AVAC Board Member Jeanne Marrazzo named CEO of IDSA
AVAC enthusiastically applauds the selection of Jeanne Marrazzo, MD, to serve as the new chief executive officer of the Infectious Diseases Society of America (IDSA). Marrazzo brings outstanding leadership and research expertise to this role. She has demonstrated decades of unwavering commitment to research and advocacy for HIV and STI prevention, and a deep understanding of the importance of equity, accountability and trust in science, research and global health.
“Jeanne Marrazzo is an extraordinary choice and perfectly suited to lead IDSA and the larger infectious disease field into the future, especially at this particularly perilous moment,” said AVAC’s executive director, Mitchell Warren. “Her deep commitment to rigorous science, inclusion and equity in research, community engagement, and accurate, evidence-based communications is unparalleled — and is needed now more than ever.”
IDSA represents clinicians, scientists and public health experts from around the world, who are driving policy and advocacy to address critical issues in combating infectious disease, from workforce development to clinical guidelines to pandemic preparedness. Marrazzo’s vision, abiding integrity and leadership at IDSA will be a boon for the field.
Marrazzo, an AVAC board member, previously served as the director of the NIH’s National Institute of Allergy and infectious Disease (NIAID). Marrazzo was put on administrative leave by the new US presidential administration earlier this year and was formally dismissed from her position in September. She has consistently displayed extraordinary commitment, courage and leadership in responding to attacks on the NIH and on science generally.
“Her actions are a model for all who believe equity and evidence are the bedrock of science, research and health. We proudly stand with Dr. Marrazzo, and we look forward to her leadership and partnership in sustaining progress against HIV and other infectious diseases and in helping re-build trust and confidence in science and public health,” said Warren.
Global Health Watch: 4 African Countries Sign Bilateral Health MoUs with US, New People’s Research Agenda, Hepatitis B Vaccine Shift
Issue 46
This week covers fast-moving developments with new US bilateral Memos of Understanding (MoU) across Africa, including reactions from Kenya’s High Court, which suspended the agreement over the issue of sharing of health data, alongside new reporting on the adverse impact of US policy changes affecting science and research institutions, and a major reversal in US hepatitis B vaccine policy. We also track the newly updated People’s Research Agenda.
Four African Countries Signed Bilateral Health MoUs with US; Kenya’s Court Intervenes
So far, four Africa countries have signed bilateral health MoUs with the US under the “America First Global Health Strategy”: Kenya, Liberia, Rwanda and Uganda. These agreements provide 5 to 10 years of funding and health support in exchange for co-financing, health data, pathogen-specimens, and national health system data, marking a major shift in how global health cooperation is structured under US leadership. Kenya’s agreement, which was the first and largest to date, promises about US $1.6–1.7 billion over five years and a commitment from Kenya to raise domestic health spending. Civil society groups across Africa and globally are sounding alarms about the process noting that agreements have been negotiated and signed without public consultation, parliamentary oversight, or community input. Thursday, Kenya’s High Court issued a conservatory order, temporarily blocking any transfer or sharing of sensitive health data until a full hearing in early 2026. The Court is reviewing two major petitions: one on data protection and digital rights, and another on whether the MoU bypassed constitutional requirements for parliamentary approval.
IMPLICATIONS: These MoUs begin to reconstruct US-led global health investments, moving away from multilateral frameworks and programs informed by community and civil society input toward bilateral, government-to-government agreements. This raises critical questions about sovereignty, transparency, and equity with health data and biological samples being treated as bargaining chips, and unclear protections for privacy, benefit-sharing, or local ownership. The Kenya High Court’s ruling underscores the seriousness of these concerns. African nations with larger economies, such as Kenya, may be better positioned to push back against problematic provisions, but many other countries may not have the same leverage.
The Consequences of US Policy Decisions on Science and HIV Research
A wave of new reports and commentary are showing the far-reaching impacts of recent US policy decisions on science and global health. STAT released American Science, Shattered, a multipart investigation detailing how actions taken under the US Administration have disrupted research labs, upended scientific careers, and fractured an eight-decade partnership between universities and the federal government.
In case you missed it, scientists, researchers, and advocates participated in the Save AIDS Research Marathon sharing firsthand accounts of what decades of federally supported HIV research have delivered—and what stands to be lost. Their stories highlight how foundational US investments have driven breakthroughs in the treatment and prevention of HIV and other diseases that have saved tens of millions of lives, and how recent project terminations and budget cuts are already reverberating across the research landscape.
US Panel Votes to Change Longstanding US Hepatitis B Vaccine Policy
Last Friday the Advisory Committee on Immunization Practices (ACIP), which was dismissed and replaced with vaccine-skeptical members, voted (contentiously) to change longstanding US hepatitis B vaccine policy. Instead of universally recommending that all newborns receive a hepatitis B vaccine at birth, without any new data or evidence, the committee now advises that a birth dose be given only to infants born to mothers who test positive for the virus or whose infection status is unknown. The panel recommended that mothers who test negative for hepatitis B delay vaccination for two months and use antibody testing to determine whether to administer a third dose, further decreasing the likelihood that infants will receive full immunization against a leading cause of liver cancer.
IMPLICATIONS: This decision reflects broader disruptions at the US Centers for Disease Control and Prevention (CDC) that are eroding evidence-based vaccine policy in the US and raising alarm among global health advocates. Leading physician groups and public health experts issued a warning that the policy change could result in unnecessary illness and death, arguing that it departs from the robust scientific evidence that underpinned the universal birth-dose strategy. At a time when confidence in vaccine programs remains essential to strategies for the control of infectious disease, this decision brings uncertainty into routine vaccine recommendations and risks further eroding trust in public health institutions.
Just Launched! The 2025 update of The People’s Research Agenda
AVAC and partners released the 2025 update of The People’s Research Agenda (PRA), a people-centered framework to drive equitable and accelerated HIV prevention research and development (R&D) and product introduction. The PRA tracks the science, highlights where investments align—or fail to align—with community priorities and identifies critical gaps that must be addressed for the pipeline of HIV prevention to meet the needs of diverse populations. This year’s update includes an expanded online dashboard for tracking, translating, and advocating for HIV prevention R&D.
CONTEXT: The past ten months have wreaked havoc on biomedical research, and the path forward now demands sharper priorities, smarter investments, and a deliberately balanced portfolio that reflects what is both needed and achievable to drive real epidemic impact. Every funding decision carries greater weight in determining whether communities will have meaningful choices in prevention. Sustaining progress requires protecting the full continuum of research: investing in basic science and early-phase discovery, supporting late-stage trials and product development, and ensuring community engagement and implementation science remain central to translating advances into access. Ultimately, the goal is a pipeline that delivers viable, effective, people-centered prevention options to those who need them most.
We are delighted to share our 2025 update of The People’s Research Agenda (PRA), offering an online, interactive dashboard for tracking, translating, and advocating for HIV prevention research and development (R&D). First developed in 2024 in partnership with global advocates and communities (and launched at the HIV Research for Prevention (R4P) conference in Lima), the PRA sets out a people-centered framework for equitable and accelerated R&D and product introduction. The PRA tracks the science, shows where investments align—or fail to align—with community-defined priorities, and spotlights critical gaps in the pipeline of prevention options needed to meet the diverse realities of all populations.
Because HIV prevention R&D must remain a core priority in the HIV response, the PRA offers the evidence and insight needed to secure support for a community-centered research pipeline. More than a report and data tool, the PRA is a continually updated accountability mechanism that can transform information into influence.
Since the People’s Research Agenda first launched in 2024, much has happened. US funding cuts terminated an entire portfolio of critical HIV prevention research programs, including ADVANCE and BRILLIANT, which were studying African-led vaccine concepts; MATRIX, which was studying shorter-acting, user-controlled ARV-based PrEP and dual-purpose options; and MOSAIC, which was conducting an implementation science study of PrEP options. But new efficacy trials are now underway testing a monthly PrEP pill and several early-phase vaccine candidates are investigating a number of strategies.
The field must face head-on this new reality with sharper priorities and smarter investments. We invite you to dig into this 2025 update of the PRA, to join in our calls to action, and continue the fight for critical research that will finally bring the HIV epidemic to an end.
Global Health Watch: World AIDS Day advocacy, first injections of LEN for PrEP, CDC turmoil, Kenya signs US MoU
Issue 45
In 1990, the US Centers for Disease Control and Prevention (CDC) codified five principles under the late Walter Dowdle as its pledge to the American people, including a promise to ground every public-health decision in the highest-quality scientific data and to treat all people with dignity, honesty and respect. But today, as political forces undermine science and erase commitments like World AIDS Day, we are reminded just how fragile those principles have become, and how essential they remain.
This week we track both momentum and mounting threats in the HIV response: powerful World AIDS Day advocacy even as the US refused to recognize it; first recipients of lenacapavir for PrEP in Brazil, Eswatini, South Africa and Zambia; continued CDC turmoil that threatens trust in vaccines and science-based public health; the US’ “New G20” without South Africa; and Kenya signs the first US global health Memo of Understanding (MoU).
World AIDS Day
Despite the current US administration refusing to recognize December 1 as World AIDS Day (as described here in National Public Radio’s Goats & Soda), global media coverage and action were strong. On South Africa’s eNCA evening newscast, CAPRISA’s Slim Abdool Karim and AVAC’s Mitchell Warren underscored the need for smart, strategic decisions to prevent infections and ensure access to treatment. ABC News featured additional warnings about the devastating impact of US cuts and politics, and CNN highlighted what happens when ideology trumps epidemiology.
For additional reflection, Emily Bass and Ben Plumley offered a powerful—and sobering—conversation via the Shot in the Arm podcast about how political decisions can upend global HIV progress, and how affected countries are increasingly taking control of their responses.
At ICASA, the Lancet published a six-paper series on Sustainable HIV prevention in Africa, which shares why epidemic control depends on shifting from fragmented, donor-led programs to country-led, integrated systems, using examples of impact from seven African countries.
And in New York City, the #SaveHIVFunding campaign rang the NASDAQ stock market’s opening bell in recognition of World AIDS Day and a national week of action, sending a powerful message of unity, resilience, and national resolve to protect the lifesaving HIV programs that millions of people in the US and around the world rely on.
First Injections of LEN for PrEP
This week people in Brazil, Eswatini, South Africa and Zambia received the first injections via implementation programs outside of the US of lenacapavir for PrEP (LEN). The Global Fund to Fight AIDS, Tuberculosis and Malaria anticipates additional deliveries of LEN in the coming months to both Eswatini and Zambia as well as to Kenya, Lesotho, Mozambique, Nigeria, South Africa, Uganda and Zimbabwe. See AVAC’s updated map of Global Fund and PEPFAR supplies to early introduction countries. Meanwhile, national regulatory agencies in Malawi and Zimbabwe approved LEN for PrEP, bringing the total number of approvals to six. See AVAC’s updated LEN regulatory map.
IMPLICATIONS: These milestones signal a new dawn for HIV prevention—the speed at which LEN is being approved and delivered shows what’s possible when political will, funding, community engagement and innovation align. But this speed must now be matched by scale and equity: to truly change the trajectory of the epidemic, LEN must reach all who need it and be sustained over time. Read more about the events by advocates and partners on LinkedIn here, here and here. Also GBGMC’s Micheal Ighodaro explored the transformative potential of LEN for PrEP if countries commit to access, especially for key populations in Think Global Health.
Continued Chaos at the US Centers for Disease Control and Prevention (CDC)
A recent New Yorkerinvestigation captures the political interference at the CDC under Health and Human Services (HHS) Secretary, Robert F. Kennedy Jr., which includes changes that are undermining the scientific consensus that vaccines do not cause autism. This week the Advisory Committee on Immunization Practices (ACIP), which was dismissed and replaced with vaccine-skeptical members, meets to consider delaying the hepatitis B vaccine dose at birth, which would be a major departure from decades of proven public-health practice. The Committee meets under a new chairperson, Kirk Milhoan, who has blamed vaccines for causing cardiovascular disease, and began his post just this week. Meanwhile, the CDC issued a warning to clinicians to watch for Marburg virus cases linked to an outbreak in Ethiopia, highlighting emerging global health threats amid institutional instability.
IMPLICATIONS: By dismantling long-standing expert advisory processes and politicizing vaccine guidance, the US is undermining domestic immunization programs and also global confidence in science-driven public health. The potential delay or rollback of routine immunizations threatens to reverse decades of progress, fueling distrust that could spill over into HIV, TB, and other health areas. At such a pivotal moment for HIV prevention, cure research, and vaccine development, destabilizing vaccine policy in the US risks eroding momentum worldwide.
Following the closure of the widely hailed G20 summit in South Africa last week where the US was notably absent, this week, the US shared plans for a “New G20” for 2026, which adds new members and excludes South Africa from the summit in Miami next December. In a statement, US Secretary of State, Marco Rubio unfairly and alarmingly called out South Africa’s current government: “Rather than take responsibility for its failings, the radical ANC-led South African government has sought to scapegoat its own citizens and the United States”. In response, South Africa signaled it will take a “commercial break” from G20 participation during the US-led presidency.
IMPLICATIONS: The exclusion of South Africa in the US-led 2026 summit is a warning sign. South Africa has been a leading voice for African and Global South priorities, including equitable access to health, the HIV/AIDS response, and social justice. By sidelining the country with mis- and dis-information, the US risks marginalizing regions already facing unequal burden of disease and limited resources. Key funding, efforts to expand access to medicines and HIV prevention tools may suffer from fractured governance and most vulnerable communities could lose out on representation, accountability, and the collective leverage needed to secure health equity worldwide.
Kenya Signs MoU Under New US Global Health Strategy For $1.6B
Kenya became the first country to sign the controversial US Health Memos of Understanding (MoU) earning $1.6B in funds disbursed through the next five years in exchange for health care data and specimens for the next 25 years. US Secretary of State Rubio suggested this was the first of many countries (up to 50) to sign the MoUs.
IMPLICATIONS: Kenya’s decision trades long-term access to health data and biological samples for short-term funding raising serious concerns about sovereignty, consent, and accountability. If this agreement becomes the model for dozens more countries, the future of global health cooperation could shift toward transactional arrangements that prioritize US geopolitical interests over community rights and health equity.
Now streaming on Hulu: HIVUnwrapped: Where Fashion Meets Science — a powerful look at how HIV researchers and fashion designers are teaming up to bring information on HIV to new audiences.
Join us for a conversation on the state of HIV cure research in Africa and the opportunities to strengthen and scale Africa-led innovation with leaders from Africa Health Research Institute, KwaZulu-Natal, Root to Rise and moderated by Anna Miti.
World AIDS Day in 2025 comes at a moment of unprecedented change. Over 60 years of investment in global health, forty years of innovation and progress in the fight to end the HIV epidemic, and many of the critical programs that provide access to HIV prevention in high burden countries are in disarray and at risk of collapse. As the US government withdraws and redirects resources, the just-launched UNAIDS report shows the number of people living with HIV is predicted to increase from 40 to 50 million people by 2050, unless HIV incidence reduces dramatically. Yet, in the midst of the chaos, there’s a historic opportunity to defeat HIV by scaling-up the breakthrough technology of long-acting injectable PrEP.
As governments and HIV prevention champions around the world scramble to reimagine a people-centered HIV response and build anew, what will it take to finally achieve targets to drive down incidence and reach epidemic control?
1. Fulfill the promise of science with accelerated, equitable access to injectable lenacapavir (LEN) for PrEP, delivered at scale
Science and advocacy have delivered astounding progress in developing biomedical options for HIV prevention. Injectable LEN for PrEP is moving from research to rollout faster than any product before.
Current commitments from the Global Fund and PEPFAR to provide doses for two million people by 2028 in 12 initial countries represent a good start, but fall far short of reaching targets to achieve impact, which calls for 20 million PrEP users by 2030.
Making LEN for PrEP available for all who need and want it is possible. Coordination among all stakeholders, and a shared priority to achieve epidemic control, can build a sustainable market for LEN that drives volume up and prices (and HIV incidence) down; puts communities at the center of program planning and implementation; is supported by inclusive policies; and integrates with sexual and reproductive health services that offer choices in HIV prevention to meet diverse needs. To learn more about who and what must come next to realize this potential, check out AVAC’s suite of LEN resources and track updates on rollout with our long-acting PrEP dashboard.
2. Expand, strengthen and sustain community and civil society leadership in the HIV response
Engaged advocates are fundamental to the success of HIV prevention R&D and rollout and to the larger global health movement. Involving community, civil society and global health advocates too little or too late has taught the field valuable lessons. Community leadership was on full display at last week’s Global Fund replenishment. Informed and supported community leadership has reshaped and improved both clinical trials and the broader landscape of policies, planning and programs for HIV prevention. From the strategic organizing and monitoring by the Coalition to build Momentum, Power, Activism, Strategy & Solidarity (COMPASS) Africa, to the policy wins and mentoring successes of AVAC’s Fellows & Advocacy Navigator programs, to the high-impact reach of Coalition to Accelerate & Support Prevention Research (CASPR), these initiatives represent highly effective models for community engagement. Stay tuned for detailed reports on the impact of these models in the weeks ahead.
3. Double down on the research pipeline for HIV prevention and a People’s Research Agenda
The US government’s attack on HIV research has been just as evidence-free, ideological and devastating as the drive to dismantle foreign assistance. With epidemic control in sight against one of the fastest mutating viruses ever known, HIV prevention scientists and advocates know that now is the time to press on the gas, not stall out. From vaccines and bNAbs to multipurpose technologies (such as the Dual Prevention Pill), to novel long-acting PrEP (such as a monthly PrEP pill), advancing the development of options to meet diverse needs and offer choice is key to effective HIV prevention and ending the epidemic.
As the new year approaches, there’s no doubt what needs to happen: deliver effective options with speed, scale and equity; invest robustly in developing the options we still need; and center the leadership of communities at every level of the HIV response. The world has every capacity to end the HIV epidemic in our lifetime, now we must summon the political courage to do it.
Since January 20, 2025, the new US Presidential Administration has made massive cuts to HIV research, dismantling the infrastructure for conducting research and pushing misinformation on the benefits of research. In rapid response, AVAC worked together with a volunteer coalition of the nation’s leading HIV researchers and advocates to conceptualize, organize, and host the 24-Hour Marathon to Save AIDS Research.
This event is a core component of AVAC’s ongoing advocacy to protect HIV research from drastic cuts to research funding, programs and partnerships. Using our convening power, research expertise, and research translation experience, this group of dedicated individuals brought advocates and researchers together in solidarity and shared critical messages about why HIV research matters with the larger global community.
In the months prior to the marathon, AVAC and partners sounded the alarm that the government’s relentless cuts to critical foreign aid would soon be followed by attacks on public health, scientific research, and science at large. As predicted, in March 2025 the administration began to cancel grants and dismantle federal institutions, with immediate and devastating impact on HIV research. AVAC worked quickly to raise awareness, educate researchers, advocates, and partners, and collaborate with these groups to protect life-saving research. The network mobilized leading voices in research, strengthened advocacy skills through teach-ins, tools, and resources, educatedpolicy makers, and disseminated timely and accurate information to track the impact of cuts to HIV research. Researchers and advocates harnessed this momentum to bring critical messages about the urgency of reversing funding cuts and the real-world impact of breakthroughs in HIV research to a larger audience.
Ultimately, the Save AIDS Research marathon on September 16-17 reached over 7,000 advocates, researchers, stakeholders, policy makers, journalists and community members from 28 countries and 30 U.S. states. The event featured 75 presenters representing major research institutions, public health organizations, civil society organizations and communities impacted by HIV all over the world, along with 42 endorsing organizations and robust engagement from viewers throughout all 24 hours of the livestream. (All 24 hours of content are available online for ongoing advocacy.) The marathon covered an incredible breadth of topics, including the legacy of innovation from HIV research; the role of advocacy in an equitable and effective HIV response; the implications of intersecting and emerging epidemics; advances in prevention, treatment, vaccine and cure research; the growing portfolio of Africa-led HIV prevention research; innovative models for delivering care; and community movements to sustain access to HIV services.
As an interactive, public event, participants also had the unique opportunity to engage directly with researchers, share their personal stories, connect with each other, and discuss ideas to strengthen future HIV research advocacy and action. As one livestream attendee reflected, “This is a valuable example of people uniting across sectors and across the globe to share evidence-based information on the importance of research.”
Dr. Joseph Eron, the Principal Investigator of the HIV/AIDS Clinical Research Unit at UNC-Chapel Hill and chair of the ACTG network, also reflected on the critical role of this kind of community engagement in research, commenting during his presentation in Hour 3, that the event was “a great example of dissemination to the community, something that’s open and accessible.”
What began as a simple idea became an incredible demonstration of the collective power and dedication of the HIV research community. Diverse members of the HIV research community came together to amplify global advocacy messages, counter misinformation, and strategically advocate to protect decades of progress to end the epidemic. Dr. Jeanne Marrazzo, the former Director of NIAID, reinforced this belief in the strength of the field during her presentation in Hour 8: “No one can stop us if we continue to fight together, stand together and continue to tell the truth and advocate for science and for our patients and our community.”
Later this month, AVAC will relaunch an updated version of its groundbreaking Peoples Research Agenda (PRA) to highlight the risks to and priorities for the HIV prevention pipeline, how federal cuts impact the prevention pipeline, and what is needed to support advocates to take action.
As the field navigates the constantly evolving funding environment, AVAC will continue to do the critical work of tracking and translating the latest scientific and funding developments, and ensuring advocates are informed and supported in the ongoing fight to end HIV. Mitchell Warren, AVAC’s Executive Director affirmed, “Saving AIDS research is not a 24-hour exercise; it is a commitment from all of us involved to tackle this collective challenge.”
Advocacy: Now more than ever – and AVAC needs you more than ever, too
2025 has been a year like no other. During these challenging times, AVAC’s Global Health Watch has been the go-to source for tracking and analyzing attacks on global health and the HIV response, pandemic preparedness, and human rights: from the US government’s foreign aid freeze and subsequent funding collapses to the politicization of science and erosion of public health infrastructure. Thanks to our partners and many supporters, we were able to introduce and push out 43 issues of Global Health Watch, providing consistent, trusted context so you can navigate the turmoil with clarity, purpose and solidarity.
Global Health Watch is about translating chaos into actionable insight, identifying risks early, informing rapid advocacy, and supporting global movements to defend evidence-informed, rights-based and community-centered health responses. In a time when misinformation and political interference threaten decades of progress, AVAC is proud of its role as a steady source of analysis, strategy, and coordination. We’ve done it for the past 43 weeks. We’ll keep going as long as these threats remain.
As the US moves into Thanksgiving later this week, we give thanks to our community who stops at nothing to safe-guard hard-won progress against HIV and global health equity. Next week marks our 30th anniversary as an organization. While so much in the field has evolved in this time, what we do and why we do it remains constant—thanks to your support and collaboration.
Next week is Giving Tuesday. If you depend on Global Health Watch and the work that AVAC and our partners do, please support us to ensure we can continue tracking developments in real-time, strengthening advocacy networks, and equipping partners with the tools and information they need to respond effectively. Together, we can continue to protect global health and all that communities have fought so hard to build.
Join Us at ICASA and the 8th Biomedical HIV Prevention Forum
Advocacy in Action
As seismic shifts in global health funding and strategy unfold, the 2025 International Conference on AIDS and STIs in Africa (ICASA), happening December 3–8 in Accra, Ghana, comes at a pivotal time. For more than three decades, ICASA has served as a critical platform founded by African scientists, activists, and advocates to fight stigma, drive research, and elevate African leadership in the HIV response. This year, this mission is more urgent than ever.
AVAC and partners will be in Accra to meet this moment. On December 2, we are joining partners to co-host the 8th Biomedical HIV Prevention Forum (BHPF), an official ICASA pre-conference with the theme Advancing Biomedical HIV Prevention as a National Priority Through Choice.
This forum will bring together prevention champions; advocates, civil society representatives, researchers, youth leaders, development partners, and government officials from the Ministries of Health and Finance and ensure that the promise of biomedical prevention is fully realized.
If you are in Accra, be sure to join the many satellite sessions in which AVAC and partners are involved.
Wednesday, December 3
Future Proofing Person Centered HIV Care: Ensuring Appropriate Integration for and with Key Populations, hosted by the International AIDS Society, 17:45-18:30
Thursday, December 4
Launch of The Lancet HIV & The Lancet Global Health Joint Series on Sustainable HIV Prevention in Africa, hosted by the Government of Malawi, Malawi’s National AIDS Commission, the African-led HIV Control Working Group (HCWG), and Georgetown University’s Center for Innovation in Global Health; learn more,10:50-11:35
Saturday, December 6
Why CHOICE Matters in Ensuring an Integrated, Sustainable Response to HIV, hosted by the African Women Prevention Community Accountability Board (AWPCAB) and African Sex Workers Alliance (ASWA) in partnership with ViiV Healthcare, 13:10-13:55
Innovating to Scale PrEP in a New Reality: Country-Led Strategies for Sustainability, Local Ownership, and Impact, hosted by AVAC and the Coalition to Accelerate Access to Long-Acting PrEP; download flyer, 14:05-14:50
Sunday, December 7
Voices and Partnerships to Advance Health Innovation and Equity, hosted by Unitaid, 13:10-13:55
Community Booth
AVAC and partners will “takeover” the Unitaid Community Booth on Friday, 5 December between 9:30 and 13:30, and on Sunday, 7 December between 12:00 to 16:00 to feature programming that brings together advocates and community members with other key stakeholders to discuss LEN for PrEP rollout, emphasize prevention as sustainability, and advance youth leadership. Be sure to visit the UNITAID booth on Friday, 5 December between 9:30 and 13:30 to secure a schedule of the program and join the conversations.
As conversations unfold at ICASA, two urgent imperatives must anchor our collective advocacy: accelerating equitable access to approved HIV prevention options and sustaining a forward-looking research agenda that responds to community priorities and drives long-term impact. In the face of historic US funding cuts and a shifting global health architecture, these goals are more essential than ever.
The People’s Research Agenda (PRA), which is being updated for ICASA, is a vital tool for shaping and demanding the HIV prevention research the world needs. Whether you’re participating in the Biomedical HIV Prevention Forum or broader ICASA conversations, we encourage you to look out for the updated PRA and use it to frame your priorities, raise your voice, and influence what comes next.
AVAC Statement on the 8th Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria
Global public and private sector donors pledged over $11 billion at last week’s 8th Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria in Johannesburg, South Africa. In the current political and economic context, these pledges represent a recognition of the pivotal role of the Global Fund in saving lives and building health systems. But they fall well-short of the $18 billion goal.
At a time when HIV, TB and malaria science is delivering as never before, with long-acting injectable HIV prevention options, new malaria drugs and vaccines and improved TB treatments entering the market — and a potential TB vaccine in late-stage trials — funding must meet the moment to deliver life-saving new technology with speed, scale and equity. Ensuring highly effective innovations reach those who need them most requires resources. Universal access to effective health technologies is an achievable goal, with robust investment in expert institutions, national public health systems, and aligned private enterprise.
“This moment is a historic opportunity to save lives and meet major milestones against all three epidemics. With political will and commitment, proper investment in the Global Fund will be instrumental in maintaining progress and building on success,” said AVAC Executive Director Mitchell Warren.
The US pledge of $4.6 billion over three years is a decrease from the $6 billion commitment in the previous replenishment cycle. But the US did reaffirm its 1:2 match, with the US continuing to contribute 1/3 of the total to the Global Fund, hopefully motivating other funders to step-up. Now, the US Congress must appropriate funding to fully meet the new US pledge, with language codifying the 1:2 match. Congress must also ensure funds appropriated for the previous replenishment, including $1.47 billion in matched funds, are distributed.
Communities with the greatest burden of disease, which have already suffered program cuts, service disruptions and the loss of many trusted local partner organizations, and include marginalized key populations, are at even greater risk now. AVAC joins affected communities and civil society to call on all stakeholders to recommit to solidarity, transparency and global health security. Achieving this requires national governments, foundations, the private sector and civil society to develop new financial tools for sustainable, country-owned and community-led public health systems. One critical step is closing the remaining gap to reach the Global Fund goal and ensure that donors who have yet to step forward to do so with ambitious, robust pledges.
“The impact of this current shortfall will be needless death and disease. Modeling suggests up to 22 million preventable deaths by 2030 if global health funding from all sources continues to decline. Millions of lives have been saved thanks to the Global Fund, and shrinking resources threaten these achievements and risk squandering the opportunities of recent scientific advances,” said AVAC Director of Policy Advocacy Suraj Madoori.
Global Health Watch: Pandemic Accord, US MoU pressure, LEN progress & UK Global Fund cuts
African countries reaffirm support for a new multilateral Pandemic Accord even as pressure mounts to sign bilateral US health agreements. The UK has reduced its upcoming Global Fund pledge just weeks before the replenishment summit. Meanwhile, additional regulatory submissions of lenacapavir (LEN) for PrEP are being made, most recently in Rwanda, reflecting accelerated actions and real lessons learned from earlier PrEP rollouts, as launches in several countries are being planned for World AIDS Day.
African Countries Support Pandemic Accord Under Pressure to Sign Aid Agreements with US
African governments confirmed support for a multilateral Pandemic Accord under the World Health Organization (WHO) even as they face significant pressure to sign bilateral or government-to-government global health aid agreements with the US. These controversial agreements would require countries to share pathogen data, omit HIV prevention metrics, including PrEP and products like LEN, sideline civil society and key populations by removing requirements for community engagement, and bypass multilateral coordination, ignoring WHO and regional public health institutions. Advocates warn that bypassing the WHO Pandemic Accord negotiations risks repeating the inequities of COVID-19, forcing countries to share pathogen data without securing fair access to the medical countermeasures developed from them, leaving lower-income nations without the leverage needed to protect their own populations.
IMPLICATIONS: This shift toward government-to-government support and conditional health assistance is shifting global health engagement into more transactional, equity‑challenging territory. Without indicators, community input, guaranteed reciprocity or multilateral coordination, countries may be locked into deals that deprioritize their interests.
Global Fund Replenishment at Risk: UK Reduces Pledge
The United Kingdom announced that it will reduce its upcoming pledge to the Global Fund by approximately 15% for the 2026‑2028 replenishment cycle, down from £1 billion in the previous cycle to £850 million. This news comes just two weeks ahead the Global Fund’s replenishment summit, which takes place November 21 in Johannesburg—which the UK and South Africa are co-hosting. The Global Fund proposed a target of $18 billion in its Eighth Replenishment Investment Case to save an estimated 23 million lives and prevent hundreds of millions of infections between 2027 and 2029. “It took the world 18 years to halve the combined death toll from AIDS, TB and malaria; with the right resources we can more than halve it again in only six years.”
IMPLICATIONS: The cut from a longstanding major donor and summit co-host sets a worrying precedent, potentially signaling a retreat from multilateral leadership. Coupled with US cuts to global health funding generally, falling short of the Global Fund’s replenishment goal would increase disparities in access and likely shift resources and power away from communities and civil society.
Rwanda is now the 7th African country to receive a regulatory submission for lenacapavir for PrEP (LEN), which was recently approved in South Africa and Zambia, in addition to the US and European Union. For a full regulatory update,see here). The pace of progress for PrEP rollout continues to accelerate reflecting lessons learned from previous PrEP rollouts and signaling growing capacity and urgency to act. As AVAC’s new infographic below shows, the global community can learn and apply lessons, can move with speed, scale and equity, and might actually seize a PrEP opportunity instead of squandering it.
IMPLICATIONS: Regulatory submissions and approvals are only one piece in the complex process. Turning regulatory milestones into public health impact depends on aligned global funders, transparent pricing and volume commitments, and community-engaged introduction strategies. Without this, innovation risks stagnation.
The People’s Declaration—currently with more than 500 signatories, charts out a number of community priorities and demands. Join The Choice Agenda, The Legacy Project, and a global panel to discuss moving these priorities into actions and accountability.
