribution to the Global Fund; drawn from Congressional appropriations for the Global Fund; or counted toward the “ceiling” that has capped US government Global Fund contributions at a percentage of the total amount committed in a replenishment round. These concerns may be totally unfounded. The must be addressed. Prove us wrong.

I’m not just sharing this critique because I want to go sit next to my brilliant friend (wait what, you don’t read the footnotes as you go?). I’m sharing it because there is a real need for an urgent, cohesive reckoning in which Congress asks a set of questions about all of these different issues (supply chain, lack of support community systems, crushing CDC, abandoning primary prevention for the people who need it most, snatching defeat from the jaws of victory in the HIV fight and so many others) of the people responsible, including Secretary of State Marco Rubio. Good ideas with poor execution can be as dangerous as terrible ideas that never go anywhere. All of it needs attention, last minute though it may be.

Demarche May15 2026

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1. I’m not sure when the last time was that I said “this is a pretty good idea” about anything GHSD has done in the last year. I’m actually not sure I’ve said it at all. But while I did feel profoundly, cosmically seen by a dear friend who recently said to me, “If you don’t have anything nice to say, come sit next to me,” I do actually look for places to give credit where credit is (actually) due.

2. https://archive.theglobalfund.org/media/12667/archive_terg-wambo-pilot-evaluation_report_en.pdf?

3. The démarche is dated May 15, which is also the day that the new system went into effect. That was a Friday. It’s highly likely that the communication went out on that Monday, May 18 which was—in case you missed it—also the start of the World Health Assembly. The US has left the World Health Organization but the countries it is giving aid to have not. For many countries, the health officials responsible for fielding this incoming and for reverting by today with information about their Eligible Buyer—were already in Geneva when the message came in, and are still there now, as its the second to last day of the World Health Assembly and the birthday of my relative who crushes me in Crossplay. (Happy birthday. It’s your move.)