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

Issue 83

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

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

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

Congress Raises Alarm Over Expiring Global Health Funds and PEPFAR Restructuring

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

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

READ:

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

Jeremy Lewin Leaves Foreign Assistance Role

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

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

READ:

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

DRC Ebola Response Gains Ground as Funding Gaps Threaten Progress

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

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

READ:

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

What We’re Reading

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

Global Health Watch: NIH reopens South Africa Research Funding; DRC Ebola Strains Outbreak Response; WHO + FDA Leadership Shifts

Issue 82

The US National Institutes of Health (NIH) lifted research funding restrictions on South Africa; the DRC’s Ebola outbreak grows, exposing the consequences of weakened outbreak-response systems; and leadership changes at the World Health Organization (WHO) and the US Food and Drug Administration (FDA) raise questions about the future of global health decision-making.

NIH Reopens Research Funding to South Africa

The US National Institutes of Health (NIH) lifted its ban on funding research in South Africa. This comes after 18 months of “holding all research awards” for NIH research partnerships with South African institutions as the country was designated a “country of concern” alongside China. As Science reports, an internal memo notes that the “[NIH] decided it was exempt from a February 2025 executive order…that halted ‘foreign aid or assistance’ to South Africa” because “the Foreign Assistance Act of 1961 does not govern NIH funding.” The lift of this order reopens the door to new grants. However, the NIH also announced that South African scientists will no longer be eligible to receive training grants from its Fogarty International Center, because the country is upper middle-income and part of the G20. This follows last month’s announcement from the Department of State that it will phase out PEPFAR support to South Africa.

IMPLICATIONS: South Africa is one of the world’s most important HIV, TB and infectious disease research centers – built through decades of diplomacy and partnership with the NIH and US State Department, with numerous South African scientific leaders of today partnering with the Fogarty International Center. This is part of a wider unraveling of this decades-long scientific partnership spanning HIV research, treatment and prevention, emanating from false accusations made by the White House against the South African government for “not doing enough” to address unfounded claims of discrimination purportedly against the country’s white Afrikaner community. While this week’s reversal of the ban restores an important piece of that scientific collaboration, the larger relationship remains strained, including the planned PEPFAR phase out. US investments in PEPFAR and NIH partnerships in South Africa have resulted in significant contributions and innovations in the treatment and prevention of HIV, TB and other infectious diseases for people around the world, including in the US. For the HIV field especially, this reversal shows the interconnectedness of the research partnerships and bilateral programs and why both research and programmatic funding matter. The simple restoration of scientific collaboration, while continuing to withdraw and erode programmatic infrastructure will stifle scientific progress when it relies on strong public health infrastructure and partnerships made possible through PEPFAR.

READ:

NIH lifts ban on funding research in South Africa—Science
US agency lifts ban on South Africa research funding after 17-month freeze, $450 million loss—Business Insider (SA)
NIH Lifts Ban on Research in South Africa—Health Policy Watch

DRC Ebola Outbreak Illustrates Impact of Foreign Aid Restrictions

The ongoing Ebola Bundibugyo outbreak in the Democratic Republic of the Congo (DRC) is now the country’s deadliest Ebola epidemic and the second deadliest ever recorded. At an emergency WHO meeting, Director-General Tedros Adhanom Ghebreyesus said, “We must be frank: The epidemic is far from being under control… It had a big head start, and we are still playing catch-up.” WHO says it could still be brought under control within approximately three months, but only if resources and response capacity are rapidly scaled up. WHO figures report that only 60 percent of the $115 million needed to finance the response has been raised. Currently, there is no licensed vaccine or treatment for the Bundibugyo strain. Many new cases are appearing outside known transmission chains, which indicate infections are continuing to spread undetected.

READ:

DR Congo’s Ebola outbreak ‘global emergency’ as infections pass 5,000: WHO—Al Jazeera
WHO and Africa CDC welcome the allocation of Ebola vaccines to the Democratic Republic of the Congo—World Health Organization
The Guardian view on the Ebola outbreak in the DRC: a case study in why international aid matters—The Guardian
WHO says Congo Ebola outbreak can still be brought under control within three months—Reuters

Leadership Shifts at WHO and US Food and Drug Administration

The WHO and US Food and Drug Administration (FDA) are undergoing leadership changes. WHO’s chief scientist and Assistant Director-General for health promotion and disease prevention and control Jeremy Farrar will leave at the end of September. This latest departure comes amid WHO’s challenge to continue charting its future in the face of reduced donor funding, a smaller senior leadership structure, and the end of Director-General Dr. Tedros Ghebreyesus tenure later this year. Meanwhile, in the US, White House adviser on the Domestic Policy Council, Dr. Heidi Overton was nominated to lead the FDA as commissioner. She helped shape several of the Administration’s health initiatives, including its recent overhaul of childhood vaccine recommendations and is a proponent of the government’s anti-abortion policies. Her nomination comes after months of turmoil and a leadership vacuum at the FDA, which saw Marty Markary depart from the role in May after a short tenure of 13 months. Some Senators who are now debating her nomination are questioning her role in the recent vaccine order as they prepare for confirmation hearings.

IMPLICATIONS: As WHO is being forced to redefine its role and priorities amid shrinking resources, the US FDA is facing significant scrutiny and political pressure over vaccines and scientific decision-making. For global health and HIV, leadership stability and scientific independence at both agencies matter beyond the internal structure as WHO normative guidance and FDA regulatory decisions will determine which products move forward, how quickly they reach countries and communities who need them. Many national regulatory authorities around the world rely heavily on FDA’s rigorous regulatory review and approval processes to inform their decision-making in local approval, procurement, and implementation of new and emerging biomedical innovations. Similarly, countries without the capacity or expertise to independently develop treatment and prevention guidelines rely heavily on WHO’s normative guidance to ensure health policies are grounded in the latest evidence. The looming question at the FDA is whether its leadership and decisions will continue to be guided by evidence, as political pressure increasingly shapes the ideologues may potentially helm the world’s premier regulatory agency. as political pressure increasingly shapes the agency’s leadership and priorities.

READ:

High-Profile Departures Shake Up WHO Leadership, ‘Controversial’ Appointee Returns—Health Policy Watch
New CDC director tells staff she is prepared to speak ‘truth to power’—STAT
Senate Health Panel Chairman Voices Strong Reservations About F.D.A. Nominee—New York Times
Trump to Nominate Heidi Overton, a Top Domestic Policy Aide, for F.D.A. Commissioner—New York Times
Dr. Jeremy Farrar to leave WHO—Devex

What We’re Reading

SA and Zambia’s HIV shot dilemma: Demand versus supply—Bhekisisa
The post-PEPFAR playbook is already being written—Lights. Camera. Equity! Substack
Graveyard for Grants’: NIH Is Holding Up Medical Research Funding—Notus
The State of HIV Prevention: Big News, Big Moves: Reflections from AIDS 2026 in Rio de Janeiro, Brazil—AVAC
Trump 2.0 has deleted or altered nearly 400 US datasets, endangering public health, education and more—The Guardian
Exclusive: NSF set to issue lowest number of new grants in four decades—Nature
Senators Criticize Trump Administration’s Demands to Access Health Data as a Condition for Lifesaving Aid—ProPublica
USAID fallout: In Nepal, when the aid workers stopped coming, the women and babies started dying—Associated Press
Fauci: The Oracle Who Went Silent At The Wrong Time – Health Policy Watch—Health Policy Watch
Ex-Fauci adviser pleads guilty to plotting to conceal COVID-19 research records during pandemic—Associated Press
The Wrong Kind of American—The Atlantic
US policies are making a resurgence of vaccine-preventable diseases inevitable—BMJ
WHO Officials Condemn Trump’s Vaccination Changes—Health Policy Watch
More than 210 leading medical, health and patient advocacy groups oppose recent executive order on childhood vaccines—IDSA
The global health aid architecture is collapsing. The faith economy isn’t—STAT
Big Ideas in Brief: State Strategies to Sustain HIV Prevention, Care, and Treatment—O’Neill Institute
Scientists Scramble for Private Cash in Response to Fresh Funding Turbulence—Wall Street Journal

The Latest Resources from AVAC: Advancing Science, Expanding Access

Scientific breakthroughs accelerate HIV prevention—but only when they are matched with bold advocacy, sustained investment and equitable access. This month’s roundup highlights key prevention news, developments and takeaways from AVAC and explores what’s needed and what’s next to ensure the latest innovations move beyond headlines and into the hands of the communities that need them most.

Science Creates the Possibilities, Communities Create the Future

AIDS 2026, the 26th International AIDS Conference, took place 26-31 July 2026. AVAC and partners were there, convening critical conversations, bringing timely analysis and advancing advocacy to turn scientific breakthroughs into public health impact. From the mainstage to the hallways, the importance of moving from innovation to impact rang clear. As AVAC Program Manager Grace Kumwenda shares in her reflections on the conference, “we need to move from products to programs at scale; from clinics to community-centered delivery platforms; from product-focused interventions to choice-based prevention; and from scientific breakthroughs to political courage, financing, solidarity and accountability.”

AVAC’s coverage highlights what it will take to act on evidence with equity and speed. Explore conference highlights, key takeaways and resources from Rio here.

Prevention Access News

High Demand for LEN Faces Real-World Supply Challenges

AVAC’s Mitchell Warren recently spent a week in Zambia with AVAC partner Ascend Futures Foundation, which is playing a leading role in the introduction of injectable lenacapavir (LEN) for PrEP.  Mitchell was joined by Science’s Jon Cohen, who was reporting on the rollout of LEN and the real-world challenges being faced on the ground, including lack of supply. While LEN has met critical milestones with record speed, AVAC, Access Bridge and partners continue to advocate to ensure the science is matched with political will, financing and community leadership to get LEN to the people who need it most. “Science alone doesn’t change the world – people do,” said Mitchell in the article.

Read the Full Piece

Merck Announces Global Access Plans for Monthly Oral Alimatravir (AMI)

On July 24, Merck announced that it granted seven direct licenses to generic manufacturers – including three in Africa – to produce and market their investigational monthly pill for HIV prevention, known as alimatravir (MK-8527, or AMI), in 129 countries while Phase 3 clinical trials are still enrolling. Since 2012, each successive PrEP introduction has gone faster than the previous one, yet the time to market and to public health impact remains too slow. AVAC is committed to changing that, and has worked to influence trial design and implementation, and to ensure strong engagement with community representatives in the research program. These efforts coincide with broader AVAC efforts to engage stakeholders in preparation for results from the trials, and, in the case of efficacy, building the foundation for a swift path to wide-scale uptake and access.

AVAC partner Kenneth Mwehonge of HEPS Uganda told the New York Times: “Our engagement with pharma has always been fights, but it is amazing to sit with them and have them say, ‘We are learning from the other products’. It all sounds good for now, but we will wait to see how it’s put to action.”

Learn how AVAC and partners have shaped alimatravir trials.

Accelerating policy approval and uptake of the dual prevention pill in Zambia through early stakeholder engagement

The Dual Prevention Pill (DPP), a combination of daily oral PrEP and combined oral contraception, offers a novel, female-controlled option for HIV and unintended pregnancy prevention. However, promising technologies like the DPP often face delays in regulatory approval and uptake due to limited stakeholder involvement early in the introduction process. This new article in AIDS Care, authored by AVAC Fellow alum Rhoda Msiska, AVAC Senior Program Managers Kate Segal and Cindra Feuer, and Dr. Newton Donkola of Copper Rose Zambia, illustrates how early, multisectoral stakeholder engagement could accelerate DPP approval and adoption in Zambia.

Read the Article

Threats to Science in the U.S.

NIH Budget Cuts Threaten HIV Research

In this commentary for Think Global Health, AVAC’s Stacey Hannah and Mitchell Warren argue that ending the HIV epidemic will require sustained investment in the basic science that makes future breakthroughs possible. They warn that attacks on science and growing anti-vaccine sentiment threaten progress toward an HIV vaccine and could undermine advances across global health. “At a moment when scientific progress is advancing,” they write, “advocates, researchers, policymakers and communities should push back against politically motivated, fringe, anti-vaccine sentiments that threaten decades of investment to develop the tool that would finally break the back of the epidemic.”

Read the Piece

AVAC Says Stop the Waste, Fraud and Abuse in the Persecution of Tony Fauci 

Former NIAID Director and longtime champion for HIV and AIDS research Dr. Anthony Fauci is facing renewed attacks from Congress, after a Senate committee voted to hold him in contempt following a hearing about the COVID-19 response. The attacks on Dr. Fauci raise alarm bells about the current state of congressional oversight, constitutional protections and attacks on science and scientists. In a letter of support for Dr. Fauci, AVAC urged the committee to recognize the deep history of partnership that Dr. Fauci has forged with the HIV/AIDS community; one that has resulted in numerous biomedical innovations and programs that have ultimately saved millions of lives.

Read AVAC’s Statement

Podcasts

Let’s Talk About PrEP: The Future of HIV Prevention with Mitchell Warren

In this new podcast, Mitchell Warren joined Global Black Gay Men Connect (GBGMC) to talk about the future of HIV prevention and what it takes to turn scientific innovation into impact. As Mitchell puts it, “the future of HIV prevention isn’t just about groundbreaking science; it’s about making sure that science reaches the communities who need it most.”

Listen Now

The Future of PrEP: LEN and the Fight for Access

Mitchell also joined ITPC’s Make Medicines Affordable podcast to discuss the future of PrEP. While LEN is a transformative option for HIV prevention that is being rolled out with unprecedented speed, Warren discusses why scientific progress means nothing without fierce political will, stronger, resilient health systems and true equity for low- and middle-income countries.

Listen Now

The State of HIV Prevention: Big News, Big Moves: Reflections from AIDS 2026 in Rio de Janeiro, Brazil

By Grace Kumwenda, AVAC Regional Program Manager: Research Engagement

AIDS 2026 in Rio was extraordinary.

Big science across HIV prevention, treatment and cure headlined from podiums; in side rooms, we had difficult conversations around greater access to available products; and throughout, ongoing tensions played out over the future of the AIDS response and the role of the US Government. And—if you are like me—there was also a lot of trying to understand some very complicated vaccine and broadly neutralizing antibody (bNAb) science and immediately asking: What does this actually mean for people and the People’s Research Agenda? What does it mean for the field and the future? Simply put, Rio did not disappoint.

Big treatment news

A first-in-class once-weekly oral combination of islatravir plus lenacapavir achieved viral suppression as effectively as daily oral antiretroviral therapy (ART) at week 48 in the ISLEND trial, another exciting indication of where longer-acting and less frequent HIV treatment is headed. We also heard important data on long-acting treatment for adolescents. In the LATA study, injectable cabotegravir (CAB) and rilpivirine administered every eight weeks performed better than daily oral tenofovir disoproxil, lamivudine, dolutegravir (TLD) at 96 weeks, and the overwhelming majority of adolescents said they found injections easier than daily oral pills. That matters because long-acting treatment cannot only be designed for adults who already navigate health systems better than youth; adolescents and others who struggle with daily adherence also need to be part of this innovation story.

Then came the bNAbs

The CAPRISA 012C results readout was a powerful reminder that science does not always move in a straight line. A prevention trial evaluating two bNAbs together—CAP256-V2LS plus VRC07-523LS— administered subcutaneously every six months was reported to be safe but did not reduce overall HIV incidence. Unexpectedly high levels of viral resistance seen in the trial population raised important questions for the field, including whether it is time to pivot away from research on bNAbs for prevention.

It was disappointing that two bNAbs together did do any better than a single bNAb in Antibody-Mediated Prevention (AMP) studies a couple of years. These findings raise important questions about whether and how a combination bNAb approach can work for HIV prevention, as well as the implications for vaccine, treatment and cure research. In treatment and cure research, the bNAb story is more nuanced and, frankly, fascinating. Studies including RIO and FRESH are suggesting that bNAbs may be able to do something ART does not: in a small proportion of participants, immune control may persist even after the antibodies themselves have washed out of the body. There were also promising signals in children. In Botswana, two bNAbs kept 44 percent of children in the Tatelo study undetectable at six months after stopping ART, while early results from the ongoing Tatelo+ study using three bNAbs showed all participants remaining undetectable at week 24. But this is also where we have to manage expectations. The science is exciting, but effects are still seen in relatively small subsets of people, while resistance and incomplete HIV strain coverage remain challenges, strain sensitivity testing is complex and costly, and we still need much more evidence about who benefits and why. That is exactly why continued research matters.

Vaccine science is getting more precise

HIV vaccine science continues to make important—if sometimes complicated—progress. The challenge has not changed: HIV is extraordinarily diverse, it mutates rapidly and it has evolved sophisticated ways of escaping the immune system. But what has changed is the precision with which scientists are now trying to solve that problem. Instead of simply asking whether a vaccine candidate produces an immune response, researchers are increasingly asking: Can we deliberately guide the immune system, step-by-step, toward producing the exact bNAbs needed to recognize many different HIV strains? Several studies presented in Rio focused on doing exactly that.

Researchers are refining sequential vaccination, where one vaccine primes very rare B cells and subsequent vaccinations guide those cells through stages of maturation toward bNAbs. Work presented on coaxing the creation of V3 glycan-targeting antibodies showed that carefully designed vaccine sequences can steer antibody responses away from non-neutralizing pathways and toward potentially protective ones. Other approaches are trying to generate antibodies against several vulnerable sites on the HIV envelope at once. That may ultimately be critical because an effective vaccine is unlikely to rely on one antibody class alone. Scientists are increasingly exploring how to induce bNAbs targeting two or three different vulnerable sites, potentially making it harder for HIV to escape.

Grace advocates for the pursuit of a preventive HIV vaccine at the AVAC HIV Cure and Prevention Research Networking Zone

New vaccine platforms are also opening possibilities. An mRNA approach designed to express HIV envelope trimers produced neutralizing antibody responses in rhesus macaques and protected a proportion of animals from SHIV challenge. None of this means an HIV vaccine is around the corner. But it does mean that vaccine development is becoming increasingly deliberate. Scientists are not simply hoping the immune system will produce the right antibodies. They are learning how to engineer and guide the immune response toward them. And despite highly effective PrEP, the case for a vaccine remains strong. PrEP only works when people can access it, choose it and use it.

A vaccine could eventually reach people who face barriers to ongoing PrEP use, people who do not perceive themselves to be at risk and communities where sustaining repeated prevention visits remains difficult and/or expensive.

So yes—we still need a vaccine.

And the MPT pipeline is getting interesting

The multipurpose prevention technology (MPT) pipeline is another space that caught my attention at the HIV Prevention pre-conference in Rio. A removable injectable depot combining CAB with the contraceptive medroxyprogesterone acetate studied for three- and six-month durations in macaques provided complete suppression of ovulation through six months, with return to fertility shortly after depot removal and a relatively short CAB tail. And in another study, a 3D-printed, 90-day intravaginal ring containing islatravir, ethinyl estradiol and etonogestrel provided protection across 12 weekly HIV exposures in macaques. If we can develop products that respond to several needs at once—and importantly, products people actually want to use—that could be transformative. But again, the key phrase is want to use. A scientifically brilliant product that does not fit into people’s lives will struggle to achieve population-level impact.

Innovation in ARV-based prevention is moving

Grace advocates for the pursuit of a preventive HIV vaccine at the AVAC HIV Cure and Prevention Research Networking Zone

We are all watching closely the efficacy program for the once-monthly oral PrEP candidate now named alimatravir (AMI). What caught my attention was not only the science, but also how Merck/MSD, the developers, are thinking about the product in people’s lives: a small, discreet tablet that could potentially be delivered beyond traditional clinics, including through pharmacies, community settings and other entry points.

Access is already part of the conversation even as alimatravir is still more than a year out from phase 3 study results. MSD announced an initial access plan that includes voluntary licensing arrangements intended to support future generic production. That matters. Access cannot be a conversation we begin after approval; it needs to sit alongside product development from the beginning. And, to be fair, the access conversations around both LEN and AMI were some of the biggest—and at times hardest—conversations in Rio. Questions around pricing, licensing, manufacturing, financing speed to scale, and equity in access were not answered. But they are exactly the conversations we need to be having now, not later. Science is moving quickly, and access planning has to move one step ahead.

Rio also provided encouraging implementation data on existing long-acting prevention options. In the PURPOSE 1 open-label extension, 95% of eligible participants chose twice-yearly lenacapavir (LEN) for PrEP, with no HIV acquisitions during follow-up and 96% injection adherence. PURPOSE 2 also reported very low HIV incidence, while real-world CAB studies continued to show strong effectiveness even as questions around late injections, testing and delivery remain important. The pipeline continues to widen, with early data on 90-day dapivirine-levonorgestrel vaginal rings adding to the range of longer-acting and MPT options under development. All this data adds another dimension to an increasingly diverse prevention pipeline—one that is more responsive to people’s different prevention and reproductive health needs.

PEP also needs its own innovation moment

And if we are talking about innovation in PrEP, then we also have to talk about post-exposure prophylaxis—PEP. PEP is one of our oldest biomedical HIV prevention interventions, yet it can still feel like the mis-placed or forgotten tool in the prevention box. We heard several times in Rio that PEP is a race against time: it needs to be started as quickly as possible after a potential exposure. But accessing it can still mean travelling to a facility, explaining what happened, navigating stigma, finding a provider who understands PEP and then completing a 28-day regimen. That hardly sounds like an intervention designed for success.

Amidst the ongoing normalization of long-acting PrEP, AIDS 2026 addressed the implications of long-acting ARVs for PEP. But how do we generate strong evidence for new and potentially better PEP products when traditional efficacy trials may be extremely difficult—or even unethical—to conduct? Researchers are now exploring innovative approaches, including zero-event trial designs, that could help us build credible evidence without relying on HIV incidence as an endpoint or traditional trial models.

But just as with PrEP, product innovation alone will not be enough. Policy and delivery have to move to address the gaps we have today. During an AVAC side meeting, we discussed the need to simplify national PEP guidelines, address gaps across different types of exposure, support differentiated service delivery, strengthen provider information and rethink how we communicate about PEP. One point from that discussion stayed with me: we celebrate someone choosing PrEP as responsible self-care, yet someone seeking PEP can still be met with judgement—as though needing PEP means they did something wrong.

That has to change.

Seeking PEP is also an act of responsibility and self-care. If we want people to use it quickly, we need to make PEP easier to find, easier to understand and easier to use—and we need the next generation of PEP products and delivery models to reflect the urgency of the moment in which people need them.

And then there is community

Grace provides a community perspective at the session “From Community to Innovation to Scale”

If the Global Village was the heart of AIDS 2026, then community remains the heartbeat of the HIV response and the “why” behind the HIV prevention pipeline. I had the opportunity to share community perspectives during a symposium on moving from community to innovation to scale, and one thing stayed with me: we still too often imagine innovation as a straight line from basic science to clinical trials, regulatory approval, implementation and then community.

Trials such as EXPrESSIVE and PURPOSE have reshaped that line, and we need to keep pushing. Community should be there from the moment we define the unmet need, through research priorities and trial design, to access, affordability, implementation and the final question that matters most: is this intervention actually working in people’s lives? And as prevention science becomes more complex, community engagement cannot simply mean inviting advocates into technical rooms; it also means investing in the knowledge and tools that allow communities to ask difficult questions and influence decisions. That is one reason I remain so passionate about initiatives like AVAC’s Clinical Trial Design Academy.

I left Rio thinking that perhaps the biggest shift is not only in the big news about what products are being developed and evaluated in the HIV prevention pipeline. The questions need to change.

For years, the biggest question in HIV prevention was: Can we develop highly effective tools to prevent HIV? Today, we increasingly know that we can. We have daily oral PrEP, two injectable PrEP products, the dapivirine ring, condoms, circumcision, and, hopefully, in the near future a monthly oral pill, with even longer-acting products anticipated in the near future. The harder questions now are: Can people get them? Can they actually choose between them – when and where and from whom they want them? Can countries afford them? Can health systems deliver them? And are we building the systems today that will be ready for the products coming tomorrow? That is where the big moves become important.

The big move we need NOW is from innovation to impact. That means moving from products to programs at scale; clinics to community-centered delivery platforms; product-focused interventions to choice-based prevention; and scientific breakthroughs to political courage, financing, solidarity and accountability.

The science is moving. “The science delivered beyond our wildest dreams,” said Dr. Raphy Landovitz in a moving plenary session.

Now everything around the science needs to move just as boldly. We need resources, moral compass, political will and government-owned prevention programs to move the science to people.

From Rio to the People’s Research Agenda: What next?

So where does all of this leave us? For me, Rio reinforced that the People’s Research Agenda has to keep pushing the field on whether the science will actually matter in people’s lives.

HIV vaccines: keep investing—but design for the real world now. We still need an HIV vaccine, and we need to stay the course. But as scientists refine sequential immunization and increasingly precise vaccine approaches, the field must also ask early what a future vaccine regimen would look like in people’s lives: how many doses, over what period, for whom, at what cost and how it could realistically be delivered at scale.

MPTs: start with people’s lives, not just what science can combine. We need to develop MPTs around the lives and priorities of the people who will use them. The research question cannot only be: what products can we technically combine? It must also be: what combinations, durations and delivery forms do people actually want—and what gives them meaningful choice and control?

ARV-based prevention: match the speed of innovation with the speed of access. Affordability, licensing, manufacturing, financing, country readiness and delivery must be planned alongside product development, not after approval. At the same time, implementation research must tell us how long-acting products work in the real world, including persistence, late injections, switching and what it truly takes to deliver genuine choice.

PEP: give PEP the innovation and urgency it deserves. PEP needs a new research, product and delivery agenda. We need shorter, simpler and more forgiving regimens; innovative trial designs that can generate credible evidence; and delivery models that get PEP to people within hours, not after they have navigated multiple barriers in the health system. And perhaps just as importantly, we need to reposition PEP as what it is: an act of self-care and responsibility.

Announcing AVAC’s 2026 HIV Cure Academy Alumni Fellows

AVAC is pleased to announce the 2026 Alumni Fellows from the HIV Cure Academy Program. This year, five alumni are putting what they gained through the Academies into action—strengthening community engagement, informing policy and advancing HIV cure research in diverse settings across Africa and the US. These grants build on a growing network of Cure Academy alumni who are translating what they learn into meaningful advocacy and action in their communities.

Each year, AVAC convenes a global HIV Cure Academy in collaboration with the International AIDS Society (IAS) and a US Academy organized through the Martin Delaney Collaboratories (MDCs) community engagement program under REACH, PAVE and I4C, equipping advocates with the skills and connections to champion HIV cure research, strengthen supportive research environments and promote ethical community engagement in clinical research. Following the Academy, participants can apply for an alumni grant to design and implement a year-long project that advances HIV cure research in their communities.

The HIV Cure Academy Alumni Fellowship is one component of AVAC’s broader HIV cure advocacy portfolio, which strengthens civil society engagement, advances meaningful community participation and ensures the development of HIV cure strategies is guided by affected communities. AVAC supports stakeholders with the information, connections and tools needed to engage in critical conversations about the future of HIV cure research.

Read on to learn more about the 2026 Cure Fellows and their projects and check back throughout the year for updates on their work to advance HIV cure research.

Global HIV Cure Academy Alumni Fellows in Partnership with the Africa HIV Cure Consortium (AHCC)

Charles Brown: High-Level Stakeholders Dialogue on Advancing and Sustaining HIV Cure Research and Advocacy in Uganda

Charles Brown is the Founder and Executive Director of Preventive Care International, a civil society organization based in Uganda. He is a 2014 AVAC Fellow alum, coordinator for the Africa HIV Cure Advocacy Coalition, member of the Uganda PrEP technical working group, the Uganda communicable and non-communicable diseases technical working group, the Uganda civil society advocates network and a steering committee member of the Uganda HIV Prevention Coalition. The High-Level Stakeholders Dialogue on Advancing and Sustaining HIV Cure Research and Advocacy in Uganda aims to strengthen and advance stakeholder involvement in HIV cure research through the creation of a platform for HIV cure researchers, policymakers, funders and advocates to dialogue on advancing and sustaining HIV cure research and the formation of an African Hub for HIV cure advocacy.

Laurel Kevine Tchmada Tayo: TheImpactVoices

Laurel Kevine Tchamda Tayo is an early-career researcher at the Centre for Research on Emerging and Re-emerging Diseases (CREMER) in Cameroon. She holds a Master’s degree in Public Health Biotechnology and is a field investigator for HIV research, with a specific focus on HIV cure-related studies. TheImpactVoices initiative aims to bridge the gap between HIV research and the community to improve awareness and community engagement around HIV prevention, care and cure research through accessible and contextualized research dissemination, youth-centered communication and digital storytelling. TheImpactVoices hopes to empower young people and people living with HIV to actively contribute to advocacy, education and sustainable health solutions in Cameroon.

Mandisa Tyadi Dukashe: SA HIV Cure Knowledge Hub Project

Mandisa Tyadi Dukashe is a public health expert, HIV specialist and PhD candidate with over 25 years of experience delivering health systems strengthening, multi-disease management and patient-centered care in South Africa (SA). She has been living with HIV openly for over 23 years. Mandisa is a founding member of the HIV Survivors and Partners Network, a co-founder of the U=U Africa Forum, a pioneer for the South African HIV Cure Knowledge and Innovation Hub, a 2020 AVAC Fellow alumni and served as a PAVE Collaboratory and CureRoar Community Advisory Board member. The SA HIV Cure Knowledge and Innovation Hub aims to strengthen collaboration among researchers, policymakers, advocacy partners and communities to advance equitable and community-centered HIV cure research and implementation. Ultimately, the Hub aims to translate collaboration and innovation into sustainable health outcomes and improved quality of life for people affected by HIV.

US HIV Cure Academy Alumni Fellows

Amelia Poulin: SPEAK: HIV Cure

Amelia Poulin, MPH, PMP, CPH is the Assistant Director for Emerging Infectious Disease at the Association of State and Territorial Health Officials, where she supports state and territorial health departments prepare for, and respond to, infectious diseases. Amelia is a Doctor of Public Health student at the University of Illinois – Chicago and was named a 2025 de Beaumont 40 Under 40 in Public Health honoree for her dedication, creativity and innovation in working towards healthier communities. SPEAK: HIV Cures is a novel dialogue academy that aims to strengthen system readiness to implement HIV cure research by bringing together alumni from the 2026 US HIV Cure Academy, leading HIV cure researchers and university students for a structured training series on dialogue and rhetoric, HIV cure science, lived experience and health policy. The project will explore how community-centered dialogue and reasoned persuasion can strengthen public health system readiness for policy implementation around HIV cure research.

Kennedy Walker: The CLEAR (Communication, Literacy, Education and Research) Toolkit

Kennedy Walker is a Psychology and Human Development & Family Studies student at the University of North Carolina at Greensboro, where he is an Honors College and Guarantee Scholar. Kennedy has worked across community engagement, advocacy and research through organizations including the Florida State University Adult Trials Network, Charlotte Pride and the Office of Intercultural Engagement at UNCG. The CLEAR Toolkit is a community-informed communication and health literacy initiative designed to strengthen conversations between people living with HIV, healthcare providers, researchers and community advocates. Through stakeholder listening sessions and collaborative development, the project will create practical resources to improve communication, shared decision-making and understanding of HIV treatment and cure research. The CLEAR Toolkit aims to build trust, increase health literacy and create a scalable resource that can be adapted across HIV care, research and community settings.

Global Health Watch: Exec Order Changes Childhood Vaccine Recs, $2B in Faith-based Aid, NIH Restricts Policy Rx

Issue 81

This week, the US Administration announced $2 billion in global health funding for faith-based organizations; US Congress intensified oversight of PEPFAR and the bilateral global health agreements; the NIH moves to restrict policy-focused research; and – perhaps most alarmingly – the US President issued an executive order rewriting longstanding, evidence-based childhood vaccine recommendations.

US President Issues Executive Order Changing US Childhood Vaccine Recommendations

The US President issued an executive order to overhaul the US childhood vaccination recommendations. The order bypasses the longstanding scientific review process traditionally led by expert advisory bodies including the CDC’s Advisory Council on Immunization Practices (ACIP), which has historically informed this process, before being politicized by the current Administration. The order reduces the number of vaccines recommended for all children; calls for the combined measles, mumps and rubella (MMR) vaccine to be administered as three separate shots; shifts several vaccines—including hepatitis A and B and COVID-19—to “shared clinical decision-making”; and expands exemptions for school immunization requirements. Public health leaders and clinicians immediately condemned the order, warning that it contradicts decades of scientific evidence, creates confusion and raises new barriers for vaccine access.

IMPLICATIONS: The latest executive order is another divergence from evidence-based public health policymaking and toward politically driven decision-making. Public health experts warn that replacing established scientific review with executive action could erode confidence in childhood immunization, increase vaccine hesitancy and reduce vaccination coverage, leading to more outbreaks of vaccine-preventable diseases. A New York Times article profiles Japan as a “cautionary tale” after the government modified its vaccine schedule for MMR in 1993, making the measles and rubella single shots and the mumps component entirely voluntary. Consequently, coverage of mumps vaccination plummeted, and cases then soared – resulting in deaths among unvaccinated children in Japan. The changes by the federal government also signal how vaccine policy is being developed in the US, raising concerns that scientific expertise is being sidelined in favor of political priorities, and driven by misinformation and skepticism in vaccines.

READ:

‘This is so Wrong’: Experts Condemn Trump’s Vaccination Order—Health Policy Watch
Should the M.M.R. Vaccine Be Split Into Three Separate Shots?—New York Times
Trump administration order would upend nation’s childhood vaccine schedule—Washington Post
Trump’s vaccine plan would require millions of individual shots last used decades ago—Associated Press

US Administration Awards $2 Billion to Faith-Based Organizations

The US Department of State awarded $2 billion in global health and humanitarian assistance to faith-based organizations (FBOs), the largest allocation of foreign aid to these groups in more than 20 years. Under its “America First” Global Health Strategy, the funding, a majority spread over five years, will support faith-based hospitals and clinics in 17 countries and emergency humanitarian response, with major awards going to a consortium of Christian FBOs including World Vision, Samaritan’s Purse and Compassion International. Of the $2 billion awarded, approximately $1.4 billion will be for healthcare programming primarily in Africa.

IMPLICATIONS: News of global health funding is welcome after such sweeping cuts and months of delay, but it marks a major shift in how the US is delivering its foreign aid. The Administration claims the awards reflect a more efficient, results-driven approach and were not based on religious affiliation. However, former USAID officials and global health experts question whether the decisions were guided by evidence. FBOs historically are critical partners in delivering critical care and global health programming in countries that receive US foreign assistance. However, prioritizing a smaller group of FBOs over a broader range of implementing partners, where funding has been frozen or contracts terminated, could reshape HIV prevention and global health programs, and these large FBOs have many of the same administrative and overhead costs as other international NGOs, which were heavily criticized by the Administration in closing down USAID. Concentrating resources in fewer organizations also raises questions about whether diverse, community-led approaches to HIV prevention and health equity will continue to receive the support needed to reach the populations most affected. Moreover, representatives from recipient FBOs contend that the new money does not easily supplant or replace funding lost from the cuts and dismantling of USAID, when many FBOs were adversely affected and forced to reduce programming or shutdown services.

READ:

Trump admin literally puts its faith into a $2B pledge—Devex
The new “America First Global Health Strategy” could erode years of progress under PEPFAR—Brookings
US State Dept Causes Closure of CDC Zimbabwe—To End A Plague… Again
Trump administration to give faith-based groups $2B in funding for global health work—NPR
US announces nearly $2B in ‘historic’ faith-based partnerships—Devex

US Congress Continues to Take Oversight Actions on Global Health Programs

Democratic members of the US Congress continued oversight of the US Administration’s global health policies this week with new inquiries into PEPFAR and the Administration’s “America First” Global Health Strategy. California Representative Robert Garcia, the ranking Democratic member of House Oversight and Government Reform Committee, requested in a letter answers from the US Secretary of State following disruptions to PEPFAR and emerging data showing how they have contributed to the deaths of hundreds of thousands of people and the closure of at least 1,700 HIV service sites. Separately, Democratic Senator Raphael Warnock of Georgia led colleagues in a separate inquiry, questioning the Department of State’s reported requirement that African countries grant US officials direct access to sensitive national health data systems as a condition of receiving global health assistance through the bilateral memorandum of understanding (MOUs) agreements that are currently being negotiated with recipient countries. As part of the inquiry, Senate signatories requested a formal briefing from the State Department to answer these questions and provide updates on the data conditionalities present in these agreements.

IMPLICATIONS: The escalation of these congressional inquiries reflects mounting concern in both chambers of Congress over the Administration’s continued restriction and termination of congressionally appropriated global health funding, the lack of transparency surrounding its bilateral Memoranda of Understanding (MOUs), and the need for greater accountability in how the Administration is unilaterally reshaping US global health policy and using foreign assistance as leverage. These latest requests for information also suggest that sustained advocacy by the global health community is beginning to influence policymakers, as new evidence continues to document lives lost and the erosion of global health infrastructure resulting from this accelerated restructuring. While congressional oversight alone will not reverse these policy changes, it demonstrates that coordinated advocacy is elevating global health issues and helping shape the debate around future policy.

READ:

Ranking Member Robert Garcia Demands Answers on PEPFAR as Trump Administration Guts Lifesaving HIV/AIDS Programs—House Committee on Oversight and Government Reform
Warnock Leads Inquiry into State Department Efforts to Seek Personal Health Data in Exchange for Aid to Developing Nations—Senator Raphael Warnock

US Senate Blocks White House OMB Rule as NIH Faces New Policy Research Restrictions

Following the US Senate’s official vote to temporarily block the White House Office of Management and Budget’s (OMB) proposal to give political appointees greater authority over federal grant decisions (until December 11), Nature reported this week that the National Institutes of Health (NIH) has begun turning away grant applications for research where the primary purpose is to shape and inform policymaking. This, coupled with the Administration’s attempt to weaken the role of scientific review through the blocked OMB regulation, demonstrates increasing intention to politicize federal research priorities in line with political ideology and not evidence. Internal NIH documents reportedly state that policymakers are no longer considered “mission-relevant stakeholders”, placing dozens of health policy research grants in question.

IMPLICATIONS: Efforts to reshape the US research enterprise are extending beyond a single OMB proposal to influence what research is funded, who can use it and how scientific evidence informs public policy. While advocacy from the scientific community is gaining traction, the temporary block does not resolve overall concerns about political influence over research funding. And restricting support for policy-focused research would weaken the evidence base that informs decisions on HIV, infectious diseases, pandemic preparedness, and public health, making it more difficult for policymakers to respond to emerging health challenges with rigorous scientific evidence guiding decision-making that is aimed towards saving lives.

READ:

White House Attempt to Control Science Grants is Blocked – For Now—Health Policy Watch
The White House’s new, quiet plan to attack public health—USA Today
NIH’s New Ban on Research to Inform Policy Undercuts its Mission—27UNIHTED Substack
NIH limits funding for research on the health effects of public policy—Nature

What We’re Reading

Aids is no longer exceptional. What happens now?—Bhekisisa
Highlights of AIDS 2026—The Lancet HIV
Anxiety in Paradise: Highlights From the 26th International AIDS Conference in Rio de Janeiro—The Body
“Something Has to Change” — Conference Takes From Implementation Specialist Dr. LaRon E. Nelson—TheBodyPro
DoxyPEP linked to reduction in syphilis and chlamydia among gay men in Australia—Aidsmap
Solidarity makes science accessible for all – this is the roadmap for ending the AIDS epidemic—The Independent
Evaluating the impact of two decades of USAID interventions and projecting the effects of defunding on mortality up to 2030: a retrospective impact evaluation and forecasting analysis—The Lancet
We prepared for Ebola — but not this Ebola—STAT
There Is No Public Health Outside of Politics—American Journal of Public Health
Merck’s alimatravir licensing deal receives mixed response—The Lancet
Peru Participates in Clinical Trials Yet is Excluded from the Benefits Achieved—Acción Internacional para la Salud
New HIV Guidance Aims To Protect More Women—Rewire
HIV care suffers under Senegal anti-gay law—The Lancet
Pakistan’s HIV Surge Exposes Infection Control Failures at Health Facilities—Health Policy Watch
Nigeria’s Lenacapavir Rollout Needs a Safe Pharmacy Delivery Pathway—Nigeria Health Watch

Global Health Watch: Fauci in Contempt + New NIAID Director, Senate Blocks OMB’s Grant Proposal, New CDC Director, AIDS 2026 Highlights

Issue 80

This week, the US Senate Committee on Homeland Security & Governmental Affairs voted along party lines to hold Anthony Fauci in contempt of Congress for his refusal to answer questions during last week’s hearing on the COVID-19 response testimony – while it was rumored that Steven Quay, a lab-leak proponent, is in line for Fauci’s old job. At the same time, the US Senate Appropriations Committee did step up to stop the White House OMB’s politicization of federal research grants. There’s also – finally – a new leader of the US Centers for Disease Control and Prevention (CDC). And the HIV/AIDS community is unpacking major themes emerging from the AIDS 2026 conference.

Anthony Fauci and the Future of NIAID

The US Senate Committee on Homeland Security & Governmental Affairs voted Thursday to hold former NIAID Director Anthony Fauci in contempt of Congress, raising a years-long political campaign against him just a week after he was grilled by Republican Senators for hours over the COVID-19 pandemic and its origins. Much of the scientific and public health community rallied around him after his appearance: “Dr. Fauci is a public health pioneer, who has saved more lives than anyone sitting in the Senate today. He has dedicated his life to public service. Because of Tony Fauci, science has moved faster, lives have been saved and communities are more engaged in every phase of infectious disease research,” wrote AVAC’s Executive Director in a statement. “[Fauci’s] career was built on evidence, intellectual rigor and an unwavering commitment to improving people’s lives,” wrote American Society for Microbiology CEO Stefano Bertuzzi in a letter to the committee, calling Fauci’s scientific record “the gold standard.”

Following the hearing, Health and Human Services Secretary (HHS), Robert F. Kennedy Jr. (RFK Jr.) appeared in media interviews targeting Fauci and pushing misinformation on vaccines and medical information, all while preparing to appoint Steven Quay, a pharmaceutical executive and prominent advocate of the COVID lab-leak theory (and longtime Fauci critic) to lead NIAID, the agency Fauci and then Jeanne Marrazzo directed for nearly four decades and which oversees $6.5 billion in annual research funding. Quay was not even among the finalists interviewed for the role, but Kennedy selected him nonetheless, according to Politico. Quay—a physician and pathologist—could become the first NIAID director drawn from the pharmaceutical industry rather than academia or the NIH, despite lacking formal training in infectious diseases.

IMPLICATIONS: Quay’s expected appointment would mark a major shift in the leadership and direction of NIAID, which is arguably the world’s most influential biomedical research agency. This, along with the Senate Committee’s decision to hold Fauci in contempt of Congress signals that alignment with the Administration’s ideology is more important than scientific expertise in setting US research priorities and public health policy. Together, the message is clear: if you dare to challenge political ideology, it has consequences. This will likely have a chilling effect on researchers and scientists reluctant serve in government and speak out during health crises.

READ:

Senate panel votes to hold Anthony Fauci in contempt of Congress—Washington Post
‘I Am What I Am’: Fauci’s private notes reveal a scientist navigating science, politics, and fame—Science
Fauci woes could deter scientists from public service—Axios
RFK Jr. targets Fauci and pushes medical misinformation in fiery CNN interview—CNN
The pandemic debate the US isn’t having—CIDRAP
Spotlight on Fauci Said to Boost Book Sales for Kennedy and His Publisher—New York Times
Why we’re still fighting over COVID-19—Philadelphia Inquirer
Fauci praised as ‘hero’ by public health experts after Senate hearing—USA Today
AVAC Says Stop the Waste, Fraud and Abuse in the Persecution of Tony Fauci—AVAC
A lab-leak proponent is in line for Fauci’s old job—Politico
Who Is Steven Quay, the Biotech Exec Likely to Take Fauci’s Old Job?—MedPage Today
Trump suggests Fauci should be prosecuted—Reuters

US Senate Blocks White House OMB’s Grant Proposal Temporarily

This week US Senators on both sides of the political aisle moved to temporarily block the White House Office of Management and Budget’s (OMB) proposal to give political appointees greater authority over grant decisions and weaken the role of scientific peer review. In a stopgap spending bill released by Senate appropriators, Democrats and Republicans joined in adding a provision that would prevent the OMB rule from taking effect until at least December 11, while Congress negotiates broader government funding measures. The proposal was originally slated to go into effect on October 1, but opposition from appropriators, including Senate Appropriations Chair Susan Collins, slowed the path forward.

IMPLICATIONS: This development suggests that months of public opposition and advocacy from the advocacy and scientific community may be beginning to influence policymakers. The Senate’s intervention is one of the first signs that resistance to the OMB proposal extends beyond the scientific community and into both parties in Congress. However, the delay is only temporary, and, if implemented, the rule could fundamentally reshape the US research enterprise by injecting political considerations into grantmaking, weakening peer review and undermining the international collaborations that drive progress against HIV, emerging infectious diseases and other global health challenges.

READ:

US Senate Confirms New Centers for Disease Control and Prevention Leader

The US Senate confirmed Erica Schwartz as the next director of the Centers for Disease Control and Prevention (CDC), after a year without a confirmed leader. Schwartz is a former deputy surgeon general and chief medical officer of the US Coast Guard. During her controversial confirmation hearing, she agreed to uphold scientific integrity and transparency, but did not challenge or speak to RFK Jr.’s position on vaccines and other controversial health policies.

IMPLICATIONS: Schwartz will take over the agency, which has seen a major reduction of its workforce, political battles over vaccine policy and mounting public health threats. While her appointment to the leadership post may bring some stability, many public health leaders question whether she is able to lead an independent CDC outside of the Administration’s political pressure as RFK Jr. continues to attempt to reshape federal health policy. Will Schwartz defend scientific evidence, particularly on vaccines, infectious diseases and outbreak preparedness? That is the question the many advocates and leaders are waiting to answer.

READ:

Senate confirms Schwartz for CDC director—Axios
Senate Confirms Erica Schwartz as CDC Director—Associated Press

International AIDS Conference Wraps Up: Rising Above to Meet the Moment

The International AIDS Conference (AIDS 2026) concluded last Friday. It was marked by extraordinary scientific progress and growing political and financial uncertainty. New data showed the consequences of the US Administration’s retreat from global health leadership, with nearly 2,000 HIV service sites closed and prevention programs for key populations severely disrupted following cuts to PEPFAR and other foreign-aid programs. While delegates applauded Merck’s decision to license its investigational monthly oral PrEP pill, alimatravir, to generic manufacturers before Phase 3 trials are complete, leaders warned that supply shortages threaten the rollout of injectable lenacapavir for PrEP (LEN) and called attention to the exclusion of Latin America in access agreements despite its central role in clinical research. Other major advances in prevention, treatment and cure, including innovative community-based and pharmacy delivery models for long-acting prevention and news of two more patients with HIV and cancer were cured following stem cell transplants for cancer treatment were presented showing the promise of new technologies, but the conversation focused on whether they can be developed and deployed feasibly and at scale.

IMPLICATIONS: AIDS 2026 underscored a stark reality: the greatest barriers to ending HIV are increasingly political rather than scientific. Across sessions on prevention, vaccines, cure research, artificial intelligence and service delivery, one theme emerged repeatedly: innovation alone is not enough. As AVAC’s Mitchell Warren shared in a commentary, translating scientific breakthroughs into public-health impact will require sustained political commitment, financing, supply chains and delivery systems that can move with speed, scale and equity. As governments cut funding and retreat from longstanding partnerships, the conference made clear that communities are not merely beneficiaries of the HIV response, they are its leaders, and the future of the epidemic will depend on their ability to shape the research, policies and programs that come next.

READ:

The Human Pain Behind Global HIV Funding Cuts—POZ
AIDS 2026: Rising Above to Meet the Moment—AVAC
Beyond AIDS 2026: AVAC’s Top 10—AVAC
Aspen clinches deal to produce new once-a-month HIV tablet—Medical Brief (SA)
What a merger says about the future of the AIDS response—Devex
The US government’s mislabelled map of Africa at a global Aids conference shows again a failure to understand the continent—The Guardian
New US HIV agreements leave civil society and key populations on the sidelines—Aidsmap
Three HIV announcements South Africa made in Rio—Bhekisisa
Two more people cured of HIV after stem cell transplants, offering more clues to long-term remission—Aidsmap
Video of the PrEP and PEP vending machine in Sao Paulo—IST/AIDS

What We’re Reading

State Department restores some global health funding—New York Times
Zimbabweans Fleeing Xenophobia in South Africa Battle to Get HIV Medicine Back Home—Health Policy Watch
Trump Pathogen Agreements and Global Equity Proposals—Public Citizen
FDA approves Moderna’s mRNA flu vaccine, the first to use the technology—STAT
The Emails Show Why We Sued Robert F. Kennedy Jr.—MedPage Today
Why the need for the WHO has never been greater—Nature
Deep dive: The future of US foreign aid—Devex
What ‘America First’ Means for Global Health—The Atlantic
“No One Knows When It Will End”: A Doctor on the Ebola Emergency—The New Yorker
Blanche assures anti-abortion supporters that Dobbs will be ‘permanent in every single state’—Politico
Legislative Responses to Trump’s Expanded Global Gag Rules as House Approves FY 2027 Foreign Aid Bill—PAI
One year since Kennedy canceled mRNA vaccine projects, science shows how wrong he was—STAT
Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed—Health Policy Watch

AVAC Says Stop the Waste, Fraud and Abuse in the Persecution of Tony Fauci

AVAC vehemently opposes the decision by the U.S. Senate Homeland Security and Governmental Affairs Committee to hold Dr. Anthony Fauci in contempt for his refusal to answer questions during last week’s hearing on the COVID-19 response. Certain members of the committee have made clear their intentions to pin the shortcomings of the U.S. response to COVID-19 on others by blaming and dragging renowned government scientists and public health practitioners such as Dr. Fauci through politicized proceedings without any evidence and using conspiratorial conjecture.

“Dr. Fauci is a public health pioneer, who has saved more lives than anyone sitting in the Senate today. He has dedicated his life to public service. Because of Tony Fauci, science has moved faster, lives have been saved and communities are more engaged in every phase of infectious disease research,” said Mitchell Warren, AVAC’s Executive Director. “He is a leader, partner, ally, advocate, and friend to those who care about advancing science and ending infectious diseases in the US and around the world. The Senate must end this clear waste, fraud, and abuse of government oversight powers and taxpayer money being used to advance baseless conspiracies and politically target career public servants.”

In a letter submitted to the committee in support of Dr. Fauci, AVAC urged the committee to recognize the deep history of partnership that Dr. Fauci has forged with the HIV/AIDS community; one that has resulted in numerous biomedical innovations, domestic and international programs that have ultimately saved millions of lives – guided by the steady hand of Dr. Fauci, through numerous Presidential administrations and Congresses, regardless of political make up.

“Dr. Fauci dedicated his career to investigating and finding solutions to novel viruses and got involved with HIV at a time when AIDS was taking the lives of some of the most vulnerable, marginalized communities across our nation,” added Warren. “Throughout his career, Dr. Fauci has blazed a trail of trust-building and honest dialogue – especially with those who disagree with him.”

The latest attempt by the Senate committee to weaponize governmental oversight powers further obfuscates the shortcomings of the nation’s pandemic preparedness, especially in light of the current administration’s dismantling and defunding of the very public health and research infrastructure Dr. Fauci helped construct in his years of service with bipartisan support. Distrust in public health and issues of vaccine scepticism continue to rise as the government attempts to relitigate Dr. Fauci’s role in the COVID-19 response, instead of tackling urgent needs of healthcare access and global health security. The decision to hold Dr. Fauci in contempt places him in the hands of a Department of Justice that has been charged with pursuing perceived enemies and critics of this administration – threatening public servants like Dr. Fauci further exacerbates the brain drain of apolitical scientific experts choosing to leave or completely forgo public service careers in fear of simply following the evidence, just as Dr. Fauci has in his nearly 40-year career.

AVAC calls on Congress to halt this harassment of Dr. Fauci, whose career, track-record, and devotion to public health research and development has changed the very course of the public health at home and abroad.

“These specious attempts to relitigate Dr. Fauci’s role in the national response to COVID-19 are nothing more than the latest example of waste, fraud, and abuse of power in Washington, which is harming Americans by continuing to obscure flaws and gaps in our country’s medical countermeasure and pandemic response capabilities,” added Warren. “If the Senate cares about making this country safer they will end the targeting of scientists and public servants, reverse the cuts to publicly funded science, stand up against unlawful disruption of long-standing international research partnerships and the wanton destruction of the US Agency for International Development (USAID) and erosion of PEPFAR programs. AVAC calls on the Senate to stop the distractions and get back to the work of protecting public health.”

Beyond AIDS 2026: AVAC’s Top 10

Our team compiled a list of AVAC’s top 10 takeaways from AIDS 2026. These topics sparked discussions and ideas among our team and AVAC’s larger partner network, and will carry our work well into the future.

1. The implications of US government cuts

The implications of the US administration’s efforts to dismantle its longstanding role as the global leader in the HIV response are coming into focus – and it’s not a pretty picture.

Credit: amFAR

First, amfAR released a report providing the first concrete detail on the impact of PEPFAR cuts: surveying 166 organizations in 46 countries, they found that nearly 2,000 service sites had been forced to shutter.

Almost no organizations were able to fill the funding gap with other donors. Services for key populations (KPs) were “decimated”: among implementing partners, 73% stopped at least one KP service and 67% stopped outreach services.

Prevention overall took a huge hit: almost half of respondents stopped activities like condom or PrEP distribution. Two-thirds reported interruption of PMTCT and nearly one in four stopped providing prevention of mother-to-child transmission services entirely. As AVAC’s Navita Jain told POZ, when foreign aid funding was frozen, “We were in year eight of a 10-year project, really getting momentum going and accelerating prevention research, and the cuts had a massive effect, with no guidance provided or a plan for a way forward.” 

As widely reported, first by former AVACer Emily Bass, and then by most major media outlets, a US State Department official displayed a mislabeled map of African countries, with African government officials in the room. As Jirair Ratevosian said, the map “should never have made it onto the screen, especially during a presentation about partnerships with African governments,” but more importantly, it’s a disappointment “that this mistake became one of the conference’s biggest media stories. Because AIDS 2026 produced important science, serious policy analysis and real progress on issues ranging from PrEP delivery to global aid transitions.”

2. Prevention innovation includes speed, scale and equity…

One of the most exciting developments arrived days before the conference, when Merck/MSD announced seven direct licenses to generic manufacturers to produce their investigational monthly pill for HIV prevention, known as alimatravir, while Phase 3 clinical trials are still enrolling.

The announcement reflects responsiveness to advocates’ longstanding calls to accelerate access to PrEP options, and deep engagement with advocates throughout the clinical trial program. Since 2012, each successive PrEP introduction has gone faster than the previous one, yet the time to market and to public health impact remains too slow.

Granting licensing agreements to generic manufacturers while clinical trials are still enrolling, before it is known if the product is effective, should significantly reduce the time to market for the product. The current timeline gives the field ample opportunity to work with ministries of health, donors, communities, and Merck to plan for broad access to the monthly PrEP pill, which lends itself to innovative delivery models – from pharmacies to community-based distribution approaches.

3. …but too often, Latin America is still left behind

It is cruel irony that Brazil was host country to the conference, a key site for clinical trials of cabotegravir, lenacapavir and alimatravir, but has been left out of voluntary licenses for all three products.

While Merck/MSD shared information about a memorandum of understanding with Fiocruz to manufacture alimatravir for the region, the timing and next steps remain unclear: “Now is the time to plan for even speedier and wider access if alimatravir works,” said Access Bridge Executive Director Wawira Nyagah. “This must include pricing transparency from Merck and their generic licensees, accelerated investments by donors to design and implement integrated programs that offer the monthly pill as part of choice of product and service delivery models that actually reach people who need it, everywhere. This should be based on public health imperatives; not on World Bank country classifications or geographical location. Anywhere the HIV epidemic is increasing must be included, full stop.”

4. Innovative delivery and community involvement are expanding access…

AIDS 2026 showcased exciting models for HIV prevention service delivery that are removing barriers to access, reducing stigma and burden on healthcare systems. In São Paulo, vending machines delivering HIV tests, PrEP and PEP are available in subways, normalizing widespread access to HIV prevention.

Sri Lanka and the Ukraine have introduced mobile PrEP delivery programs, and in Kenya and South Africa, pharmacy delivery is reducing the load on health clinics following the drastic cuts to PEPFAR service delivery programs. The recently launched SCALE-IT project in Zambia is implementing a model for community-based delivery of PrEP options, including injectable PrEP, with more information expected soon. As we look ahead to alimatravir, the potential for a monthly PrEP pill opens the door to innovative delivery models. While alimatravir trials are still enrolling, AVAC has called on the stakeholders to ensure models are well-conceived and planned, adequately funded, and set up for success. With this timeline in hand, there’s no excuse for getting it wrong.

5. …but supply issues pose a serious threat to LEN rollout.

From countries across the globe, the same message echoed across AIDS 2026: there is demand for LEN now and the current supply is not enough. While recent commitments from PEPFAR and the Global Fund are encouraging, demand is rapidly outpacing supply across the globe – and there is an urgent need from donors to address bottlenecks and place more orders.

Access Bridge’s Nyagah reinforced this point: “People are being offered products that fit their lives, but the systems are not growing fast enough to supply it.” If supply issues are not urgently addressed, the field risks losing the demand, community trust, and current progress in LEN uptake that we have collectively worked so hard to achieve. For more on this topic, Jon Cohen’s recent piece in Science provides a deep dive into the challenges facing LEN rollout in South Africa and Zambia amidst the current political and funding landscape.

6. The urgency of vaccines: advancing the science, deepening our understanding

At a plenary session, Sandhya Vasan described why a vaccine is still needed, even with expanded PrEP options like lenacapavir, echoing AVAC’s recent commentary on the scientific challenges and emerging insights in the vaccine field and what’s in the research pipeline. Vasan highlighted long-standing partnerships with communities as foundational to vaccine research and vaccine confidence, as well as the need for continued investment and support for upstream vaccine research.

Community engagement was on full display at the HIV Cure & Prevention Research Networking Zone, where one of the best-attended sessions was the People’s Research Agenda Think Tank on HIV vaccines. AVAC’s resources on preventive vaccines and bNabs explain the science behind vaccine research.

In addition, the CAPRISA team announced results from the CAPRISA 012c Phase 2 trial examining a potential combination of two broadly neutralizing antibodies (bNAbs) as prevention. The trial found that a six-monthly combination of the CAP256 and VRC07 bNAbs was safe but did not provide protection against HIV acquisition in young women in South Africa and Zambia. As AVAC Executive Director Mitchell Warren noted, “We had hoped that combining two bNAbs in this study would provide greater protection than a single antibody, but sadly it did not.” Antibody research has always been about more than product development – research shared at the conference continues to deepen the understanding of HIV and the immune system and will continue to inform the next generation of vaccine and cure strategies.

7. Cure took another step forward

Two case presentations at the conference shared two more patients with HIV and cancer were cured following stem cell transplants for cancer treatment.

As AVAC’s senior program manager for HIV cure, Jessica Salzwedel says, “Thirteen people have now been cured via stem cell transplant. Every cure is an exciting step forward, but we must stay focused on the inequity of all 13 of these occurring in high-income countries – and ensure that our work expands access to cure information, research opportunities, and solutions.”

Cure strategies must go well beyond the science: efforts must include confronting the stigma of HIV and expanding research advocacy and engagement, especially in Africa. At pre-conference and conference sessions, along with a session at the HIV Cure & Prevention Research Networking Zone, attendees explored promising elements of the “kick and kill” strategy, gene editing technologies, the role of broadly neutralizing antibodies in “control” strategies, and how community members can get more involved.

8. Harnessing the power of AI for HIV while centering communities in the response

Many sessions explored the promise of AI to strengthen design and delivery of HIV programs, while highlighting potential pitfalls if we neglect to prioritize transparent regulatory frameworks and partnership with communities in the design, use, and oversight of AI systems.

ITPC Executive Director and AVAC Board member Solange Baptiste noted the urgency of approaches to AI that are human-centered: “We need a community governance layer built into the AI ecosystem…one that ensures communities help shape priorities, oversee the implementation, identify harms and hold systems accountable throughout the AI lifecycle.” The final plenary of the conference for the first time included a presentation on AI by Global Fund’s Izukanji Sikazwe, highlighting the dangers when the right innovations fail to scale and balancing the concept of AI as a partner with the risks AI can bring. For more insights from AVAC on the evolving discussions around AI, check out our quarterly AI and HIV Newsletter and Advocates Guide to AI and HIV Programs.

9. Partnerships power the HIV response by advancing community-centered priorities

As the field faces devastating funding cuts, strong partnerships between national, regional and global advocates are more important than ever. AVAC’s partnerships underpinned so much of the critical work discussed at AIDS 2026: to ensure key populations are not left behind, to advance community-led monitoring and community-based delivery, and translate choice into impact.

In each case, success was made possible by bringing together diverse stakeholders with the singular goal of developing innovative, community-centered approaches to the HIV response. As AVAC’s Warren reflected following the conference, “Communities are the leaders of AIDS programming. All over the conference they led plenaries, symposia, abstracts. These are not recipients, they are leaders who are driving the conversations.”

10. Communities are the heart of the AIDS response, and the Global Village is the heart of the AIDS conference.

In conversations, meet-ups, and protests coordinated across the Global Village, the power of advocates and coalition-based advocacy was a key theme of the conference. AVAC’s HIV Cure and Prevention Research Networking Zone brought delegates, researchers, advocates, and community members together for interactive discussions, expert-led sessions and networking conversations.

The Zone featured the “HIV Funding Saves Lives” quilt created by COMPASS and the Global Advocacy Data Hub to convey the impact of funding cuts on communities. Attendees signed the quilt, adding their voices to the demands for HIV funding to be restored. As advocates look ahead, connections built at the Networking Zone will strengthen for future coalition-based advocacy.

AIDS 2026: Rising Above to Meet the Moment

The World Must Act with Speed, Scale and Equity

By Mitchell Warren, Executive Director, AVAC

One of the most memorable moments for me at AIDS 2026 wasn’t a scientific presentation. It wasn’t a late-breaking abstract, or a standing-room-only session. It was a conversation with a ministry of health official from one of the first countries preparing to introduce lenacapavir (LEN) for HIV prevention. We weren’t discussing whether people wanted the product. We weren’t debating whether it worked. We were talking about running out.

Countries preparing for rollout of this groundbreaking prevention method – one that provides near-perfect protection from infection – are already worried they won’t have enough supply to meet demand.

For decades, the HIV field has worried about generating demand for prevention. At AIDS 2026 in Rio, we confronted a very different challenge: the demand is building. The question now is whether the world is prepared to meet it.

This was a conference defined by something arguably more important than any single scientific breakthrough. It was the recognition that as a field, we must confront the pressing challenge of political will and moral decision-making. As Raphy Landovitz asked in a stirring plenary session: do we have the courage, partnerships, and urgency to fight for science, which remains under attack?

After this week in Rio, I believe we absolutely have the courage, and the conference theme – Rethink. Rebuild. Rise. – provides a roadmap for how we turn it into impact.

Slides presented at AIDS 2026 by AVAC partner Access Bridge during a session on the promise of long-acting PrEP

First, we must rethink what success looks like. For years, success in HIV prevention meant developing new products to prevent new infections. Today, though, success means ensuring people can actually get the option that best meets their needs – how do we deliver this extraordinary range of options?

The range of HIV prevention options has grown in ways we only dreamed of a decade ago: beyond condoms which remain as essential today as they were at my first AIDS conference 30 years ago, we now have injectable PrEP which provides near-perfect protection in clinical trials and is becoming more widely available; a vaginal ring that provides a unique female-initiated option; and a monthly oral PrEP pill is in late-stage trials (and accelerated access planning).

But more options do not automatically mean more choice. Choice is not simply a shelf full of medicines. Choice is a health system capable of delivering them. It is procurement systems that can purchase multiple options instead of one. It is healthcare workers trained to welcome diverse individuals and counsel people without bias, rather than steering everyone toward the same intervention or the one the health provider thinks is best for them. It is financing that rewards access instead of rationing it.

In Rio, I heard government representatives, implementers, and community advocates ask operational questions about choice that would have sounded impossible just a few years ago. How do we effectively forecast demand and introduce multiple long-acting options? How can we ensure speed, scale and equity across environments, from rural clinics to urban hospitals? How can we simplify delivery and offer PrEP where people want it, and not just where systems want them?

We must think big. In a matter of months, a once-in-a-generation opportunity will present itself as generic lenacapavir becomes available, and this highly effective prevention option, hopefully, becomes more accessible. Governments, donors, manufacturers, and global procurement agencies should be planning for millions of people—not thousands—to access long-acting PrEP. Importantly, we also heard in Rio how the new interest in LEN is actually motivating people who had not come forward to test and are found to already be living with HIV. The novelty of LEN is becoming a catalyst for universally testing and connecting all people with the products and services they need – whether or not they are living with HIV.

The HIV response has always moved fastest when those most affected have shaped research questions, demanded accountability, challenged institutions, and insisted that innovation reach the people who need it most.

As countries begin introducing long-acting prevention, community leadership becomes even more important. Communities that trust delivery systems, prevention methods and messages are much more likely to accept new methods. And ultimately, it will be communities that tell us whether products are truly accessible, whether health systems are delivering meaningful choice, and whether equity is more than just a conference slogan.

The “HIV Funding Saves Lives” quilt, created by COMPASS and the Global Advocacy Data Hub to convey the impact of funding cuts on communities

Second, we must rebuild. Rio was also the first global AIDS conference that had data presentations about the impacts of the dismantling of USAID and the dramatic restructuring of U.S. foreign assistance.

Since then, prevention programs have been diminished, services for key populations have been interrupted, research has been halted, partnerships have been strained. Organizations have closed their doors. Communities are feeling those consequences every day. Jerop Limo, an AVAC advocacy partner and adolescent HIV programming expert, summed it up perfectly in the recent POZ piece on the impact of funding cuts, “People are disengaging from healthcare spaces and missing appointments. This is not the system we had, the one that was working.”

The release of UNAIDS’ United to End AIDS special report and a companion KFF-UNAIDS analysis show the challenge of translating scientific progress into the impact needed to end AIDS as a public health threat by 2030. The report shows HIV financing entering one of its most precarious periods in decades, with international assistance declining 18% between 2024 and 2025. Donor government funding fell by $2.1 billion in 2025—the largest annual decline since global HIV funding began scaling up. This is not just a warning. It’s not just a ‘cautious stabilization of where things are. It is an alarm bell that we have to change how we do what we do, and how we fund what we do, if we want to succeed.

As colleagues from Duke and Friends of the Global Fight underscore, rebuilding cannot mean returning to the systems that existed before.

We can’t go back, but we also can’t stay still. We have to build something new.

The good news is that new opportunities and promising signs are emerging. Countries are assuming greater ownership of their HIV responses. Regional institutions are stepping forward. New partnerships are forming, and new institutions are stepping up to lead.

Across conversations in Rio, there was broad consensus that sustainability of the HIV response cannot remain overly reliant on any one country government and the whims of its leadership. A broad coalition of countries, communities, philanthropy, industry, and global institutions working toward shared goals must equally share responsibility for the future of the HIV response.

In fact, hosting the conference in Brazil was a powerful reminder that political commitment to universal HIV services can achieve a lot. But even Brazil cannot introduce every new prevention technology without strong partnerships. Manufacturers must be willing to expand access, multilateral organizations must be willing to commit to volume guarantees and investments that meet demand, and donors must prioritize and be willing to invest in what’s required to ensure equitable rollout.

Raphy Landovitz’s plenary highlighted the critical choices the field has ahead of us to ensure we meet this moment.

Lastly, we must rise to meet this moment. After every setback, whether political or scientific, the global HIV community has found a way to turn adversity into action, setbacks into solidarity, and uncertainty into progress. That was on display more than ever in Rio, where we were reminded that disappointment also moves science forward.

One of the week’s significant scientific presentations came from the CAPRISA antibody study. The results were disappointing: the trial found that a six-monthly combination of two broadly neutralizing antibodies (bNAbs) was safe but did not provide protection against HIV acquisition in young women in South Africa and Zambia. Researchers concluded that while the antibody combination demonstrated strong potency in laboratory studies, it did not achieve antibody levels needed for protection in people.

With this study, we had hoped that combining two bNAbs would provide greater protection than a single antibody, but sadly it did not. But antibody research has always been about more than product development. The CAPRISA 012c study continues to deepen our understanding of HIV and the immune system, and will continue to inform vaccine design, cure research and the next generation of prevention strategies.

Every carefully conducted study answers important questions. Every unexpected result helps redirect investments toward more promising approaches. That is how scientific progress works.

AIDS 2026 convened at a pivotal time: we now have just four years until 2030—the deadline for global HIV targets and the Sustainable Development Goals.

By the end of this year, we should know whether long-acting PrEP is reaching people at scale. By the International AIDS Society conference in Geneva next July, we should know whether generic lenacapavir is expanding access, whether research investments are holding, whether community-led programs have been restored, and whether countries are closing the equity gap. If those indicators are moving in the wrong direction, we must change course in real-time.

The legacy of Rio will be determined by whether we seize this extraordinary moment. Even as we rethink and rebuild things, we must ensure that we center communities, follow their lead, and rise up to support the populations that need this work more than ever. And just like a well-conducted clinical trial, a conference should answer some questions and raise new ones:

Will donors and governments purchase enough lenacapavir to meet demand instead of limiting access? Will pharmaceutical companies accelerate voluntary licensing and affordable pricing so new innovations reach everyone, everywhere without years of delay? Will donors invest boldly enough to match the science? Will countries protect community-led organizations and programs for key populations, recognizing that these are not optional additions but essential pillars of an effective response? Will researchers continue pushing the boundaries of vaccines, antibodies, cures, and long-acting treatment, even when some studies disappoint?

The science has never been stronger, communities have never been more ready, and the need has never been more urgent. Rio reminded us that ending HIV is no longer limited by what we know, it is limited only by the courage to act.

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Join Us, Thursday, August 13 @ 10.00am EDT

What We’re Reading

1. The implications of US government cuts

2. Prevention innovation includes speed, scale and equity…

3. …but too often, Latin America is still left behind

4. Innovative delivery and community involvement are expanding access…

5. …but supply issues pose a serious threat to LEN rollout.

6. The urgency of vaccines: advancing the science, deepening our understanding

7. Cure took another step forward

8. Harnessing the power of AI for HIV while centering communities in the response

9. Partnerships power the HIV response by advancing community-centered priorities

10. Communities are the heart of the AIDS response, and the Global Village is the heart of the AIDS conference.

Stay up-to-date!

AVAC Says Stop the Waste, Fraud and Abuse in the Persecution of Tony Fauci 