Global Health Watch: Assault on US vaccine policy, contradictions in HPV and HIV vaccine science; 14 countries sign America First MOUs

Issue 50

January 9, 2026

The assault on vaccine policy and confidence intensified this week as the US overhauled its childhood immunization schedule, reducing the number of vaccines recommended and breaking decades of evidence-based practice. At the same time, the human papillomavirus (HPV) vaccine recommendations remain intact, and a new Phase I HIV vaccine trial launched demonstrating the contradictions of the moment.

Beyond the US, 14 countries have now signed bilateral health agreements with the US under the America First Global Health Strategy. At the same time, the US President signed a new executive order withdrawing the US from and defunding over 60 international organizations and treaties. And as this issue began to publish, Health Policy Watch reported that Germany plans to cut its funding by half for the World Health Organization’s Hub for Pandemic and Epidemic Intelligence. This suite of decisions shows sweeping upheaval in global health policy, governance and funding.

Continued Assault on Vaccines: US Shifts Vaccine Policy

The US Administration overhauled its childhood immunization schedule, reducing the number of vaccines universally recommended for children and moving several (including rotavirus, influenza, hepatitis A & B, respiratory syncytial virus [RSV], and others) to recommended categories only for children deemed at high-risk. Researchers at the US Centers for Disease Control and Prevention (CDC) and leading pediatric and public health organizations are criticizing the new policy, warning it could weaken protections against preventable diseases and is contrary to decades of evidence-based practice and adds confusion among providers and families. They also note that this change was made without broad scientific consensus or a transparent process and bypassed traditional advisory review. Just after the change in policy, a federal court ruled in favor of major medical societies, including the American Academy of Pediatrics, to proceed in their lawsuit against the Department of Health and Human Services (HHS) challenging changes to COVID-19 vaccine policy and replacement of members of the CDC’s Advisory Committee on Immunization Practices (ACIP) with people who lack the credentials and required experience.  

IMPLICATIONS: These changes to the US vaccine schedule, which come on the heels of reduced US support for global vaccine initiatives such as Gavi, the Vaccine Alliance, and cuts to mRNA vaccine development, represent yet another assault on vaccine science and confidence. By narrowing recommendations for routine vaccines without clear evidence or expert consensus, the Administration risks weakening public trust in vaccine programs at a time when vaccine acceptance is critical to controlling preventable diseases. This policy shift could fragment national standards, spur state-level pushback, and increase disparities in vaccine uptake, undermining decades of progress and complicating global efforts to sustain strong immunization coverage.

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HPV Vaccine Update and Self-Collection for HPV Test 

Amid these broader changes to pediatric vaccine policy, the human papillomavirus (HPV) vaccine remains recommended for 11–12-year-olds in the US, easing concerns that it might be removed from the routine guidance. The updated guidelines also endorse a single-dose HPV vaccine schedule, which reflects emerging evidence that one dose can be highly effective. At the same time, new recommendations from the US Health Resources and Services Administration say that women ages 30 to 65 with an average risk of cervical cancer can opt for a self-administered HPV test.

IMPLICATIONS: While this shift could simplify delivery and improve uptake, important questions remain. Experts caution that the strongest one-dose data come from studies in females with limited follow-up and note that there is very little evidence on one-dose efficacy in males. As implementation moves forward, continued data collection and careful monitoring will be essential to ensure long-term protection for all. For self-collection of samples for testing, this shift could improve screening rates.READ:  

New HIV Vaccine Strategy Kicks off Amid Larger Assault on Vaccines and Science 

Meanwhile, a new chapter in HIV vaccine research begins as first vaccinations for the IAVI G004 Phase I clinical trial were announced this week. This early-stage HIV vaccine trial stands out because it is the first germline-targeting vaccine designed to induce broadly neutralizing antibodies (bNAbs) against more than one major site on the HIV envelope—specifically both the CD4 binding site and the V3 glycan region. Most prior HIV vaccine candidates have focused on the CD4 binding site alone, making IAVI G004 a long-anticipated scientific advance. Importantly, this trial also reflects recent political shifts: it was initially envisioned as part of a larger NIH-partnered collaboration (DESIIGN), but changes in US government priorities have reduced the size of the trial. See AVAC’s tracker of the full HIV vaccine clinical trials pipeline.  

IMPLICATIONS: This trial continues to show a cruel irony in HIV prevention. Scientifically, it represents a meaningful step forward in germline-targeting strategies that could strengthen immune responses and lead to an eventual HIV vaccine. But, it also highlights how political and funding disruptions are constraining the breadth and depth of vaccine research by limiting collaborations, reducing funding and placing greater strain on already fragile pipelines.

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14 African Countries Have Signed Bilateral Agreements with US Under its America First Global Health Strategy

At least 14 African countries have now signed five-year agreements with the United States under the “America First” Global Health Strategy. Recent deals with Botswana, Ethiopia, Ivory Coast, Madagascar and Sierra Leone, cover HIV, malaria, maternal and child health, pandemic preparedness, and other priority areas, require co-investment from partner governments, and include commitments on data sharing (which has been controversial; a court case in Kenya has challenged this provision), and health system reforms. The total now surpasses the $16 billion mark.

IMPLICATIONS: While these agreements may restore some funding after earlier foreign aid disruptions, they also reinforce a shift away from multi-stakeholder cooperation and toward government-to-government agreements with conditions that may come at the expense of low-and-moderate-income countries. As this model extends to more countries across Africa, how nations navigate sovereignty, accountability, and long-term health system strengthening will be critical for ensuring these billions translate into sustained, equitable impact. 

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