Global Health Watch: USAID in the Spotlight, Gavi Replenishment, Defense of the Rescissions Package and ACIP

Issue 22

June 27, 2025

This week brought major media attention to the devastating dismantling of USAID, even as the FDA’s approval of lenacapavir for PrEP signaled new hope in HIV prevention. At the same time, vaccines were under even greater assault as the US administration announced it would withdraw support from Gavi based on spurious claims, while the CDC’s Advisory Committee on Immunization Practices met for the first time since the Secretary of Health and Human Services fired leading vaccine experts and replaced them with a group of skeptics. Also, top administration officials defended reckless and unlawful proposals and actions in Congressional hearings. This issue unpacks it all.

Media Coverage Highlights USAID Dismantling Amid Regulatory Approval of New PrEP Option

Media outlets including The New York Times, The New Yorker, and NPR’s This American Life podcast spotlighted the devastating consequences of the US Administration’s dismantling of USAID while also covering the US FDA approval of lenacapavir (LEN) for PrEP last Wednesday. AVAC’s latest blog, The Cruel Irony of Prevention, highlights how scientific breakthrough and political sabotage collide at a critical moment in the global HIV response. 

IMPLICATIONS: The approval of LEN should mark a turning point in the fight to end the HIV epidemic. But without restored funding, political leadership, and bold, coordinated action, the promise of this breakthrough could be squandered. AVAC’s court case challenging the foreign aid freeze and our advocacy tools—like the Gears of Lenacapavir for PrEP Rollout—offer a roadmap for protecting progress and accelerating equitable access.  

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Gavi Replenishment Meeting and the Assault on Vaccines 

At this week’s Gavi replenishment meeting, US Health and Human Services Secretary (HHS), Robert F. Kennedy Jr. (RFK Jr.) shared a video message announcing that the US would withdraw support from Gavi, the Vaccine Alliance. Gavi leads efforts to ensure global access to vaccines and finances vaccines for more than 60% of children around the world. The withdrawal of support marks a dramatic departure from decades of bipartisan US leadership in global vaccination efforts. In his remarks, Kennedy amplified misinformation about the combination vaccine for diphtheria, tetanus and pertussis (DTPw vaccine), falsely implying it causes more harm than good. Gavi, which later announced that it secured $9 billion out of its total 2026-30 requirement of US$ 11.9 billion to support immunization in low-income countries through 2030, rejected RFK Jr.’s claims in a statement providing context and linking to data on the positive impact of the DTP vaccine, including saving an estimated 3 million lives every year.  

In further efforts to undermine vaccines and vaccination programs, at the House Energy & Commerce Health Subcommittee hearing, RFK Jr. defended his overhaul of federal health agencies and his removal of all members of the US Advisory Committee on Immunization Practices (ACIP). Lawmakers challenged him sharply, including Rep. Kim Schrier, D-Wash., who is a pediatrician; watch her powerful video here. RFK Jr. appointed a new group of ACIP members, including a number of prominent vaccine skeptics, and the committee this week in sessions filled with mis-information. 

IMPLICATIONS: 

The US withdrawal and spread of vaccine disinformation at the Gavi replenishment threatens global access to vaccines that are part of the foundation of community wellness and resilience in low-income countries. This comes at a time when coverage is already backsliding and outbreaks of vaccine-preventable diseases are on the rise. Losing US support is destabilizing global health and eroding trust in lifesaving programs.  

The hearing made clear that Kennedy’s sweeping restructuring threatens public health infrastructure and disrupts ongoing efforts in HIV prevention, STI research, and vaccine confidence. Discarding experienced experts and sidelining established science advisers risks undermining key disease surveillance and immunization guidance.  

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NIH Staff Ordered to Stop Certain Grant Terminations 

Last week, a federal judge ruled that the National Institutes of Health (NIH)’s termination of more than 900 grants on politically sensitive topics, including vaccine hesitancy, was illegal. This week, the judge also rejected the government’s request to delay enforcement of his ruling, which means that the NIH must begin restoring funding immediately, even if the case goes to appeals. In an email, NIH instructed staff to halt any further grant terminations, however, NIH employees told Science they have not yet received instructions to restore terminated grants. 

IMPLICATIONS: 
This decision shows positive steps in rebuking the Administration’s efforts to dismantle funding for science and biomedical research, and is a step toward preserving crucial grants related to HIV, STI, and DEI-focused research.

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US Senate Hearing on Rescissions Package 

The US Senate Appropriations Committee heard additional testimony, including written testimony from Bill Gates, in another hearing on the US rescissions package, which proposes clawing back $9.4 billion in previously approved spending, including $8.3 billion from foreign aid (including PEPFAR/HIV programs). Budget Director Russell Vought defended the package, while senators, including Committee Chair Susan Collins and Vice-Chair Patty Murray, voiced strong opposition, warning that these cuts could undermine global health, humanitarian aid, and democratic institutions. July 18 is the deadline for the Senate to vote on the package. 

IMPLICATIONS: This package would eliminate over $900 million from global health programs, and passage would codify, or make legal, the unlawful dismantling of USAID. In addition, Congressional approval of this package would lead to more requests for rescissions from the Administration. The proposed Fiscal Year ‘26 budget and rescissions package have far and deep implications for health, science, and research in the US and around the world. As we’ve stated in earlier analysis of the rescission package, it would dismantle the architecture for global health, including health programs and research that have broad bipartisan Congressional and public support, and which support the government’s stated aim of keeping Americans and the world safer, healthier and more prosperous. 

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CDC’s Incoming Director

Susan Monarez, PhD, the current acting director of the US Centers for Disease Control and Prevention (CDC) appeared before the Senate Health Committee. She is the nominee to lead the CDC and is respected among the scientific community. In her testimony, she strongly supported vaccines as safe and effective and pledged for evidence-based decision making in CDC decisions, including defending mRNA vaccine platforms and upholding integrity on the ACIP.  

IMPLICATIONS: Monarez, if appointed, will have the difficult job of following HHS Secretary RFK Jr.’s leadership and evidence-based decision making. With scientific expertise and commitment to vaccine policy, she may serve as a stabilizing force at the CDC. 

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What We’re Reading

Updated Resources