Global Health Watch: Hepatitis B vaccine trial halted, HIV advocates demand action, LEN for PrEP access, Global Fund’s malaria accelerator

Issue 91

October 23, 2026

International pressure halted a controversial hepatitis B vaccine trial in Guinea-Bissau; HIV advocates rallied to protect US research funding as the midterm elections approach; and AVAC and Access Bridge call for accelerated access to LEN for PrEP. Meanwhile, the Global Fund prepares to select a new leader at its board meeting next week and vote on a proposed $2-3 billion malaria funding mechanism that could reshape the role of private philanthropy and country ownership in global health financing.

Guinea-Bissau Trial Halted, But Broader Vaccine Policy Concerns Remain 

Following last week’s uncertainty, the controversial US-funded hepatitis B vaccine trial in Guinea-Bissau was halted following international criticism and a police investigation. As The Guardian reports, judicial police seized vaccine doses earlier this week, and the study’s lead investigator confirmed that the trial would not proceed because it lacked government approval. The $3.2 million study, which received $1.6 million from the US Centers for Disease Control and Prevention (CDC), would have restricted hepatitis B vaccination from 7,000 newborns during their first six weeks of life. The global health community condemned the trial as unethical, especially given high rates of hepatitis B infection in the country and the WHO’s recommendation that all infants receive a birth dose within 24 hours. This week, a new US modeling study found that delaying the universal hepatitis B birth dose could increase chronic infections, adding to concerns about proposals to replace routine newborn vaccination with individualized decision-making. 

IMPLICATIONS: The Guinea-Bissau trial involved Danish researchers Peter Aaby and Christine Stabell Benn, whose work US Health Secretary Robert F. Kennedy Jr. has repeatedly praised and cited in support of his anti-vaccine policy agenda. This controversy reflects broader concerns about US vaccine policy and scientific independence. This week, the board overseeing the NIH Clinical Center publicly criticized the establishment of a new vaccine injury research clinic without prior consultation, raising concerns about political interference and public trust. Meanwhile, the US continues to experience a resurgence of measles, which is likely a result of growing gaps in vaccinations. Taken together, these developments highlight the importance of independent scientific oversight, ethical research practices and evidence-based immunization policies, both in the US and globally. 

READ:

HIV Advocates Demand Action to Protect HIV Research as US Midterm Elections Approach

Last Friday, the NIH finally released the long-delayed Notice of Funding Opportunity (NOFO) for the Centers for AIDS Research (CFARs), which is important. However, the long-awaited NOFOs to renew NIH’s HIV clinical trials networks remain outstanding. This week, 139 organizations sent an urgent letter to the US Congress, warning that overdue clinical trial funding, political interference in scientific research and the potential diversion of research funding jeopardizes decades of scientific progress with consequences extending far beyond HIV. Many of these organizations gathered during IDWeek 2026 for the Save HIV Funding campaign’s #CutsKill rally alongside panels of the AIDS Memorial Quilt to demand action. As Jeanne Marrazzo, CEO of the Infectious Diseases Society of America (IDSA), reminded partners at the rally, “Nothing has hurt me as much in the last year as the cruel and devastating cuts and attempts to silence us around HIV care, advocacy and research. Please keep fighting; we really need to just not look away for a second.” AVAC’s Mitchell Warren added, “It is possible today, and it’s possible because of science. But it’s going to be made real because of choices we all get to make.”  

IMPLICATIONS: The US mid-term elections are Tuesday, November 3, where new members of the US Congress will be elected. Their job will be to determine the future of federal HIV research funding and oversight. Advocates’ actions show the importance of sustained advocacy, and its success, in protecting decades of scientific progress. The release of the CFAR funding opportunity is a positive development, but the work is far from over. Watch the video from the rally and take action through Save HIV Funding. 

READ:

No Time to Lose: A Call to Reach Three Million People with LEN by 2027

AVAC and Access Bridge issued a global call to action and new publication urging governments, donors, manufacturers, implementers and advocates to accelerate the rollout of injectable lenacapavir (LEN) for PrEP to reach at least three million people by the end of 2027. This new, more ambitious target will drive affordability, build a sustainable PrEP market, and accelerate impact. It is a significant acceleration from the Global Fund and PEPFAR’s existing commitment to reach three million people over three years. AVAC and Access Bridge call on the Global Fund and PEPFAR to place orders now for enough doses to reach at least 2.4 million people in 2027, building on the 600,000 person-years ordered for 2026. Countries must forecast based on actual need rather than available budgets, regulators must accelerate approval of lower-cost generics, manufacturers must ensure sufficient supply, and additional donors are needed to be even more ambitious in 2027 and beyond. Equally important are investments in community-led demand creation and delivery systems that make LEN accessible as part of comprehensive prevention choice. 

IMPLICATIONS: The coming year represents a critical window for action and whether LEN’s extraordinary scientific promise translates into access at the speed and scale needed to reduce new HIV infections. Faster scale-up can create a larger, more sustainable PrEP market, driving prices down and expanding access to future prevention options. The ambition must extend beyond three million people in 2027 toward 20 million by 2030. As Access Bridge’s Wawira Nyagah says, “Three million people by the end of 2027 is a starting point, not an endpoint.” 

READ:

Global Fund’s Proposed Malaria Accelerator Tests the Future of Country-Led Financing

The Global Fund is considering a new funding mechanism that could mobilize an additional $2-3 billion for malaria programs through its proposed Malaria Impact Accelerator (MIA). This mechanism could expand access to existing malaria interventions and accelerate new innovations in countries with the highest malaria burden and lowest economic capacity. The New York Times calls the proposal “a potentially transformative shift” in global health financing, as technology entrepreneurs and investors anticipate substantial new philanthropic wealth from artificial intelligence (AI) companies. The proposed investment would give donors unprecedented influence over which interventions countries implement. The Global Fund Board is expected to vote on the mechanism at its board meeting next week, where it is also expected to elect its new leader.  

IMPLICATIONS: The prospect of billions in additional funding offers an important opportunity to accelerate malaria prevention and treatment amid shrinking development assistance. New donors bring resources and ambition, but sustainable progress against HIV, tuberculosis, malaria and other health threats depends on strong national health systems and community priorities that cannot always be captured through short-term metrics. But as the New York Times article highlighted, “In the documents outlining the terms of the deal to the Global Fund board, the organization’s executives said the arrangement would give a donor unprecedented power to decide what interventions a country will use, upending the model the Global Fund has used for nearly 25 years, and noted that the amount and duration of the support is uncertain, tied to a volatile industry.” As the Global Fund Board considers the proposal alongside upcoming leadership changes, its decisions could help define how emerging philanthropic investments complement, rather than reshape or replace, country-led global health financing.

READ:

Reaching Key Populations with Long-Acting PrEP

The need for PrEP amongst key populations (KPs) is high yet KPs remain underserved in many PrEP programs. To help address this need, Global Black Gay Men Connect, Access Bridge, and AVAC, alongside local partners in Eswatini, Kenya, and Zambia, convened Human Centered Design (HCD) Lite workshops to gather insights to develop KP-focused messaging on long-acting PrEP.  The resulting findings were synthesized into a demand generation toolkit, consisting of summary insights, guidance for developing materials, and sample materials.

Register

What We’re Reading

Resources

Aftershocks Roundtable: How do we rebuild our HIV and public health infrastructure?

Join The Choice Agenda and IAPAC’s José M. Zuniga – author of the new book “Aftershocks: Trump 2.0, Public Health, and Our Better Angels” – and a dynamic panel to discuss the profound disruption of public health systems over the past almost two years and the urgent need for a coordinated movement to defend and ultimately rebuild them.

Register