The Tuberculosis Implementation Framework Agreement (TIFA) project, led by JSI, builds on the U.S. government’s investments in tuberculosis (TB) programming to accelerate countries’ progress towards national and global health targets, including TB, HIV, malaria, emerging health threats, and maternal and child health. Through direct engagement with local governments and partners in Africa and Asia, TIFA facilitates the co-design of Health Commitment Grants (HCGs), which are short-term, fixed-amount, milestone-based awards tailored to address specific gaps reaching health goals. These grants support locally-led programs, strengthen national coordination, and promote innovation, adaptation, and accountability to build more resilient health programs. The grants mitigate financial risk and improve accountability and transparency by paying only for the achievement of pre-defined deliverables. Globally, JSI implements the Department of State-managed TIFA project with partner Open Development. In India, JSIPL leads the management of TIFA grants to support TB, integrated health, and global health security priorities.