AVAC strongly condemns Secretary of Health and Human Services, Robert F. Kennedy, Jr., for removing all members of the Advisory Committee on Immunization Practices (ACIP). This committee of vaccine experts—with decades of experience in vaccine development, delivery and safety—is responsible for developing the country’s vaccine policies and recommendations for the Centers for Disease Control and Prevention (CDC). At a time when science is under political attack and vital programs are being defunded, AVAC stands with researchers, advocates, and communities calling for Congress to defend public health and unbiased science, which is essential to safeguarding the health of all Americans. The Secretary’s actions attack the integrity of ACIP membership and is a direct threat to public trust in our health systems and in the essential role of vaccines in disease prevention.

“Vaccines remain among the most powerful public health tools ever developed,” said Mitchell Warren, executive director of AVAC. “Vaccines have transformed the global response to infectious diseases, from smallpox to measles to COVID-19, and they are central to the vision of ending the HIV epidemic. At a moment when the US should be investing more in vaccine science, access, and public confidence, it is investing less and simultaneously undermining vaccines generally. Secretary Kennedy’s short-sighted and unceremonious removal of all ACIP members is an alarming escalation in this administration’s campaign to dismantle evidence-based health policy, science and research.”

ACIP’s long-standing commitment to base vaccine recommendations purely on the evidence represents the highest standards of ethical guidance to protect human health. The Secretary’s decision undermines not just US vaccine strategy, but global confidence in immunization programs and guidance that have long relied on US leadership. In addition, Kennedy appointed a new panel of members yesterday, many of whom have shared publicly their anti-vaccine views, with limited experience in vaccine policy or public health. This new panel could take actions that turn this trusted scientific body into a platform for mis- and dis-information and anti-vaccine policies.

The destruction of ACIP adds to the five-month litany of assaults on vaccines and the systems that support them.  From proposed cuts to the Fiscal Year 2026 budget, to the defunding for global vaccine access programs like Gavi and domestic immunization initiatives at the US CDC, to the undermining of the essential role of measles vaccines, the closure of the leading NIH-funded HIV vaccine consortia (CHAVD), to the dismantling of USAID’s HIV vaccine R&D programs and the recommendation to remove COVID-19 vaccines from the US immunization schedule for children and pregnant women, this administration has worked to subvert the importance and impact of life-saving vaccines and erode public trust for vaccine science.   

Vaccines work. Human papillomavirus (HPV) is responsible for 99% of cervical cancers. The HPV vaccine prevents over 90% of cancers caused by HPV, including anal, cervical, penile, throat, vaginal, and vulvar globally, and if more widely available, could prevent hundreds of thousands of annual deaths, according to the WHO. Similarly, hepatitis B (HBV) accounts for 1.1 million deaths globally, and yet the HBV vaccine prevents as many deaths every year, according to WHO. Furthermore, without a vaccine review panel, rollout of anticipated vaccines that protect against gonorrhea, could make access difficult for many Americans when drug resistant gonorrhea is on the rise globally.

“We are witnessing other countries eliminate cervical cancer through robust HPV vaccination and screening programs while the US risks reversing decades of progress,” says Alison Footman, AVAC’s senior program manager of STIs. “The ACIP plays a critical role in ensuring vaccines, including those that prevent STIs like HPV and hepatitis B, are accessible, and recommendations are guided by expert opinions. Now more than ever, we must protect the integrity of public health systems that save lives and prevent diseases.”

As public confidence in vaccines erodes, the value of vaccine science is paramount, representing one of the single greatest advances in the history of medical science, eradicating once life-threatening infections and mitigating the risk of illness from numerous diseases. In the field of HIV, the search for an effective vaccine is advancing thanks to decades of investment in basic science, clinical research, and global partnerships. This progress must be protected and accelerated. A vaccine would provide a durable, scalable form of HIV prevention that does not rely on frequent adherence or health system access, and it would be especially transformative for communities most marginalized by current systems.

AVAC calls on Congress, scientists, and civil society to speak out and stand up for science, for vaccines, and for the future of global and public health.

AVAC is delighted to release its new report, Getting PrEP Rollout Right This Time: Lessons from the Field, that examines key insights from the rollout of oral PrEP and early introduction of injectable cabotegravir (CAB) and the dapivirine vaginal ring (DVR) to inform a faster, smarter and more equitable introduction of future HIV prevention tools, including long-acting injectable PrEP, such as lenacapavir. 

AVAC conducted in-depth interviews with policymakers, program implementers, and advocates in seven countries (Brazil, Kenya, Nigeria, South Africa, Vietnam, Zambia, and Zimbabwe) to understand how policy, procurement, service delivery, and community engagement have shaped the uptake of oral PrEP and the introduction on DVR and CAB. The findings offer critical insights into what must change, what must be sustained, and what must be built to ensure new HIV prevention options are rolled out with speed, scale and equity.  

This analysis comes at a pivotal moment as the US Administration is actively working to dismantle HIV research and demolish the architecture of global health. The entire HIV response from basic research and clinical development to policy, programs, and global access to life-saving treatment and prevention is now under attack. All this as the field reaches a moment of historic promise in HIV prevention, with initial regulatory approval of LEN for PrEP from the US Food and Drug Administration expected by next Thursday, June 19. This report lays out what’s needed at this critical time to get HIV prevention into the hands of those that need it most. 

For those attending IAS 2025 in Kigali, Rwanda, next month, please be sure to join us at a special session on Monday, July 14 Re-imagining prevention: Ensuring sustainable PrEP access in an evolving funding context. And for those not in Kigali, we’ll be hosting a follow-up webinar to unpack the findings – and the next steps – soon. 

At a time of extraordinary promise, and great political uncertainty, we hope you will join other advocates, implementers, and policymakers during this webinar and together chart the way forward. 

This week brought more devastating actions from the US administration, with serious consequences for global health. From a proposed rescissions package of the current year’s funding to deep cuts in the proposed Fiscal Year 2026 budget, the end of funding to the leading NIH-funded vaccine consortia, to proposed reductions to the Global Fund match and new immigration restrictions, the threats to health, science, global partnerships, research progress, and health equity are here. Read on.

The US’ Proposed FY26 Budget and Rescissions Package Could Dismantle Decades of Progress 

On Friday, the Administration released more details on the proposed Fiscal Year 2026 (FY26) US budget that was sent to Congress to inform their drafting of the final budget. As we’ve said many times over the past four months, Congress has the Constitutional power of the purse – not the President. The proposed budget slashes PEPFAR by 34% and NIH funding by 36%, for a combined total of over $5.5 billion. It further targets the Global Division of HIV and Tuberculosis (DGHT) at the US Centers for Disease Control and Prevention (CDC) by eliminating it along with other global health programming at the agency, ends funding for Gavi’s global vaccine procurement, and more.  

A subsequent proposed $9.4 billion rescissions package of Fiscal Year 2025 funds that were already Congressionally appropriated but not spent was shared by the President on Tuesday. This package would eliminate over $900 million from global health programs, with OMB Director Vought refusing to rule out rescission cuts to PEPFAR. This package also seeks Congressional approval to codify, or make legal, the unlawful dismantling of USAID, which was initiated through presidential executive order and the reckless actions of DOGE. The House is expected to vote on this package soon. 

IMPLICATIONS: Budgets are not just about money; they clarify priorities and policies. The proposed FY26 budget and rescissions package have far and deep implications for health, science, and research in the US and around the world. They 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.  

READ: 

• AVAC Denounces White House Effort to Codify DOGE Cuts to Health, Research and Foreign Assistance—AVAC  
• Trump Budget Request Retreats on Ending the HIV Epidemic—PrEP4All  
• Trump budget request and rescission plan slashes global health funding—Devex  
• Trump wants Congress to slash $9.4B in spending now, defund NPR and PBS—News From the States 
• Trump Budget Eliminates Funding for Crucial Global Vaccination Programs—The New York Times 
• Exclusive / GOP divide looms over scrapping Bush-era HIV program—Semafor  
• Congress finally gets Trump’s request to codify DOGE cuts to NPR, PBS, foreign aid—Politico  
• WH budget chief pressed on PEFPAR funds, says Africa ‘needs to absorb more of the burden’—The Hill

NIAID’s Consortia for HIV/AIDS Vaccine Development (CHAVD) Will Not Be Renewed

On Friday, news came that the National Institute of Allergy and Infectious Diseases (NIAID) will not renew funding for the Consortia for HIV/AIDS Vaccine Development (CHAVD) when they expire next June. Founded in 2005, the CHAVD programs – based at Duke University and Scripps Research Institute – have been instrumental to advancing HIV vaccine research and development, contributing to progress toward an HIV vaccine and other scientific innovations. 

IMPLICATIONS: The shutdown of CHAVD and broader NIH pullback from vaccine research, along with the constrains on funding for the Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections (ACTG), the HIV Prevention Trials Network, the HIV Vaccine Trials Network and the Adolescent Medicine Trials Network for HIV/AIDS Intervention, represent a massive – and destructive – shift in research funding. These actions squander a decades-long investment in the search for a preventive HIV vaccine, just as these efforts are gaining momentum.  

READ:

• ‘Devastating’: NIH cancels future funding plans for HIV vaccine consortia—Science  
• Trump Administration Ends Program Critical to Search for an HIV Vaccine—The New York Times

Global Fund Match Requirement

In the US State Department’s justification of the President’s proposed FY26 budget, Secretary of State Marco Rubio notes that “should the Administration decide to provide contributions to the Global Fund in FY26, it would ensure the United States is only contributing its fair share by leveraging $1 from the United States for every $4 from other donors, instead of the current $1:$2 matching pledge.” 

Under the Global Fund match requirement, the US contribution can only be unlocked after other donors deliver on the pledges they have made. This requirement leverages American generosity to get other donors to step up.  

IMPLICATIONS: If the US Government changes the Global Fund match requirement from 1:2 to 1:4, according to Friends of the Global Fight, this would reduce the leverage power of the US contribution to the Global Fund, lower overall funding to fight AIDS, TB and malaria, slow down progress on transition to country self-reliance and limit the influence of the US in Global Fund decision-making. 

READ:  

• The enduring impact of the 1:2 match requirement—Friends of the Global Fight 
• Congressional Budget Justification, Department of State, Foreign Operations, and Related Programs—US Department of State 

President Announces Restrictions and Suspensions of Foreign Nationals from 19 Countries

The President issued a new immigration proclamation restricting or fully suspending entry into the United States for foreign nationals from 19 countries, including Afghanistan, Burma, Chad, Republic of the Congo, Equatorial Guinea, Eritrea, Haiti, Iran, Libya, Somalia, Sudan, and Yemen, while partial restrictions apply to Burundi, Cuba, Laos, Sierra Leone, Togo, Turkmenistan, and Venezuela.  

IMPLICATIONS: In conjunction with the cancellation of US funding for research and partnerships with foreign partners, and US withdrawal from multilateral institutions, these new restrictions, which are framed under national security, will have significant implications for global health partnerships, research collaborations, and the ability of researchers, policymakers, clinicians, advocates and others to participate in collaborative work. They also signal an era of isolation, where partnerships, diplomacy, trust-building and global health take a backseat to grandstanding, isolationist politics. 

READ:

• Restricting the Entry of Foreign Nationals to Protect the United States from Foreign Terrorists and Other National Security and Public Safety Threats—White House

Gavi Board Appointment Raises Questions

The Gavi Board of Directors appointed Mark Kevin Lloyd, who was nominated by the new US Administration as its newest member. Lloyd is assistant to the administrator for global health at the US Agency for International Development (USAID), overseeing global health and conflict prevention. He takes Atul Gawande’s seat, which is typically held for a US government representative. Historically, five seats on the Gavi board have been held by representatives from donor countries.     

Gavi is in its replenishment cycle and will hold a pledging summit later this month. In 2023, the Biden administration committed at least $1.58 billion toward the new cycle. Annual congressional appropriations are required to fulfill the pledge.  

IMPLICATIONS: With Gavi’s funding zeroed out in the Administration’s FY26 budget request, it’s uncertain what this new appointment signals for US engagement with Gavi going forward.  

READ:

• Trump administration official Mark Kevin Lloyd joins Gavi board—Devex  

What We’re Reading

• The Gutting of America’s Medical Research: Here Is Every Canceled or Delayed NIH Grant—The New York Times
• Ending US-global health research partnerships will cost America—STAT
• Cuts to US Aid Imperil the World’s Largest HIV Treatment Program—Bloomberg
• HIV’s Most Promising Breakthrough Has Taken a Hit—The Atlantic
• The Lavender Purge—JIAS Viewpoint
• Gilead Commits to HIV Prevention Rollout for Low-income Countries Despite Funding Uncertainty—Reuters
• Uncertain Road Ahead for Lenacapavir, a New ‘breakthrough’ HIV Prevention Drug—Positively Aware
• The US Slashed HIV/AIDS Funding. Here is How Countries that Relied on it Might Adapt—STAT
• Really, Secretary Rubio? I’m Lying About the Kids Dying Under Trump?—The New York Times (opinion) 
• NIH Funding Policy Deals New Blow to HIV-related Trial Networks—Science 
• The US Bought $12 Million in Aid for Poor Nations. Under Trump, it May be Destroyed—Washington Post
• US May Strip Harvey Milk’s Name From Navy Vessel—The New York Times

Resources

• The Disappearing Funds for Vaccine Research, The New York Times
• US Global Health Country-Level Funding Tracker, KFF 
• An Update on PEPFAR Reauthorization, KFF
• Impact Metrics Dashboard
• Advocates’ Guide: Understanding the President’s Proposed Fiscal Year 2026 (FY26) Budget and Its Implications for Science, Research and Global Health, AVAC
• Preparing for a Supreme Court Decision That Could Change Health Care Coverage for Millions of Americans, Equality Federation and CHLP (2025), CHLP 
• Research Matters, AVAC, HIVMA, TAG

Webinar: The Scientific Journey of Lenacapavir: From basic science to clinical development to impact

Join us on Wednesday, June 11 at 11am ET

Learn how sustained US support from NIH discovery science to South Africa’s clinical research infrastructure made the development of LEN for PrEP possible.  

Speakers include:  

• Wes Sundquist (University of Utah), on the early-stage science behind capsid inhibitors.  
• Linda-Gail Bekker (Desmond Tutu HIV Foundation), on the PURPOSE 1 trial in South Africa, where not a single HIV infection occurred. 

The US presidential administration released its full US FY26 budget proposal on Friday, and it includes a series of devastating cuts that threaten to roll back HIV prevention efforts in the US and globally by decades. In a cruel irony, this proposal comes just as the field reaches a moment of historic promise in HIV prevention. 

Lenacapavir (LEN), the twice-yearly injectable form of HIV PrEP, is expected to be approved by the US Food and Drug Administration (FDA) later this month, and WHO is expected to release a recommendation and guidelines in July. Named Science magazine’s 2024 “Breakthrough of the Year,” LEN for PrEP represents the culmination of decades of investment in the earliest stages of scientific innovation, from basic science to global partnerships.  

LEN for PrEP shows what’s possible when the world invests in HIV prevention. However, the NIH is initiating a new policy to prevent international research, including within the HIV clinical trial networks, other HIV clinical trials are halted, leading HIV vaccine discovery research is terminated, and PEPFAR prevention programming is defunded.  

Just how important is basic science research to product development? And how vital is the South African research infrastructure for innovation in HIV and TB? Well, as just one example, without NIH investments over the past two decades, the world would not be on the cusp of approval and introduction of LEN for PrEP. 

Join us on Wednesday, June 11 at 11am ET for an essential conversation on what’s at stake. 

The Scientific Journey of Lenacapavir: From basic science to clinical development to impact

Learn how sustained US support from NIH discovery science to South Africa’s clinical research infrastructure made the development of LEN for PrEP possible. 

Speakers include: 

• Wes Sundquist (University of Utah), on the early-stage science behind capsid inhibitors. 
• Linda-Gail Bekker (Desmond Tutu HIV Foundation), on the PURPOSE 1 trial in South Africa, where not a single HIV infection occurred. 

This couldn’t be more timely, or important! This Thursday, Dr. Sundquist, Moupali Das of Gilead Sciences and Yvette Raphael of Advocates for the Prevention of HIV in Africa (APHA) will be honored together by the American Association for the Advancement of Science (AAAS) with the Mani L. Bhaumik Breakthrough of the Year Award for their leadership in the discovery and development of LEN for PrEP. Their roles in advancing LEN as an option for HIV prevention show what’s possible with well-funded basic research, international collaborations and community-centered priorities. 

Advances like these take time, money, support, commitment and global partnerships. Defending why research matters depends on understanding its value and telling its story. The field must urgently make the case for sustained investment. Join us June 11 and see more resources to support your advocacy below. 

This week we see new developments that could reshape global health financing and US policies on science and research, including the release of the full FY26 budget, which is expected later in the day. From a potential operational collaboration between the Global Fund and Gavi to more intense threats to NGO funding, foreign aid, and vaccine guidance, this issue shares the implications of rising political pressure. Read on.

Global Fund and Gavi Collaboration

The Global Fund to Fight AIDS, Tuberculosis and Malaria and Gavi are in discussions about working more closely together and combining certain administrative and operational functions. Driven by the major cuts from the US government as well as other governments in the run-up to replenishment processes for both, these two leading global health organizations are looking to collaborate to enhance efficiency and reduce redundancies at the country level.  

IMPLICATIONS: The Global Fund and Gavi are looking to coordinate more closely and find efficiencies. This potential collaboration underscores what may be a broader trend in global health financing to maintain critical health services worldwide. 

READ: Global vaccine and health bodies could team up more to tackle US-led funding crisis—Reuters

Upcoming Congressional Hearing Targets NGOs

For US advocates and NGOs, next week’s House Subcommittee on Delivering on Government Efficiency (DOGE) hearing, “Public Funds, Private Agendas: NGOs Gone Wild”, will be one to watch. The Committee, chaired by Representative Marjorie Taylor Greene, will scrutinize the use of federal funds by NGOs. In an announcement, the Committee wrote, “NGOs have expended billions of hard-earned taxpayer dollars in pursuit of agendas that most Americans oppose… Congress must also act to shut down the pipeline that keeps this money laundering machine running.” 

IMPLICATIONS: The US Congress plays a pivotal role in shaping the future of science and research through its oversight, funding and policy making. Hearings like this can influence which initiatives are protected or targeted. AVAC and partners will monitor this hearing as part of our work to tracking threats to evidence-based advocacy, research, and decision making. 

Watch the Livestream: June 4, 2025 at 2:00 pm ET

Elon Musk Leaves White House After Driving the Efficiency Cuts 

Elon Musk is leaving his unofficial role as an advisor in the new US administration after he oversaw the gutting of federal agencies, foreign aid and fired thousands of federal workers through his Department of Government Efficiency (DOGE) initiative. Musk’s departure comes days before his temporary appointment was set to expire May 30, and follows declining sales of his Tesla brand cars and his criticism of the FY26 spending bill, which would add trillions to the national debt. 

IMPLICATIONS: Musk’s departure marks an end to a chaotic period of continuous cuts and firings by the new administration that upended global health, research funding, and foreign aid, and will take significant time and effort to repair.  

READ:  

• Elon Musk Leaves Trump Administration Amid Rift over “Big, Beautiful Bill”—Democracy Now 
• After four months of disruption, Elon Musk signals he’s leaving government—Politico  

The Latest on Foreign Aid Cuts 

The new administration is attempting to make official major budget cuts under DOGE, including those to foreign aid. The US president will submit a $9.4 billion “rescissions” package to Congress next week, but this week, as the administration is expected to release of the full FY26 budget today, many Democrats are pushing back and asking whether the cuts are smart or legal. Sen. Patty Murray and Rep. Rosa DeLauro are warning that the Office of Management and Budget’s refusal to provide required budget details is making it hard for Congress to plan the FY26 budget and hindering the FY26 appropriations process. And House Foreign Affairs Committee Ranking Member Gregory Meeks (D-NY 5) and Rep. Sara Jacobs (D-CA 51) have asked the GAO to investigate whether the dismantling of USAID and cancellation of thousands of contracts have actually saved money. 

IMPLICATIONS: The coming weeks will be important as Congress will either reassert independence in its control over the US’ investments in science and foreign aid or rubberstamp the White House agenda.  

READ:  

• Top Democratic appropriators accuse Vought of obfuscation—Politico Pro 
• Top Democrats ask GAO to assess impact of foreign-aid cuts—Politico Pro 
• White House plans — at last — to send some DOGE cuts to Hill—Politico  

US Avoids Due Process and No Longer Recommends COVID-19 Vaccine for Certain Populations

The US administration is no longer recommending COVID-19 vaccines for healthy children or people who are pregnant. Health and Human Services Secretary Robert F. Kennedy Jr. announced this change in social media after bypassing the traditional CDC advisory process.  

IMPLICATIONS: This action could significantly undermine vaccine access, insurance coverage, and public trust in health guidance. 

READ/LISTEN: 

• RFK Jr drops Covid-19 boosters for kids and pregnant women from CDC list—The Guardian 
• RFK Sends a Message on Vaccines—The New York Times 

What We’re Reading

• Rubio’s claim that it’s ‘a lie’ that people have died from foreign-aid cuts—Washington Post
• Frontline AIDS launches Transition Initiative to secure the future of HIV services—Frontline AIDS
• An NIH Grant Is Restored, With a Catch: Cut a Study on Trans Youth—Chronicle on Higher Education
• NIH staff stage walkout during director’s town hall as tensions persist over research cuts, ideology—CNN
• African Nations Ask WHO for Increased Funding as Global Health Aid Hits Decade-Low—Health Policy Watch
• The UK should be taking the lead on international aid – not abandoning women and girls around the world—The Independent
• The White House keeps promising ‘lifesaving’ aid that’s not coming—Washington Post

Resources

• US Global Health Country-Level Funding Tracker, KFF
• An Update on PEPFAR Reauthorization, KFF
• Impact Metrics Dashboard
• Advocates’ Guide: Understanding the President’s Proposed Fiscal Year 2026 (FY26) Budget and Its Implications for Science, Research and Global Health—AVAC
• Critical Advocacy: How Civil Society is defending the HIV Response and Global Health—AVAC
• Research Matters—AVAC, HIVMA, TAG

By Mitchell Warren, first appearing on Devex.

Right now, the US global AIDS response could best be described as rearranging deck chairs while the ship drifts entirely off course.

We are not witnessing bold reform, but an intentional unraveling of America’s legacy in global health. And it’s happening without the congressional engagement that has, historically, yielded such remarkable success.

Reimagining and realigning global health programs is not inherently bad. In fact, it was a spirit of reimagination that led to the creation of the President’s Emergency Fund for AIDS Relief, or PEPFAR, the most successful global health program in our country’s history. But we were off track on global targets related to HIV before January 20. To right the ship requires a thoughtful, intentional strategy. That is not what is happening.

Before Donald Trump’s second presidential inauguration, we were lagging behind in progress toward established HIV targets due to COVID-19, among other factors. But now, we are in a parallel universe entirely.

Once Upon a Time, When Rubio Supported PEPFAR

In the original PEPFAR legislation, Congress intentionally included a direct line of accountability from the global AIDS coordinator, who oversees the program, to the US Secretary of State. That structure mattered — both for US credibility abroad and for effective, data-driven results at home.

In his hearings on Capitol Hill last week, Secretary Marco Rubio shared details around the administration’s proposed plan to restructure the State Department. These changes would marginalize the program, moving it to report to the under secretary for economic growth, energy and environment oversees. This creates an additional, wasteful, and ineffective layer of bureaucracy. It also consolidates authority under a State Department with diminishing health expertise, due to the dismantling of the US Agency for International Development, which means the intellectual capital of hundreds, if not thousands, of global health experts has been lost.

Again, realignment is not a bad thing. But there are core principles that must guide any change to PEPFAR’s structure — sustainability, local ownership, transparency, and comprehensive prevention. Once we have aligned around these principles, only then can we have conversations about the right level and structure of the program. Conversations around both principles and structure must include Congress.

PEPFAR’s incontrovertible success has been possible only through bipartisan and bicameral support. The program has been upheld for more than two decades through rigorous congressional oversight. Members of Congress — Republican and Democrat — have long demanded accountability, performance, and results. And they got them.

Ongoing assessment is built into the very fabric of the program. Throughout its 20 years and across multiple presidential administrations, PEPFAR’s strategy, operations, and impact have continually been evaluated to ensure it remains successful. Each global AIDS coordinator has talked about going to Capitol Hill to defend PEPFAR’s budget. And, every year, that defense was successful, including during Secretary Rubio’s tenure on the Senate Foreign Relations Committee.

In fact, no one knows better than Secretary Rubio — who served on the US Senate Foreign Relations Committee from 2011 until his confirmation as secretary of state — what it means to be a member of the committee overseeing PEPFAR’s impressive data. Then Sen. Rubio has said of PEPFAR: “The dividends it pays from a human element are extraordinary, and you need to look no further than Africa, where millions of people are alive because the United States pays for their antiviral medication.”

HIV Treatment, Prevention and Integration into Global Health Agenda

A sustainable HIV response means saving lives, consistently, predictably, and comprehensively. PEPFAR realignment should be driven by how best to sustain impact. And sustainability should not be interpreted as strictly financial. With 1.3 million people newly infected each year, we can’t just treat our way out of an epidemic, we must also prevent.

Right now, there are nearly 40 million people living with HIV globally; more than 30 million are on lifesaving HIV treatment. Under the Trump administration, PEPFAR’s focus is solely on treatment, with no prevention treatment for anyone except pregnant and breastfeeding women. 

Sustaining impact requires that national governments don’t just own their own responses; they must also fund them. To ensure that people don’t fall out of treatment, that needs to happen in a comprehensive way. In addition to treatment and prevention, an effective strategy needs to integrate the HIV response into the broader global health agenda.

PEPFAR doesn’t need a departmental reorganization. What it requires is congressional recommitment to protecting the program’s mandate and ensuring it stays focused on what it does best: saving lives through data-driven, evidence-based health programs. PEPFAR represents a 21-year congressional legacy of bipartisan, bicameral support that has fundamentally changed the trajectory of the epidemic.

Through deep congressional engagement, we have changed the way the response to HIV is designed, funded, and monitored. And we’ve had a game-changing impact on global health security and diplomacy.

If the administration is intent on unraveling America’s legacy in global health, Congress must veto that agenda. It must preserve PEPFAR’s integrity and the US’s commitment to the goal of ending HIV as a public health threat.

We don’t need to rearrange deck chairs. We need political courage. Lives depend on it.

This May 18^th, HIV Vaccine Awareness Day (HVAD), comes as HIV vaccine science and collaboration have never had more promise — and as AVAC celebrates its 30^th anniversary. When AVAC began in 1995, we were the AIDS Vaccine Advocacy Coalition, founded to speed research and development, grounded in equity, for an HIV vaccine. As the potential of PrEP and other HIV prevention emerged, we broadened our focus to ensure progress across the pipeline of prevention research, and to advocate for delivery and access to new interventions.

HVAD 2025 comes as the US presidential administration is actively working to dismantle HIV research and demolish the architecture of global health. The entire HIV response — from basic research and clinical development to policy, programs, and global access to life-saving treatment and prevention — is now under attack, and the world runs the risk of reversing the strides made to end HIV.

These threats to the HIV response could not have come at a more critical time for prevention. Regulatory approvals and introduction of injectable lenacapavir for PrEP are imminent; the first ever ARV-based, dual-purpose product to prevent pregnancy and HIV is also poised for rollout; and a range of next-generation products, including new HIV vaccine approaches, to meet diverse user needs was being ushered through upstream development—all work that benefitted from US funding that is now in jeopardy.

To put all of this in perspective, AVAC has put together a report, HIV Prevention R&D at Risk: Tracking the Impact of US Funding Cuts, highlighting the impact of US cuts on the pipeline of HIV prevention research and development. AVAC will continue to track these cuts and their impact, to amplify the damage they will cause, and to fight for their reversal.

The backbone of all these efforts is science — from basic discovery, to clinical research, to implementation projects — to which US support has been fundamental. A classic example is lenacapvir for PrEP. Without NIH-funded basic science, the capsid inhibitor, which targets the shell of the HIV virus and is the basis of lenacapavir would not have been discovered. And without long-term investments in research infrastructure in South Africa, the PURPOSE 1 and 2 lenacapavir efficacy trials would not have demonstrated efficacy so quickly and clearly. Stay tuned for our upcoming webinar in June, The Scientific Journey of Lenacapavir: From basic science to clinical development to impact to learn more about this remarkable story.

For decades, both sides of the aisle of US politics have recognized that this work brings our country prosperity, security, improved health and pride. With the quest for an HIV vaccine now in early upstream R&D, the story of lenacapavir for PrEP shows the essential importance of bipartisan political support for the NIH; the need to invest in long-term global research capacity; the power of public-private partnerships; and the essential role of community engagement and advocacy to accelerate R&D and delivery.

For more testimony about these issues, you can also watch a new video documenting the 25years of progress and leadership of the NIH-funded HIV Vaccine Trials Network (HVTN).

This HVAD, AVAC invites you to join us in the fight to protect, sustain and rebuild. The webinars and resources provided below frame the issues and include tools and key messages for your advocacy!

Webinars

• May 16 at 9am ET, Recent Advances in Eliciting Broadly Neutralizing Antibodies (bNAbs) for HIV-1 Vaccine Development
  Global HIV Vaccine Enterprise
  
  Explores cutting-edge approaches in HIV-1 vaccine development. Experts will discuss innovative immunogen design, B cell maturation strategies, and key findings from clinical and preclinical studies. Learn how translational research is shaping the next generation of HIV vaccines. Register

• May 28 at 9am ET, HIV Prevention at a Crossroads: Why we still need an HIV vaccine
  Global HIV Vaccine Enterprise and IAVI
  
  Discusses the continued need for an HIV vaccine in the context of the expanding HIV prevention landscape and uncertain geopolitical environment. Panelists and audience members are invited to explore the potential public health impact of an HIV vaccine, including related socioeconomic and equity considerations. Participants will further reflect on the rising threat to vaccine science and why investments in HIV vaccine R&D remain a strategic priority in the global HIV response. Register

• June 11 at 11am ET, The Scientific Journey of Lenacapavir: From basic science to clinical development to impact
  AVAC
  
  Join us for the compelling story of the development of lenacapavir and the critical role of US support. Wes Sundquist, from the University of Utah, will share the story of capsid inhibitor discovery; and Linda-Gail Bekker, from the Desmond Tutu HIV Foundation, will discuss the critical role of South Africa in clinical development; all of this work, backed by long-term US support. Register

Resources

• Jatt LP, Mgodi NM, Buchbinder SP, Gray GE, Kublin JG. An HIV Vaccine in the Era of Twice-Yearly Lenacapavir for PrEP – Essential or Irrelevant? N Engl J Med. 2025 Apr 24;392(16):1561-1563. doi: 10.1056/NEJMp2415893. Epub 2025 Apr 19. PMID: 40260855.
  
• HIV Prevention R&D at Risk: Tracking the Impact of US Funding Cuts, AVAC’s analysis of the impact of US Government funding cuts, terminated projects, and other policy changes on the HIV prevention research and development (R&D) pipeline, and on HIV research broadly.
  
• Research Matters – Resources to Protect Research Funding, AVAC, TAG and the HIV Medicine Association (HIVMA) co-created a new resource hub, Research Matters, to support advocacy for sustained NIH funding.

Share Your Story

Additionally, AVAC and partners are collecting stories of impact—if you know someone willing to share their story about how NIH cuts are affecting their work, contact John Meade Jr. at [email protected]. This HuffPost article by Katie Edwards, from the University of Michigan, is a terrific example of a researcher sharing the real-world toll on scientists, trial participants, communities, research and public health.

Thank you for standing with us to protect science, health, and progress.

This week’s issue covers the Secretary of Health and Human Services’ defense of deep NIH budget cuts before Congress, leadership changes at WHO, and the latest update in AVAC’s lawsuit attempting to halt the US foreign aid freeze.

Importantly, this issue also includes new resources and analysis about the impact of the US administration’s short-sighted cuts on biomedical research. We at AVAC just launched a new report, HIV Prevention R&D at Risk: Tracking the Impact of US Funding Cuts, which puts the impact of the US government’s dismantling of HIV research and global health infrastructure into urgent context. And our colleagues at the Treatment Action Group (TAG), Médecins Sans Frontières (MSF), and the South African Medical Research Council (SAMRC) launched a new report detailing the specific impacts of funding withdrawal on HIV and TB research in South Africa.  

As HIV Vaccine Awareness Day approaches this Sunday, May 18, we spotlight what’s at stake as the entire HIV response—from basic discovery, to clinical research, to access, and equity—is under attack. Read on for more.

HHS Secretary Defends Proposed FY26 Budget in Front of US House and Senate

On Wednesday, Secretary of Health and Human Services Robert F. Kennedy Jr. testified before the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies and the Senate Committee on Health, Education, Labor and Pensions (HELP) to try and defend the US administration’s proposed Fiscal Year 2026 (FY26) budget. The proposed budget calls for a nearly $18 billion cut to the National Institutes of Health (NIH). In response to questioning, Kennedy repeatedly cited the need to reduce “waste” and redirect funds toward chronic disease prevention and domestic health programs. He continually denied that the cuts to the workforce and funding have harmed ongoing clinical trials and falsely claimed that research grant terminations have resulted in no scientists losing their jobs. He signaled support for biomedical research only if it aligns with “Gold Standard science” and US national security interests. 

In advance of the meetings, US Senator Bernie Sanders (D), released a report documenting “Trump’s War on Science”. See AVAC’s new resource hub Research Matters: Resources to Protect Research Funding,  co-created with TAG and the HIV Medicine Association (HIVMA), to support researchers advocating for sustained NIH funding and see the letter AVAC and more than a dozen partners submitted to the Senate HELP Committee urging lawmakers to reject the cuts to NIH funding for HIV, TB, and STI research and highlighting the impact of these cuts on lifesaving innovation and research infrastructure. 

IMPLICATIONS: Kennedy’s testimony confirmed the administration’s intent to permanently reshape the federal public health infrastructure. If the proposed budget is enacted, these changes could devastate HIV prevention research, halt progress on new tools like injectable PrEP, and silence inclusive science.  

READ: RFK Jr. Acknowledges Proposed NIH Cuts Will ‘Hurt’—Newsweek

WHO Restructures

The World Health Organization (WHO) announced major cuts to its headquarters and the departures of long-time leaders in response to the $1.7billion shortfall and pressure to decentralize operations. Jeremy Farrar, former head of the Wellcome Trust and current WHO Chief Scientist, will lead the largest division on Health Promotion, Disease Prevention and Control — one of the four new divisions in the organization. Sylvie Briand will replace Farrar as the new Chief Scientist. Up to 40% of headquarters staff may be laid off and its 10 divisions will be consolidated into four.

Meanwhile, UNAIDS pushed back against merger proposals and plans under WHO’s UN80 initiative Task Force, which is tasked with reforming the UN system.

IMPLICATIONS: With WHO seeking to relocate critical infectious disease programs to the Global South, these changes could open space for more regionally driven research agendas. The changes also offer a chance to refocus country-led responses.  

READ:  

• BREAKING – WHO Director General Shakes Up Agency with Brand New Leadership Team—Health Policy Watch
• WHO’s Samira Asma Reportedly Leaving Tedros’ Leadership Team – UNAIDS Scraps Merger Plan—Health Policy Watch

Judge Denies USG’s Request to Restart Foreign Aid Freeze and Orders All Payments to Resume

In the ongoing AVAC vs. Department of State and Global Health Council vs. Trump lawsuits, the federal District Court denied a motion by the government for an indicative ruling regarding the preliminary injunction that is being reviewed on appeal by the US Court of Appeals for the DC District. Last month, the government asked the court to revisit its earlier ruling, citing a new Supreme Court decision, but this week, the judge rejected the motion, reaffirming that the freeze violated the law. The court also lifted a temporary pause it had placed on processing funds for non-plaintiff organizations, which means the government must now fully comply with the injunction and resume payments to all affected programs for work completed prior to February 13.

What We’re Reading

• Scientists go silent as funding cuts escalate—Science
• ‘What do we do with uncertainty?’ A former CDC director’s advice to new physicians and scientists—STAT
• US funding cuts have crippled our HIV work – what’s being lost—The Conversation
• Scientists Hail This Medical Breakthrough. A Political Storm Could Cripple It—The New York Times
• What is Trump’s ‘most favored nation’ drug pricing policy and how will it reduce costs? Explained—The Economist
• Q&A: HIV shot ‘must reach all who ask for it’—SciDevNet
• Institutionalizing politicized science—Science
• WHO and Medicines Patent Pool announce sublicensing agreement for rapid diagnostic test technology—WHO
• Breaking: RFK Jr. says Matthew Buzzelli, a lawyer with no public health experience, is the Acting CDC Director—Inside Medicine
• Why the 1 senator who can rein in RFK Jr. isn’t calling him out—Politico
• HIV RNA Testing Appears Unnecessary for Patients Taking Oral PrEP—TheBodyPro

Resources

• U.S. Funding Cuts Threaten 39 Research Sites in South Africa Putting Scientific Advancements and Hard Won Progress Against TB and HIV at Risk—TAG and MSF
• HIV Prevention R&D at Risk—AVAC
• Advocates’ Guide: Understanding the President’s Proposed Fiscal Year 2026 (FY26) Budget and Its Implications for Science, Research and Global Health—AVAC
• Worldwide Prevention, Shared Protection: Why STI Funding Matters—AVAC
• Critical Advocacy: How Civil Society is defending the HIV Response and Global Health—AVAC
• Research Matters—AVAC, HIVMA, TAG
• Impact of NIH Grant Terminations—Association of American Medical Colleges

Save the Date!

The US President’s proposed budget for next year includes sweeping cuts to the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), US Agency for International Development (USAID) and the elimination of vital global and minority health research programs.

These cuts represent an effort to extend legally challenged cuts made by executive order earlier this year, and to codify them into law with congressional approval. If successful, they will result in the drastic cut of US federal investments in global health research, development and delivery.

This initial “skinny budget”, introduced by the President, is a proposal and not yet law. A more detailed version will be released by mid-to-late May and the US Congress will ultimately decide funding levels for Fiscal Year 2026, which begins October 1. So, advocates must speak up now to protect funding for research and programming that saves lives and livelihoods. Read on for resources to support your advocacy.

• PxPulse Live: Critical Advocacy—How Civil Society is defending the HIV Response and Global Health, AVAC’s newest podcast episode maps out connections to economic justice and explores where advocacy must focus now. Featuring Asia Russell of Health Gap and Amanda Banda of the COMPASS Coalition in conversation with AVAC’s Director of Communications Kenyon Farrow.
• Advocates’ Guide: Understanding the FY26 Proposed Budget and Its Implications for Research and Global Health, AVAC’s Advocates’ Guide provides a snapshot of the impact of these cuts on biomedical research and programs that support health and development, and frames priorities for advocacy.
• Worldwide Prevention, Shared Protection: Why STI Funding Matters, AVAC’s brief on cuts to vaccine development for sexually transmitted infections and the broader STI landscape of research, testing and prevention in the US and globally.
• Science in the Crosshairs: Research Advocacy in a Time of Crisis, The Choice Agenda webinar exploring what these attacks mean for communities, researchers, and implementers. The conversation covers actionable advocacy strategies for fighting back. Moderated by Matthew Rose from the Human Rights Campaign, and features Sybil Hosek from University of Illinois – Chicago, Riko Boone and Lizzy Lovinger from TAG, John Meade from AVAC, and Nyaradzo Mgodi from University of Zimbabwe Clinical Trials Research Centre.
• Research Matters: Resources to Protect Research Funding, AVAC, TAG and the HIV Medicine Association (HIVMA) co-created a new resource hub, Research Matters, to support researchers advocating for sustained NIH funding. These tools include an Advocacy Toolkit to help move our collective efforts forward. Please share this link with any researchers who have received NIH funding—we will continue to update the hub with resources to support continued advocacy for biomedical research.
• AVAC and partners are collecting stories of impact—if you know someone willing to share their story about how NIH cuts are affecting their work, contact John Meade Jr. at [email protected]. This Huffington Post piece by Katie Edwards at the University of Michigan is a terrific example of a researcher sharing the real-world toll on scientists, trial participants, communities, research and public health.

Thank you for standing with us to protect science, health, and progress.