From spotlighting the impact of US-supported HIV research to advancing the future of the HIV response; accelerating pediatric HIV cure research to shaping the global STI agenda, AVAC is driving and tracking the critical conversations defining HIV prevention and advocacy. Read on for this week’s resources and perspectives.

“International research is not an optional ‘add-on’ to the US HIV effort—it is a foundational engine of innovation, testing, and learning and it provides the scaffolding for creating a cascade of benefits for HIV management in the US and for research beyond HIV,” write University of California, San Francisco’s Judith Auerbach, Duke Global Health Institute’s Jirair Ratevosian and AVAC’s Mitchell Warren in a new Health Affairs piece. The authors highlight how US-supported international HIV research—particularly in African countries— delivers direct benefits to Americans, and why cuts to that research may undermine those benefits.

Practical Considerations for Pediatric Cure Research

AVAC Senior Program Manager Jessica Salzwedel joins leading HIV cure researchers from Johns Hopkins Medicine on a new podcast discussing a recent publication on the ethics of pediatric HIV cure research, HIV Cure Research: Ethical and Real-World Practical Considerations for Pediatric and Adolescent Populations in the Journal of Pediatric Infectious Disease Society. The episode covers work born out of the PAVE Collaboratory, the only NIH-funded HIV cure research consortium focused on perinatal HIV. Learn more about AVAC’s broader cure portfolio.

AVAC and Access Bridge Join Kenya Health Integration Summit 2026 

At the Kenya Health Integration Summit, AVAC and its partner Access Bridge shared key insights on strategies to support KP integration and PrEP rollout, and strengthening people-centered health systems—underscoring the critical role of advocates and communities in driving progress. Together, AVAC and Access Bridge work to ensure effective scale-up of new prevention options while safeguarding equitable access for all populations amid a volatile funding landscape.

AVAC at AIDSWatch 2026 and SYNChronicity 2026

John Meade, AVAC Senior Program Manager for Policy, took the stage as a plenary speaker at AIDSWatch this week, where more than 600 advocates converged to push US Congress to support HIV research and programs. “The same forces dismantling PEPFAR and expanding the Global Gag Rule are also attacking LGBTQ+ people, public health and bodily autonomy here in the US,” said John, calling for coordination across domestic and global HIV advocacy movements.

Also this week, AVAC Executive Director Mitchell Warren joined Congressman Herb Conaway, Judith Feinberg, Greg Millett, and JD Davids at the SYNChronicity conference for an important discussion on What’s New & Next in the HIV/AIDS Response. Slides from his presentation are available.

AVAC’s Alison Footman to Co-Chair the 2026 STI Prevention Conference

Mark your calendars for the 2026 STI Prevention Conference in Atlanta from August 31-September 2. AVAC’s Senior Program manager, Alison Footman, who leads our STI program is co-chairing the meeting with Barbara Van Der Pol of the University of Alabama. At a critical moment for STI advocacy, this convening is designed to spark conversations and collaboration about prioritizing prevention strategies, service delivery models, research and policy approaches that are responsive to community needs as funding remains precarious.

Other Must See Resources From This Week

• Putting Communities First in HIV Research with Yvette Raphael — Global Health Unfiltered podcast
• CAB-LA: The prevention jab that never had its moment, and what it leaves behind as LEN arrives — Bhekisisa article by Ida Jooste
• Speeding Up Access to PrEP — AVAC infographic charting the time from efficacy results to key milestones for injectable LEN and CAB, the DVR and oral PrEP
• Gilead Could Potentially End HIV. But Will It Be Able To? — PharmaVoice
• 180,000 Infections in 2024, 47,000 by 2045 — If SA rolls out the twice-a-year HIV prevention jab fast enough — Bhekisisa

A US federal court blocked the US Administration’s efforts to overhaul the CDC’s Advisory Committee on Immunization Practices (ACIP) amid intensifying challenges to vaccine science, while the National Institutes of Health (NIH) Director sought to reassure lawmakers over funding delays and shifting research priorities. At the same time, the State Department quietly removed five “America First” health agreements from public access as scrutiny grows over Zambia’s draft MoU, and Argentina announced its intent to withdraw from the World Health Organization (WHO). 

Court Blocks ACIP Overhaul as Broader Challenges to Vaccine Science and Policy Intensify 

A US federal judge blocked Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.’s attempt to overhaul pediatric vaccine policy and restructure the ACIP, a gold-standard panel of medical experts. RFK Jr. previously replaced 17 members of ACIP with a mix of anti-vaccine, anti-science representatives, and the ACIP subsequently began to undermine vaccine recommendations. Tuesday’s court ruling came in response to a lawsuit filed by a number of leading public health organizations, arguing that the Administration’s actions bypassed established scientific and procedural safeguards, raising concerns about political interference in long-standing vaccine recommendation processes and policy. Read AVAC’s An Assault on Vaccine Science and Policy, and the Stakes for Global Health. Also this week, a US federal working group drafted a confidential report proposing the creation of a diagnostic category specifically for COVID-19 vaccine injuries and side effects to be reviewed by the recently restructured ACIP. 

IMPLICATIONS: The court ruling underscores the ongoing tension between political leadership and scientific governance in US public health institutions. By intervening, the court has temporarily safeguarded the integrity of evidence-based vaccine policy, but the dismantling of vaccine science and abdication of the country’s historic role as a leader in evidence-based public health continues. As AVAC’s Alison Footman PhD, MPH warned in an August statement, “These actions dangerously sow vaccine disinformation and mistrust, which has proliferated since the COVID-19 pandemic. Dangerous ideology results in dangerous policymaking, putting many lives at stake and complicating efforts to both discover and implement clinical and cost-effective interventions.”  

READ: 

• Judge Blocks RFK Jr.’s Overhaul of Vaccine Recommendations—MedPage Today  
• Federal judge puts RFK Jr.’s new vaccine schedule, advisers on ice—Politico  
• Fewer Americans trust government’s childhood vaccine recommendations: Survey—The Hill 
• Federal judge stalls health secretary RFK Jr.’s overhaul of vaccine policy—STAT  
• Judge Strikes Down Kennedy’s Vaccine Policies—New York Times 
• A New Level of Vaccine Purgatory—The Atlantic 
• Viewpoint: Uncertain victories mustn’t distract us from staying focused on defending health—CIDRAP 
• Federal judge blocks RFK Jr’s overhaul of vaccine recommendations—The Guardian 
• Confidential Report Calls for Sweeping Changes to Track Covid Vaccine Harms—New York Times 

NIH Director Testifies, Promises to Disburse Funds as Agency Calls for Input into Strategy 

US NIH Director Jay Bhattacharya testified on Tuesday at a closely watched House Appropriations hearing, acknowledging the slowdown in grantmaking and assuring lawmakers that the NIH will work to secure agreement from the Office of Management and Budget (OMB) to spend the full $48.7 billion NIH budget by the end of fiscal year 2026. Rosa DeLauro (D-Conn.) raised the right issue: “I find it disconcerting that it took a congressional oversight hearing to prompt OMB to do what it should have done weeks ago.” A day prior, the NIH launched its first public webinar to solicit input on its next five-year strategic plan, signaling an effort to engage stakeholders in shaping future priorities. Yet, the NIH’s evolving approach to soliciting and funding research proposals (see last week’s Global Health Watch), including shifts in how projects are reviewed and prioritized, is being hotly debated. Join the next NIH strategy webinar April 8 and provide input to comments and suggestions on their “Framework for the NIH-Wide Strategic Plan for Fiscal Years 2027-2031”. 

IMPLICATIONS: While NIH leadership is seeking to reassure Congress – and the research community – that funding will be fully deployed and that strategic planning remains inclusive, the slowdown in awards and changes to funding processes suggest otherwise. At a time when sustained investment and scientific independence are critical, short-term disruptions have lasting impact. Science does not operate with an on/off switch, it depends on sustained investment, stable institutions and trust. “When the Administration stops research funding abruptly, it rewinds scientific progress. It will take time and even more resources to get these studies back online—squandering the potential of future breakthroughs that are based on established, gold-standard science,” warned AVAC’s Stacey Hannah in an August statement.   

READ: 

• NIH pivots away from agency-directed science—Nature  
• White House lifts hold on NIH research spending—Science  
• NIH will spend its full budget this year, agency director promises House appropriators – STAT 
• NIH Director Sails Through House Appropriations Oversight Hearing—MedPage Today 
• US State Department not answering aid oversight questions—Devex   
• Bhattacharya Appropriation Oversight Hearing—Drug Monkey 

State Department Pulls “America First” Health MoUs as Zambia Draft Reveals Contentious Terms 

The US Department of State quietly and without explanation removed the five previously published Memoranda of Understanding (MoUs) with African countries from its website. This further limits transparency around the agreements, which were only posted publicly last week following pressure from civil society in the US and MoU partner countries. At the same time, analyses on Zambia’s draft MoU reveal significant funding reductions, co-financing requirements, and links to broader economic and mineral access negotiations.

IMPLICATIONS: The shift toward bilateral, co-financed “country ownership” models is increasingly highlighting significant cuts to US investments in global health, uneven disclosure, non-transparency and growing indications of transactional terms tied to broader geopolitical and economic interests. The quiet removal of the publicly available MoUs underscores a pattern of limited transparency and accountability, making it difficult for countries, civil society, and implementers to assess obligations, plan for continuity or respond to risks.

READ:  

• State Department Removes Controversial Health Agreements with African States from Website Without Explanation—Public Citizen 
• U.S. Considers Withholding H.I.V. Aid Unless Zambia Expands Minerals Access—New York Times  
• Zambia’s Draft Memorandum of Understanding With the U.S. Government: What Do We Know?—Health Gap
• The Department of State has an (even bigger) Accountability Problem—To End A Plague…Again Substack

Argentina Announces Plans to Depart from WHO

Argentina announced its intention to withdraw from the WHO, marking a significant shift in its global health engagement. The decision represents ongoing skepticism toward multilateral institutions and a push to reassert national control over health policy and financing. Argentina’s exit follows months of criticism of the WHO guidance during the COVID-19 pandemic, and closer ties with the White House.

IMPLICATIONS: Argentina’s withdrawal raises concerns about fragmentation in global health multilateralism and governance at a time when coordinated responses are essential. This is a broader trend in reduced support for multilateral health institutions, including the US’ decision last year to withdraw from the WHO, signaling growing strain on global cooperation at a critical moment for global health. For the HIV response and pandemic preparedness, reduced cooperation risks slowing responses to new and resurgent infectious diseases, undermining shared accountability, and complicating efforts to ensure equitable access to prevention, diagnostics and treatment worldwide. 

READ:

• Argentina says it will withdraw from the World Health Organization, echoing Trump—Associated Press 
• Argentina to withdraw from WHO after Trump exit, citing ‘deep differences’—Reuters
• Video: What Happens When the Next Pandemic Hits?—Georgetown University Global Health Institute 

“International research is not an optional ‘add-on’ to the US HIV effort—it is a foundational engine of innovation, testing, and learning and it provides the scaffolding for creating a cascade of benefits for HIV management in the US and for research beyond HIV,” write University of California, San Francisco’s Judith Auerbach, Duke Global Health Institute’s, Jirair Ratevosian, AVAC’s Mitchell Warren in a new Health Affairs commentary. 

What We’re Reading

• Pressure Builds as Pandemic Talks Reach Final Week with Little Consensus—Health Policy Watch
• After a Decade of Progress Against HIV, PrEP Enters a Precarious Era—JAMA
• White House Puts RFK Jr.’s HHS on Tighter Leash After MAHA Setbacks—Wall Street Journal
• United States is cutting ties with influential global cancer agency—Science
• The indirect — and sometimes surprising — benefits of vaccines—STAT
• Cambodia advances in HIV fight, but new infections continue—KHMER Times
• US pulls away from family planning. What about the $600M saved for it?—Devex
• New International Planned Parenthood chief steps in amid anti-rights surge—Devex
• Merging UNFPA and UN Women would undermine gender equality globally—Devex
• 180 000 infections in 2024, 47 000 by 2045 – if SA rolls out the twice-a-year prevention jab fast enough—Bhekisisa
• CAB-LA: The prevention jab that never had its moment, and what it leaves behind as LEN arrives—Bhekisisa
• Podcast: Putting communities first in HIV Research with Yvette Raphael—Global Health Unfiltered
• UK government axes flagship global health project—The Guardian
• Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation—Health Policy Watch
• US State Department not answering aid oversight questions—Devex
• HIV Cure Research: Ethical and Real-World Practical Considerations for Pediatric and Adolescent Populations—Journal of the Pediatric Infectious Diseases Society
• How AI “Besties” in South Africa Are Changing Uptake of HIV Medication—Think Global Health

US-funded HIV research conducted in Africa and other high-burden settings isn’t just a foreign aid story — it’s a direct driver of American public health gains. What gets discovered there impacts how healthcare is delivered here. It shapes the drugs Americans take, the guidelines their doctors follow, and the public health initiatives that serve the hardest-hit communities.

A new Health Affairs piece by Judith Auerbach, Jirair Ratevosian, and AVAC’s Mitchell Warren makes the case that cuts to US-supported global HIV research don’t just hurt partner countries. They undermine the scientific pipeline that delivers those advances to Americans most in need. As the Administration scales back global health investments, the US risks squandering decades of research returns just as they’re beginning to pay off.

Read the full piece.

This week, France sharply cut its contribution to the Global Fund, adding to the replenishment shortfall and broader strain on multilateral global health financing. Meanwhile, the US launched a new global health funding platform tied to bilateral agreements, even as delays in MoUs and shifting timelines continue uncertainty about service delivery under PEPFAR and what its future and the future of multilateralism looks like. Amid these shifts in global health architecture, The Lancet launched the inaugural issue of The Lancet Regional Health – Africa to elevate African leadership in health research and policy.

France Cuts Contribution to Global Fund

France, traditionally the second-largest contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, has reportedly sharply reduced its pledge for the latest replenishment cycle. After increasing its support by 20% in each of the previous two cycles, France cut its contribution by 58%. This, combined with delays in a pledge from the European Commission and reductions in contributions from other major donors, brings the Fund well under its $18 billion target. As reported previously, the Global Fund Board approved $10.78 billion in country allocations for the 2027–2029 cycle and set aside $260 million in catalytic funding to accelerate access to innovations, including scale-up of lenacapavir for long-acting PrEP, new molecular tuberculosis diagnostics and improved malaria vector-control tools. 

IMPLICATIONS: France’s cut reflects a broader reduction in support for multilateral global health institutions at a time when the global health architecture is being reconstructed. As Health Policy Watch notes, “when it comes to healthcare, multilateralism has yielded many tangible benefits that are helping keep people alive. In a world where every country stands alone, these benefits will simply fall away.” Moving forward, the question is not only which multilateral organizations will be appropriately funded, but whether future global health partnerships can preserve the collective action needed to address HIV, tuberculosis, malaria and emerging health threats, and what forms those partnerships will take. 

READ:  

• Global Health Infrastructure Is Changing. Why Getting It Right Matters—Health Policy Watch
• Global Fund Faces $5bn Shortfall as France Slashes Support, EU Delays Pledge—Health Policy Watch

US Launches New Global Health Funding Platform as Bilateral MoUs and PEPFAR Timelines Pass

The US State Department launched the “Advancing Global Health” Annual Program Statement (APS), a new global health funding mechanism that could provide up to $4.5 billion into projects tied to the administration’s emerging bilateral health Memoranda of Understanding (MoU) agreements with partner countries. The platform is designed as a standing funding mechanism where international organizations, NGOs, universities and others can respond to targeted calls for grants and compete for funding awards between $500,000 to $250 million.

The US State Department also released the full text of MoUs with Ethiopia, Kenya, Mozambique, Nigeria and Uganda. The documents do not include data and specimen-sharing provisions, and only five of the 24 signed agreements have been published, despite the deadline to finalize MoUs by December 31, 2025. This delay led to PEPFAR-supported countries, which have not yet signed agreements or secured funding under the MoUs, being granted a three-month extension to continue to receive funding at current levels. PEPFAR programs had previously been expected to stop operating after March 31, 2026, but the last-minute authorization allows funding to continue as MoUs are negotiated and implementation plans are completed in countries with signed MoUs. In addition, appropriated third quarter funds have not been transferred to global HIV programs administered by CDC, with buffer funds being used to cover costs, threatening services disruptions, and further destabilizing health systems.

IMPLICATIONS: These developments continue the shift toward bilateral global health funding tied to broad government-to-government agreements negotiated in conjunction with mineral rights, data access and other provisions under the “America First” framework. While the new APS could mobilize significant resources, limited transparency across the APS and MoUs, delays in finalizing agreements and transferring appropriated funds, lack of civil society engagement and unequitable terms, raise concerns about how smoothly the transition will unfold and to what degree politics and power dynamics are driving the model. The need for a last-minute three-month extension for PEPFAR programs further highlights the operational risks of this shift and raises serious concerns about further disruptions to HIV services.

READ:  

• Discomfort over US agreement—The Times Group (Malawi)
• US Bilateral Health Agreements Published Under the Case Act—Public Citizen
• Department of State Officially Releases 5 MoUs—To End a Plague…Again Substack
• PEPFAR’s Next Quarter Could Be Its Last—Health Security Policy Academy
• US launches $4.5B platform inviting NGO support for bilateral health deals—Devex
• The State Department Is Asking the World for New Global Health Ideas—Lights, Camera, Equity! Substack
• PEPFAR Bridge Plans Extended, Possibly Without New Money—To End a Plague…Again Substack
• US Clarifies Type of Health Data Requested in Zimbabwe Talks—Health Times (Zimbabwe)

The Lancet Launches New Journal to Elevate African Leadership in Global Health

The Lancet launched its inaugural issue of The Lancet Regional Health – Africa, a new publication to elevate African leadership in health research, policy and clinical practice. The journal aims to address longstanding imbalances by amplifying African voices and prioritizing research grounded in the lived experiences of communities, health systems and policymakers across the continent. A comment by Africa CDC colleagues reimagines a future global health architecture. 

IMPLICATIONS: Framed as part of a broader effort to decolonize, localize and re-center health and medical research, the journal will publish evidence and analysis on the issues most critical to African populations while challenging Western-centric paradigms that have historically dominated global health discussion and debate.  

READ:

• Amplifying African voices to lead science for better health—The Lancet Regional Health—Africa  

What We’re Reading

• VIDEO: USAID: Last Week Tonight with John Oliver—HBO
• Samantha Power, former US Ambassador to UN: Closing USAID was soft power suicide—BBC
• How Congress can restore the independence of US science—Nature
• UMR Releases Annual NIH Economic Impact Report: 2026 Update—United For Medical Research
• Scientists Get a Glimpse to How New Pandemics Are Made—New York Times
• Africa CDC and ECDC strengthen joint commitment to Global Health Security—Africa CDC
• A Motto for All Health Workers: Resist, Resist, Resist—The Nation
• How Public Health Lost The Narrative – And How It Can Win It Back—Health Policy Watch
• As Women’s Rights Falter Globally, US Moves To Weaken UN Support For Gender Equality—Health Policy Watch
• Botswana’s HIV services struggle—The Lancet
• Waste, Fauci and ‘Transgender’ Mice: How MAGA Is Warming to Animal Rights—New York Times
• Americans trust Fauci over RFK Jr. and career scientists over Trump officials—Ars Technica
• As controversial decisions mount, FDA shuns public advisory meetings—STAT 
• My CROI 2026 Notebook: Science, Surprises, and the Big Question of Choice—AVAC 
• CROI 2026: Hot Takes—AVAC 
• Preparing for AI-enabled Bioweapons—Project Syndicate

The last few weeks have been action-packed for HIV prevention (and for AVAC and partners), with unpacking data and discussions from CROI; injectable lenacapavir for PrEP (LEN) rolling out in a number of Eastern and Southern Africa countries; signings (and not) of “America First” Bilateral Health Agreements; and our latest quarterly STI and HIV updates. AVAC is tracking it all; see below for the key updates.

AVAC’s Year in Review — and the new Access Bridge

In case you missed it, AVAC just released its 2025 Year in Review, looking back at the organization’s impact throughout the year. The last year tested global health in unprecedented ways. AVAC showed up: helping protect hundreds of millions of dollars for global health; defending HIV programs and research; delivering trusted data, tools and analysis; and accelerating equitable access to innovations, like long-acting PrEP.

And just last week, we announced the launch of our Access Bridge partnership — a new Kenyan-based organization to work with AVAC and the field to accelerate product introduction and access.

CROI 2026

The annual Conference on Retroviruses and Opportunistic Infections (CROI) once again delivered a powerful mix of scientific progress and urgent warnings about the systems needed to turn real innovation into impact. From advances in HIV prevention, cure and treatment, new data on STI treatment and service delivery, the science pointed to expanding choice, but the discussion and debate underscored that scientific progress alone is not enough; sustainable funding, strong health systems and community leadership are essential to translate discovery into equitable access.

• Read new blogs from AVACers who were on the ground at CROI: check out Cindra Feuer’s Hot Takes & Grace Kumwenda’s My CROI Notebook.
• Read our roundups of key highlights (Days 1 & 2, Days 3 & 4).
• View recordings and resources from our community webinars with leading CROI presenters.

Latest Infographics: Lenacapavir Rollout Advances

Momentum continues to build around the rollout of LEN — the latest scientific breakthrough for HIV prevention. LEN delivery is ongoing in Eswatini and Zambia, it’s been launched in Kenya and Zimbabwe, and initial supply has entered Lesotho, Mozambique, Nigeria and Uganda. AVAC, Access Bridge, and the Coalition to Accelerate Access to Long-Acting PrEP continue to track the progress. Here are the latest graphics.

Tracking the “America First” Bilateral Health Agreements

AVAC Board member Stephanie Psaki examines the emerging America First bilateral health Memoranda of Understanding (MoUs) and the questions they raise around financing, transparency and the future of global health engagement in this Think Global Health piece. AVAC and partners are tracking closely developments and their implications.

Follow our Global Health Watch newsletter every Friday for the latest updates and analysis. Sign up here.

AVAC’s Quarterly Updates on HIV and STIs

AVAC’s quarterly resources bring you the latest in biomedical HIV prevention research and STIs. The latest issue of PxWire showcases the status of access to oral PrEP with the best data available since the US foreign aid freeze disrupted PEPFAR operations beginning in January 2025.

The March issue of STI Watch focuses on a growing tension in the global STI response: real scientific and programmatic progress alongside persistent underinvestment, fragile systems and geopolitics.

By Grace Kumwenda

Every year, the Conference on Retroviruses and Opportunistic Infections (CROI) feels like stepping into the future of HIV science for a few intense days. The coffee is strong, the slides are packed with data, and the hallway conversations are often as important as the plenaries. This year, I left with one big question echoing in my head: How much choice is enough in HIV prevention and treatment? That question showed up everywhere — from clinical trial design discussions to the rapidly expanding pipeline of long-acting products for both prevention and treatment. Here are a few highlights from my CROI notebook. 

The Era of Choice Is Here… But Are Systems Ready? 

Choice continued to be a recurring theme at this year’s conference. The field and science continue to build a menu of HIV prevention options: oral pills, vaginal ring and long-acting injectables administered at varying intervals, daily, 2-monthly, 6 monthly with the potential for even longer dosing intervals in the future. But choice also raises difficult questions. At the Long-Acting/Extended Release (LA/ER) Antiretroviral Research Resource Program (LEAP) Investigator Meeting held on the sidelines of CROI 2026, Carl Dieffenbach posed a provocative one: “There will be additional prevention choices developed, but the question remains: how many choices are necessary?” 

Throughout the conference, we were reminded that health systems are not always designed to handle choice or complexity. Every new product brings new requirements — supply chains, provider training, redesigned delivery models, and, importantly, funding commitments, which are increasingly limited. Still, as AVAC has highlighted in the People’s Research Agenda, the message from communities is clear: people want prevention options that fit their lives and this conversation remains relevant.

Prevention is moving toward “Ultra-Long Acting” 

If you follow HIV prevention science, you’ve probably heard the term “long-acting” more times than you can count. But at CROI this year, long-acting started to feel… almost short. Researchers are now exploring so-called “ultra-long-acting” prevention. A study on cabotegravir (CAB-ULA Extended 4M) explored whether injections could move from every two months to every four months. Researchers tested a range of doses and used pharmacokinetic modelling to predict how long drug levels would remain protective. The takeaway was that a 1600 mg injection every four months could potentially maintain protective drug levels, although an initial loading dose may be needed. It remains to be seen how different injectable options with varying dosing schedules will fit into the broader prevention landscape — and whether four-months of protection is actually “ultra-long-acting” in context. 

If four-months sounded impressive, another study raised the stakes. Researchers are now exploring once yearly lenacapavir for PrEP. Using data from four Phase 1 trials and thousands of drug concentration measurements, researchers modelled a regimen that could maintain protective levels of lenacapavir for 52 weeks. The proposed approach would require two oral loading doses at the start (as with the current six-monthly LEN), followed by a 3000 mg injection once per year. The upcoming PURPOSE 365 trial will test whether this annual regimen really works in people. If successful, it could reshape HIV prevention. Imagine getting your HIV prevention once a year! 

Additional follow-up data from the PURPOSE 1 study on the six-monthly injectable was also shared. During extended follow-up, two infections were reported: one participant who received injections on schedule, and another who missed a dose and discontinued lenacapavir, with HIV diagnosed 16 months after the last injection. This translates to a very low HIV incidence of 0.11 per 100 person-years, reinforcing the strong protective signal seen in earlier analyses. This update also underscores an important fact: there is no perfect product. 

Expanding oral PrEP options? 

We heard dosing data for MK-8527, an investigational oral drug being developed by Merck as a once-monthly PrEP pill. This data wasn’t totally new as it was also presented at CROI 2025 as a poster. Researchers presented further dose-selection data supporting the EXPrESSIVE Phase 3 trials, identifying 11 mg once per month as the dose predicted to maintain protective drug levels for a full month. Phase 2 studies, combined with pharmacokinetic modelling, showed that no dose adjustments are expected for pregnant participants or adolescents weighing more than 35 kg. If Phase 3 confirms safety and effectiveness, this monthly pill could offer a compelling middle ground between daily oral PrEP and long-acting injectables, adding another important option to the growing prevention toolbox. AVAC is supporting community engagement and Good Participatory Practice implementation throughout the trials and, in partnership with local organizations and communities, created demand generation materials for the trials.  

A Two-in-One Implant: Preventing HIV and Pregnancy 

Another fascinating early study looked at something many advocates have long called for: multipurpose prevention technologies. Scientists are developing a long-acting implant that could deliver dolutegravir for HIV prevention and levonorgestrel for contraception. Early animal studies suggest the implant could release drugs for up to a year. It’s still early days, but the idea is powerful: one product that helps address two major health needs at once. For many women, especially in high HIV burden settings, that could be transformative. 

Innovation Isn’t Just About Products — It’s About Delivery 

At CROI 2026 we saw examples of innovative service delivery models that bring prevention closer to people. A randomized study among postpartum women in South Africa showed that offering dynamic choice in how PrEP is delivered improved overall PrEP use, reinforcing a simple lesson: when people can choose how to access prevention, uptake improves. In another cluster randomized trial in Kenya, researchers compared pharmacy-based PrEP delivery models with traditional clinic-based services and found that pharmacy delivery particularly when PrEP was free and supported by HIV testing services (HTS) counsellors could successfully support both initiation and continuation of PrEP. These findings echo other promising models highlighted at the conference, including pharmacy-based PrEP study in Zimbabwe, the Person-Centred Care model in Zambia, and exploration of “post-exposure prophylaxis in your pocket.” Together, they signal a growing shift in HIV prevention, moving beyond clinic walls so people can access prevention through pharmacies, communities, and other everyday points of care. How this science translate into programs will be interesting to watch. 

Rethinking Clinical Trials: What If People Choose? 

One of my favourite sessions explored preference in pragmatic trial designs, a fascinating approach to clinical research. Instead of forcing participants into randomization, these trials ask: What if people could choose the intervention they prefer? Pragmatic trials can measure the preference effect, do people do better when they receive what they want? It’s a simple idea with profound implications. Many questions remain, including how to address potential bias, but this is one conversation I’m eager to continue following. 

A Reality Check: The Funding Cloud 

Amid the scientific excitement at CROI 2026, discussions repeatedly returned to the growing uncertainty in global HIV financing. In South Africa, more than 40% of clinics reported impacts, even among those not directly funded by PEPFAR, showing how deeply interconnected HIV systems are. Speakers also warned about silent disruptions such as reduced quality of care, weakened data systems, and strained services that may not immediately show up in the numbers. As Francois Venter of Ezintsha in South Africa noted, “the science may be racing ahead, but implementation and financing must keep pace if these breakthroughs are to reach people.” 

My Biggest Takeaway 

CROI 2026 made one thing clear, the future of HIV prevention and treatment is expanding rapidly. We are moving toward long-acting options that will include potentially once yearly prevention, but innovation alone is not enough. The real challenge now is ensuring that these tools reach the people who need them most and that communities have the information and agency to choose what works for them. Because in the end, the future of HIV prevention will not be defined by a single breakthrough; it will be defined by choices — across many facets and by many stakeholders.

By Cindra Feuer

This year’s CROI felt a whole lot leaner since my last attendance in 2017. It also felt a bit meaner, but in a good way. The field, down for the count in 2025, displayed a resilience in Denver that rose to the occasion of cuts to research, massive lay-offs, disdain for the scientific method and a general assault on the value of humanity. This time, conference participants not only reckoned with the losses but there was a spirit of organized push back; a renewed momentum rooted in the research and will.  

A clear triumph was displayed by the bouquet of emerging long-acting (LA) ARV therapeutics, offering alternatives for people who struggle with optimal adherence to daily oral treatment. Ongoing research is expanding eligibility for salvage therapy to both the treatment naïve and those with non-suppressed virus. For example, a meta-analysis of cabotegravir-rilpivirine trials (FLAIR, LATTE-2, SOLAR, ATLAS, CARES, and LATITUDE) confirms the 8-week regimen can maintain viral suppression among diverse populations and settings and with varying treatment profiles. Of course, these new therapies come with their own challenges, including cost, access and injection site reactions, but new oral, long-acting options are also in development to clear these hurdles. A phase 2 study of islatravir and lenacapavir, an oral weekly combination regimen, showed no virologic failure, paving the way for the ongoing Phase 3 studies ISLEND 1 and 2. AVAC will provide a fleshed-out picture of the rapidly expanding, next-generation LA ARV treatment pipeline ahead of the 2026 IAS conference, to complement our ongoing long-acting ARV prevention pipeline tracking.  

The SEARCH Community Precision Health Intervention, a cluster-randomized trial delivering HIV testing, PrEP, PEP and treatment referrals through community health workers in rural Kenya and Uganda, reported a striking 70 percent decline in HIV incidence in intervention communities. Reported PrEP coverage rose by just over one percentage point, so it will be important to review more data from SEARCH to understand what factors might contribute to such a steep decline in incidence. Most modeling studies and some empirical data suggest that substantially higher PrEP coverage is required to achieve even 50 percent reductions in new infections. This raises the possibility that factors beyond PrEP uptake contributed to the result, including behavioral change, treatment effects, baseline imbalances or instability given the small number of infections—22 in the control and 7 in the intervention. If relatively small increases in PrEP coverage can, indeed, generate population-level effects of this scale, the implications would be transformative. Clarifying the mechanisms behind these findings is essential to ensure that HIV prevention strategies are grounded in a clear understanding of what drives impact. 

Implementation science (like the SEARCH study) was front and center at CROI, showing many ways to reframe delivery to reach priority populations and, thereby, increase equity and access. Renee Heffron from the University of Alabama grounded the CROI audience on the difference between “implementation science” and “implementation”. The former “is meant to accelerate the research to practice timeline—it takes an average of 17 years for a novel treatment to reach practice, so there’s lots to do.” She offered up a model of implementation-effectiveness hybrid strategy whereas clinical and implementation outcomes are dual goals. For example, a hybrid study would ask “If we implement 6-monthly LEN injections in health facilities, will this be feasible and will providers counsel about PrEP options with high fidelity to the counselling guidelines and what is PrEP uptake at facility level?” A clinical outcome would only track HIV incidence at the facility and an implementation outcome would only measure fidelity to guidelines.  

Heffron asks, “Is implementation science a fleeting obsession or here to stay?” This is seemingly a loaded question, given Jay Bhattacharya, US NIH Director has gone all out with his support for implementation science, wanting to significantly increase the proportion of implementation science of the overall NIH budget from its current 7%, according to Geri Donenberg, Director of the NIH Office of AIDS Research. Others are suspicious, worrying that this support is in line with the current US administration’s efforts away from basic and clinical research.  

Among the wrinkles at this year’s CROI was the decision to forego press conferences (both live and virtual) for the global media who have faithfully covered the meeting’s key scientific breakthroughs over the years. This was a missed opportunity against the backdrop of continued, deafening attacks on science, from vaccine research and rollout, attacks on communities across the board, funding shortages, withdrawal of membership in key normative bodies and many other transgressions of laws and moral principles. CROI needs to amplify the harmonious, as well as dissident, voices of researchers and community that the conference uniquely puts forth.   

And, on an up note, I want to close with a preview report back from the AVAC-organized PEP Think Tank on the heels of CROI. Catalyzed by data that the experimental MK-8527 monthly PrEP pill might reach protective drug levels within one hour, a cross-section of talent gathered to brainstorm next-generation PEP options. Heady questions like, Is an RCT necessary? Is an RCT even possible with new PEP formulation? What evidence would be needed to qualify for a label extension? What evidence would be needed for normative guidance and national implementation guidelines? What do communities want? How to improve upon PEP programs of today while preparing for additional options of tomorrow? And how to simplify and de-silo ARVs for treatment, PrEP and PEP with the next-generation drugs? Perhaps we’ll have some answers next year at CROI 2027, in San Diego. And they will be broadcasted widely.

This week four Latin American countries have signed bilateral health Memoranda of Understanding (MOUs) with the US under its America First Global Health Strategy. This new Think Global Health analysis examines gaps between country needs and new co-financing commitments with the US.

In this issue, we also look at delays in the release of US science funding, despite congressional approval, and new developments from South Africa and AVAC shaping the global rollout of HIV prevention options. 

US Appropriated Science Funds Remain Frozen Despite Feb. 3 Law

One month after the US Congress passed a $50 billion foreign affairs spending bill, which the President signed into law, funding has still not begun flowing to several agencies that support scientific research. According to Nature, the Office of Management and Budget (OMB) has not yet authorized the release of all appropriated funds, leaving agencies unable to issue new grants. As a result, the National Institutes of Health (NIH) has not yet received approval to spend the research funding allocated by Congress, prolonging uncertainty for scientists and institutions awaiting support for ongoing and new research projects.

IMPLICATIONS: While Congress ultimately rejected the deep budget cuts proposed by the President, the delays underscore the broad expansion of the power of the Executive Branch and the fragility of the current political environment in the US. As we wrote in our February 6 issue, “uncertainty of whether global health and humanitarian programs will receive the funding Congress appropriated leave many reluctant to celebrate. Coordinated advocacy and sustained Congressional oversight will be needed to ensure all appropriated funds are obligated and spent.”  

READ: 

• Trump Administration Funding Delays Worry NIH Grant Recipients—Bloomberg
• Foreign aid is back from the dead — but it’s in the hands of the people who tried to kill it—Vox
• White House stalls release of approved US science budgets—Nature
• Delays in awards and funding calls worry NIH-funded researchers—Science

Lenacapavir Rollout Advances as South Africa Pursues Local Production 

Momentum continues to build around the rollout of injectable lenacapavir for PrEP (LEN) across multiple countries. Four countries in East and Southern Africa have now launched LEN, with national launch events last week in Kenya and Zimbabwe. Eswatini and Zambia have already begun delivering LEN, and among the nine Global Fund to Fight AIDS, Tuberculosis and Malaria–supported early adopter countries, Lesotho, Mozambique and Uganda have also received initial supply. Nigeria is expected to receive shipments beginning next week. AVAC and the Coalition to Accelerate Access to Long-Acting PrEP continue to track the progress; see updated maps of regulatory approvals, initial programmatic access and implementation science.  
 
In addition, this week, South Africa announced a new effort to enable local production of LEN, signaling growing interest in regional manufacturing. In October 2024, Gilead Sciences granted six voluntary licenses to generic manufacturers in Egypt (1), India (4) and Pakistan (1) to produce and supply generic LEN to 120 low- and middle-income countries. South Africa’s would mark a seventh voluntary license. As the majority of generic LEN is likely to come from Indian generic manufacturers (as four of six with licenses are from India), South Africa is looking to set up independent capacity and capability to be self-sufficient in the future. 
 
IMPLICATIONS: The next phase of LEN rollout will depend on how quickly early launches translate into scalable, sustained access. A seventh license for a South Africa–based manufacturer could help accelerate the pathway from licensing to large-scale supply for regions most affected by HIV. Yet, it is not clear how long it might take the South African manufacturing to reach the market and at what price. In addition, the long-term sustainability of access remains uncertain amid broader disruptions to global health funding.

READ:  

• Gilead and South Africa are negotiating a license for local production of new HIV drug—STAT  
• Kenya rolls out breakthrough HIV drug. Now the real test begins—Defrontera 
• South Africa launches bid to enable local production of long-acting HIV prevention drug, lenacapavir—Unitaid  

What We’re Reading

• Tracking the “America First” Bilateral Health Agreements—Think Global Health
• US Speeds up Signing of Bilateral Health Agreements, DRC Lawyers Challenge Minerals Deal—Health Policy Watch
• A titan of vaccine development sees his field’s achievements slip away—STAT
• Are faith-based organizations the future of the AIDS response?—Devex
• Africa CDC Flags Concerns Over U.S. Health Funding Deals—Birr Metrics
• Global health in a new era of US extraction—BMJ
• State Department eyes tuberculosis breakthroughs—Devex
• After US aid cuts, South Africa’s HIV response strains to hold the line—Devex
• Ghana and Senegal Consider Harsher Measures Against LGBTQ People—Health Policy Watch
• Community health project in Kenya and Uganda dramatically cuts new HIV infections—Science
• Inside the battle to end the Aids pandemic in the face of Trump’s cuts—The Independent
• The CDC is in chaos. But here’s where it’s devastating—Washington Post
• Turmoil Takes Hold at CDC as Top Officials Keep Leaving—Wall Street Journal
• NIH Says It Will No Longer Recognize the Research Fellows’ Union—Notus
• U.S. may be slowing rollback of vaccine policy ahead of midterms—HealthBeat
• The global fallout of RFK Jr.’s vaccine policies—NPR
• A new one-a-day-pill holds promise for HIV’s ‘forgotten population’—NPR
• States Move to Limit Access to H.I.V. Treatment—New York Times
• Impact of the US Global Gag Rules on LGBTQI+ People Abroad—Williams Institute
• Major US cohort reveals sharp racial disparities in HIV acquisition among trans women—Aidsmap

Last week, Kenya became the fourth country in Africa to start administering lenacapavir (LEN) for PrEP — the injection that offers near perfect protection against HIV. Widely considered a breakthrough HIV prevention option, injectable LEN is scaling up at record speed, in no small part thanks to the coordinated efforts of advocates and civil society groups to push for accelerated processes.

LEN was launched in Eswatini and Zambia in December 2025 — just five months after the drug received US FDA approval — and in Kenya and Zimbabwe in February 2026. As implementation continues and more countries receive supplies, countries and communities need ongoing support to ensure LEN is delivered with speed, scale and equity, alongside other available PrEP options, to those who need it most.

It’s against this backdrop that AVAC is excited to introduce Access Bridge. Incubated over the past decade at AVAC as part of our Product Introduction and Access team, Access Bridge is an independent, Kenya-based nonprofit organization advancing timely, sustainable and equitable introduction of and access to HIV prevention, sexual reproductive health and related health products.

Led by Executive Director Wawira Nyagah, who led AVAC’s work in this area for the past five years, and a team of product introduction experts, Access Bridge brings a track record of proven success in moving HIV prevention options from evidence to real-world impact.

Building upon lessons learned from oral PrEP and injectable cabotegravir, the Access Bridge team has played a pivotal role in preparing the market for new products and in the initial rollout of LEN. Through high-level think tanks co-convened with WHO and the Coalition to Accelerate Access to Long-Acting PrEP, the Access Bridge team has aligned donors, Ministries of Health, civil society, researchers, and manufacturers around shared strategies and practical solutions. The Coalition’s leadership has helped shape the global LEN agenda, unlock regulatory and licensing pathways, increase pricing and supply transparency, and drive major procurement commitments and regulatory approvals across Africa.

The team worked closely with country stakeholders to establish a Ministry of Health Community of Practice fostering cross-country learning and supported civil society in LEN priority countries including across East and Southern Africa, to ensure community leadership, accountability and transparency throughout the introduction process. Through these initiatives and collaboration with AVAC on its trusted platforms such as PrEPWatch and the Global PrEP Tracker, Access Bridge acts as a trusted convener, translator and technical partner to countries as they prepare for LEN rollout in an expanding PrEP landscape.

As the Secretariat and lead of the Dual Prevention Pill (DPP) Consortium (combining oral PrEP with oral contraception), the Access Bridge team has driven the global effort to prepare for and introduce the DPP, enabling major progress across regulatory guidance, country planning, stakeholder engagement, and delivery systems, including private sector delivery, to position the DPP for introduction. Through this coordination, the consortium defined a regulatory pathway for multipurpose prevention technologies, advanced HIV/SRHR integration at country level, built broad stakeholder buy-in, and generated growing interest in integrated prevention solutions, moving the field closer to offering women a new dual-protection option. The team has also led efforts to harness private sector strategies for family planning to deliver the DPP. The team engages directly with commercial distributors, manufacturers, and social marketing organizations to strengthen distribution pathways, expand market reach, and identify opportunities to grow the commercial sector.

Access Bridge was purpose-built to meet this moment — an era marked by scientific breakthroughs and growing demand for integrated, people-centered care. AVAC looks forward to our continued and expanded work to accelerate R&D and product introduction of new options, and will partner closely with Access Bridge into the future.

To support this critical work and learn more, head to  healthaccessbridge.org and avac.org.

Access Bridge was there as community health advocate, Samson Mutua, became the first Kenyan to receive lenacapavir at an event as Kenyan Health Cabinet Secretary Aden Duale looks on.

This week’s issue covers Zimbabwe’s decision to halt negotiations on its Memorandum of Understanding with the US for global health funding; new domestic funding in South Africa; a new investment case for US funding for the Global Fund; the launch of injectable lenacapavir for PrEP (LEN) in Kenya and Zimbabwe; and key takeaways from CROI 2026 on the links between science, funding, and delivery.

Zimbabwe Declines US Health MoU, Zambia May Follow 

This week, the government of Zimbabwe formally terminated negotiations on the proposed Memorandum of Understanding (MoU) with the United States under the America First Global Health Strategy. In a public clarification, Zimbabwe’s Secretary for Information, Publicity and Broadcasting Services, Nick Mangwana, said the government’s decision followed an inter-ministerial review and reflected concerns that the draft agreement did not reflect an equitable partnership. While acknowledging the historic role of US health assistance, including PEPFAR, the government cited risks to data sovereignty and misalignment with Zimbabwe’s commitment to ongoing negotiations on the WHO Pathogen Access and Benefits Sharing (PABS) mechanism under Pandemic Agreement adopted last year. “Zimbabwe was being asked to share its biological resources and data over an extended period, with no corresponding guarantee of access to any medical innovations—such as vaccines, diagnostics, or treatments—that might result from that shared data,” Mangwana wrote. “In essence, our nation would provide the raw materials for scientific discovery without any assurance that the end products would be accessible to our people should a future health crisis emerge. The United States, meanwhile, was not offering reciprocal sharing of its own epidemiological data with our health authorities.”  
 
Other countries are also taking critical reviews of their MoUs: Kenya’s MoU is suspended pending a court challenge. Zambia is reported to have rejected its agreement as well. A leaked draft has drawn criticism for containing weaker protections and more onerous terms than other agreements. 
 
IMPLICATIONS: These developments, along with the abrupt withdrawal of other forms of US humanitarian assistance from seven African countries, raise serious questions about the power dynamics embedded in the new bilateral approach. For many governments, the choice may not be between partnership models, but between accepting unequal terms or losing support altogether, which puts health systems, sovereignty, and long-term equity at risk.

READ:  

• Clarification on Zimbabwe’s Health Diplomacy —The Herald  
• Protecting global health in the era of the America First Strategy—The Lancet Global Health 
• US-Rwanda MoU for Health Records $1.5 billion in Soft Commitments from Private Investors—To End A Plague…Again Substack 
• Zambia and Zimbabwe Back Away From ‘Prescriptive’ US Health Deals—Health Policy Watch 
• Zambia joins the list of African countries rejecting the U.S. “strings-attached” health funds—Business Insider Africa 
• The Trump Administration Is Ending Aid That It Says Saves Lives—The Atlantic  
• US accused of ‘shameless exploitation’ over proposed Zambian health aid deal—The Guardian  
• ZNNP+ Statement on the impact of the discontinuation of negotiations under the $350 Million U.S Health funding agreement on PLHIV in Zimbabwe—Zimbabwe National Network of People Living with HIV (ZNNP+) 
• Public Health Doctors Call for Dialogue After Zimbabwe–US Health Funding Talks Stall—Zimbabwe Mail 
• Zimbabwe rejects ‘lopsided’ US health aid deal over data concerns—BBC  

South Africa Mobilizes Domestic Resources for HIV

Following the termination of USAID grants in South Africa, the country’s Finance Minister announced new domestic funding (R26 billion) to provinces for HIV programs, with an additional R410 million to be reprioritized from the national Department of Health over the medium term to offset research grant funding withdrawn by the US. The new allocation is intended to support core interventions, including prevention of mother-to-child transmission and continued access to treatment. 
 
IMPLICATIONS: South Africa’s response underscores both resilience and vulnerability in the current global health landscape. While the government’s decision to mobilize domestic resources reflects strong political commitment and a recognition that HIV programs are essential services, it also highlights the scale of the gap left by abrupt external funding withdrawals.

READ:  

• R26bn allocated towards HIV/AIDS, research amid US cuts—Cape Times

New Investment Case for Global Fund

Following the conclusion of the Global Fund’s 8th Replenishment Conference last year, Friends of the Global Fight released a new FY2027 US Investment Case urging US Congress to appropriate funding in the fiscal year (FY) 2027 budget to protect hard-won gains against HIV, tuberculosis (TB), and malaria and to prevent further disruption to services already under strain. Advocates are calling on Congress to appropriate $1.533 billion for the Global Fund in FY27, or one third of the $4.6 billion US pledge for the 8th Replenishment. The investment case underscores the Global Fund’s role as a core pillar of global health security, highlighting its impact on saving lives, strengthening health systems, and advancing country-led responses. 
 
IMPLICATIONS: This new call for continued US government investment comes just after the Global Fund fell short of meeting its $18 billion target and as the Board endorsed a shift toward a rolling, longer-term replenishment model, as well as greater emphasis on country transitions. Without predictable, robust donor commitments from public and private sectors, ambitions for achieving sustainability, methodical transition, and ending these three diseases will remain fragile.

READ:

• Global Fund fundraising shortfall hits country allocations—Devex
• Fiscal Year 2027 U.S. Investment Case for the Global Fund—Friends of the Global Fight 

Lenacapavir for PrEP launches in Kenya and Zimbabwe Amid Uncertain Future for Access

This week marked a major milestone for the rollout of lenacapavir for HIV PrEP (LEN). Both Kenya and Zimbabwe held national launch events to mark the rollout of LEN in their countries. Kenya received its first 21,000 doses last Friday and announced at the launch that the Global Fund committed an additional Sh256 million (approximately $2 million) to support rollout activities, including service delivery support, training, community engagement and systems to ensure consistent access. Zimbabwe’s initial phase of the rollout, supported by PEPFAR and the Global Fund, is expected to reach approximately 46,000 people across 24 sites. 
 
IMPLICATIONS: These rollouts mark major milestones, but the future sustainability of access remains unclear. Scaling LEN beyond this initial phase will depend on reliable financing, supply chains, health workforce capacity and long-term political commitment, all of which are under strain amid broader disruptions to global health funding. Zimbabwe’s decision to decline the MoU with the US underscores this fragility: with the transition to conditional, transactional bilateral health arrangements, access to public health tools (like LEN) risks becoming vulnerable to shifting geopolitical priorities, rather than being guided by data and public health need.

READ:

• Kenya to roll out game-changing HIV drug in March—Africa News 
• Zimbabwe rolls out long-acting HIV drug, among first countries to do so—Associated Press 
• Zimbabwe Rolls Out New HIV Prevention Drug Lenacapavir—Reuters 
• Patient zero: The first Kenyans to receive the HIV injection—Daily Nation 
• Global Fund pledges Sh256 million for Kenya’s Lenacapavir rollout—The Star 

CROI 2026: Progress in HIV Science, Pressure on the Systems That Deliver It 

The Conference on Retroviruses and Opportunistic Infections (CROI) 2026 convened this week in Denver with a clear and urgent message: scientific progress in HIV treatment, prevention, and cure cannot be separated from the global infrastructure, sustained funding, public trust, resilience, and activism needed to sustain it. Across three and half days, researchers, policymakers, regulators and advocates heard advances—from durable PrEP options like lenacapavir and MK-8527 to advances in treatment, cure and vaccine research. And critical questions on whether the world is willing and able to currently and eventually deliver these tools equitably and at scale. Speakers warned that funding cuts, dismantled programs, and political interference threaten infrastructures that took decades to build, stressing that the interruption of HIV research and delivery “is not a policy choice.” 
 
IMPLICATIONS: As the science accelerates, CROI made clear that access, delivery, and trust are the main challenges. Data presented on service disruptions after the foreign assistance freeze, alongside warnings about threats to PEPFAR and global HIV infrastructure (read this new Lancet comment), underscored that breakthrough science and innovation mean little if systems fail to deliver them equitably and at scale. Community advocates emphasized that “country ownership” must be matched by activism, real-time data, and accountability that runs in both directions.

READ:

• CROI 2026: Science, Solidarity and High Stakes for the HIV Response—AVAC  
• CROI 2026: Meaningful Progress, Expanding Choice—AVAC  
• CROI 2026 Opens With Calls to Action—POZ  
• Counting the costs of global HIV funding disruptions—aidsmap  
• French study confirms efficacy of on-demand PrEP—aidsmap  
• Dual immune modulators delay, but don’t prevent, HIV rebound after stopping antiretrovirals—aidsmap  
• Very Early ART Initiation in Children With HIV Could Lead to ART-Free Remission—MedPage Today 
• Learning From HIV, Building Better Infrastructure to Tackle STIs: Jeanne Marrazzo, MD, MPH—AJMC

What We’re Reading

• The Human Cost of Trump’s War on Science—New York Times
• What Happened in Chicago When Science Became the Enemy—New York Times
• More US Vaccine Contestation Ahead Amid Court Action and Senate Hearing for Trump’s Surgeon General Nominee—Health Policy Watch
• The Global Health Reform Debate’s Dangerous Blindspot—Think Global Health
• ‘We want to rebuild trust’: fired CDC workers form group to combat Trump’s war on science—The Guardian
• I Was a CDC Senior Leader. From What I Saw, No One Should Run Two Agencies.—MedPage Today
• Aid Cuts Are Not Leading to Reforms in Sub-Saharan Africa—CGD
• COVID’s origins: what we do and don’t know—Nature
• MFAN Releases Operational Roadmap to Deliver on the Promise of Government-to-Government Assistance—MFAN
• New U.S. Foreign Aid Emphasis on Government Partnerships is Encouraging — If Done Right—Just Security
• Philanthropy’s Response to HIV and AIDS: 2024 Grantmaking—Funders Concerned About AIDS
• The HIV/AIDS response as we knew it is over: Where do we go from here?—JIAS