Global Health Watch: Legacies of Parton & Goosby, expiring global health funds, Jeremy Lewin’s move, Ebola funding & vaccine R&D

August 28, 2026

This week, the global health community lost a powerful, if unlikely, champion in Dolly Parton. She used her singing celebrity to support science and public health, including a $1 million investment that supported early research connected to Moderna’s COVID-19 vaccine. She was a supporter of literacy, marginalized communities and HIV awareness and care. Her legacy is a reminder of what it looks like to use influence to build trust in science, which couldn’t be more important today as vaccines, public health and LGBTQI+ communities are continually undermined and politicized.

Speaking of leadership, longtime leader Eric Goosby officially retired this week. Eric served as the US Global AIDS Coordinator and led the President’s Emergency Plan for AIDS Relief (PEPFAR) from 2009 to 2013 under President Barack Obama. But before he led PEPFAR and since he returned to UCSF, Eric has been a compassionate doctor, a passionate advocate, and a tireless defender of science and human rights. His colleague and mentee, mike Reid, posted this video from Eric’s retirement celebration.

Also this week, members of the US Congress demanded that the Administration release billions in congressionally-appropriated global health funding before it expires; another leadership change is underway at the Department of State, which oversees the transformation of US foreign assistance; and in the DRC, the Ebola response is making progress even as inadequate funding threatens efforts.

Congress Raises Alarm Over Expiring Global Health Funds and PEPFAR Restructuring 

Democratic members of the US Congress are pressing Secretary of State Marco Rubio and OMB Director Russell Vought to release billions in congressionally-approved foreign assistance before it expires on September 30. In a new letter, they note that $7.5 billion remains unobligated, including more than $3 billion for Global Health Programs. They object to OMB’s reported decision to reserve approximately $1.35 billion in FY2025 global health funding for the closeout costs of USAID rather than health programs Congress funded. They also question plans for PEPFAR, citing the two-million decline in people reported as receiving PEPFAR-supported HIV treatment in 2025 and asking the Administration to explain how proposed reductions in CDC’s implementing role will affect treatment continuity, HIV prevention, surveillance, technical expertise and community-based programs. They are seeking answers by September 9.

IMPLICATIONS: If billions in congressionally-appropriated global health funding are allowed to expire, or used to dismantle USAID rather than support programs, the effects could exacerbate the disruptions already being documented across PEPFAR and other health programs. Additionally, reducing the CDC’s role would shift how PEPFAR is implemented, and also erode surveillance, laboratory, technical and data systems that help countries maintain HIV services and detect wider health threats.

READ:

• Scoop: $7.5B in US funding for international affairs at risk of expiring—Devex  
• “A Huge Grab of Power”: Trump Is Defying Congress on Foreign Aid—ProPublica  
• The Trump Administration’s Foreign Aid Review: Status of PEPFAR—KFF  
• Walkinshaw, Amo, Kelly, Markey Lead 134 Colleagues in Demanding Release of More Than $3 Billion in Lifesaving Global Health Funding—Congressman James Walkinshaw  

Jeremy Lewin Leaves Foreign Assistance Role

Jeremy Lewin officially stepped down as head of the US Department of State’s foreign assistance bureau and is now serving as the Department’s Director of Policy Planning. He will advise Secretary of State Marco Rubio on key foreign policy matters. An original DOGE agent at the beginning of this Administration, Lewin was one of the architects of the Administration’s overhaul of US foreign assistance following the dismantling of USAID, including the shift toward bilateral government-to-government agreements and the development of the America First Global Health Strategy. Lewin will now oversee the Bureau of Economic, Energy and Business Affairs and continue representing the US in G7 and G20 development discussions. 

IMPLICATIONS: Lewin’s departure is yet another leadership transition for US foreign assistance. This happens as the State Department works to implement a redesigned aid and global health system, while being unable to obligate billions in congressionally- appropriated funding. The big question for global health now is who will lead implementation of the new foreign assistance architecture that Lewin helped design, including the bilateral agreements intended to reshape PEPFAR and other US global health programs. 

READ:

• Jeremy Lewin departs the State Department’s foreign aid bureau—Devex

DRC Ebola Response Gains Ground as Funding Gaps Threaten Progress 

The Ebola Bundibugyo outbreak in the Democratic Republic of the Congo (DRC) continues to expand, with more than 560 new cases in the last week. WHO reports improvements in contact tracing and testing and issued interim guidance on prevention and control to help countries safely continue routine immunization activities during an outbreak. However, transmission remains high and funding gaps threaten the immediate response and the development of preventive vaccines. CEPI, which supports several potential Bundibugyo vaccine candidates, says it faces a shortfall of hundreds of millions of dollars for vaccine R&D, even as it launched trials this week of its fifth Bundibugyo-specific virus vaccine candidate in response to the escalating epidemic. In Uganda, the WHO officially declared its related outbreak over.  

IMPLICATIONS: Resources are needed now to prevent new infections, just as sustained investment in vaccine R&D is needed to ensure future outbreaks can be minimized. As we highlighted last week, cuts to foreign assistance and weakened surveillance and response infrastructure have compounded insecurity and other challenges confronting the DRC response. And while vaccines could help prevent Bundibugyo if proven safe and effective, they cannot replace surveillance, health workers, laboratories, community engagement and health systems needed to prepare and respond.  

READ:

• CEPI faces huge Ebola vaccine funding shortfall—Devex  
• Ebola Outbreak May Be Three Times The Officially Reported Size—Health Policy Watch 
• Ebola day 100: why this outbreak could become the deadliest in history – video explainer—The Guardian  
• After 100 days of the deadliest Ebola outbreak, it can be stopped. Here’s how | Jean Kaseya and Tedros Adhanom Ghebreyesus—The Guardian  

What We’re Reading

• Political bickering follows two deaths related to measles in Pennsylvania—NPR 
• NIH wants to shroud peer review scores. Here’s what you can do about it.—27UNIHTED 
• Comments on OMB research rule mysteriously removed from federal website—STAT 
• AP report: RFK Jr. said a Samoa trip had nothing to do with vaccines. New documents refute that—PBS Newshour 
• CDC Director’s Promise to ‘Speak Truth to Power’ Is the Wrong Goal—MedPage Today 
• The Cost of Slow Science—With & For Substack 
• The next global health architecture cannot exclude women—The Lancet
• The Next Global Health Architecture Must Deliver More Than Reform—Health Policy Watch 
• It’s Been a Slow Start for Lenacapavir PrEP in the U.S.; Are We Repeating Past Mistakes?—TheBodyPro  
• We have better tools to fight HIV. Can we afford them?—Explain (SA)  
• Some pharmacists can now apply for permits to provide HIV prevention pills without a doctor’s script—Spotlight (SA)  
• NHS England is getting a breakthrough HIV drug – but the rest of the world needs it too—The Independent  
• They Don’t Want Us to Talk About Race. But It’s the Only Way We’ll End HIV—TheBody.com
• The scourge of LGBTQ criminalisation moving across African countries – and its impact on HIV—aidsmap  
• COMPASS Participation at IAS 2026—COMPASS 
• The turbulent AI era is here. The choices we make now are critical.—Gates Notes