Global Health Initiatives (GHI) have played an important role in shaping health outcomes in countries through disease- and intervention-focused investments. As key financing mechanisms, GHIs primarily support disease-specific efforts, but their investments have an important role in shaping national health systems. This study used the Health Systems Strengthening (HSS) Investments Database, available in the Primary Health Care for Global Health Initiatives Toolbox, to examine the budgeted contributions of Gavi and the Global Fund toward HSS in 32 countries, in the period 2007–2024. Investments were categorized across key health system categories: service delivery, health workforce, health products, health information systems, governance, financing, and advocacy. They were also disaggregated across the six World Health Organization Regions.