AVAC’s Guide to AIDS 2026

The AIDS 2026 conference in Rio de Janeiro, Brazil, starting in less than two weeks, comes at a defining moment for the global HIV response. Under the theme, Rethink. Rebuild. Rise., the conference convenes as the field grapples with funding disruptions, shifting geopolitics and the challenge of sustaining progress while translating scientific breakthroughs into equitable, community-led access. Alongside the latest research, discussions are expected to focus on scaling-up long-acting HIV prevention, strengthening health systems, advancing country ownership, sustaining the research enterprise, and ensuring the HIV response remains grounded in innovation, implementation and investment.

AVAC’s resources below aim to help those attending and those following from afar to navigate the discussion and debate in and around Rio.

Read on for resources and ways to navigate AIDS 2026.

AVAC’s Guides to AIDS 2026

HIV Prevention Session Roadmap
Explore AVAC’s curated roadmap of HIV prevention sessions and key presentations to watch throughout AIDS 2026.

AI and HIV Session Roadmap
AVAC and Audere’s AI & HIV Session Roadmap, features key conference sessions on artificial intelligence in HIV prevention, care, research and global health.

HIV Research & Advocacy Networking Zone

Resources

Resource Hubs

Resource Hub: Lenacapavir for Long-Acting PrEP
The introduction of injectable lenacapavir for HIV PrEP (LEN) is underway–in some places. While the field is moving faster than it did during the first decade of oral PrEP or the rollout of injectable cabotegravir, ensuring LEN—and future prevention options—reach everyone who needs them will require even greater speed, scale and equity. This resource hub contains all the tools, resources and insights on the latest with LEN rollout.

Resource Hub: MK-8527
Expanding prevention choice means investing in a diverse pipeline of HIV prevention options. MK-8527 is an investigational antiretroviral (ARV) once-monthly oral PrEP pill currently in Phase III clinical trials. If proven safe and effective, it could offer another important PrEP option. This resource hub provides advocates with an overview of the MK-8527, the science behind it and the latest on its clinical development. It also houses our guide to MK-8527 at AIDS 20206.

Resource Hub: People’s Research Agenda
The People’s Research Agenda (PRA) sets out a people-centered framework for equitable and accelerated R&D and product introduction. This resource hub offers an online, interactive dashboard for tracking, translating, and advocating for HIV prevention research and development (R&D). It also shows where investments align—or fail to align—with community-defined priorities, and spotlights critical gaps in the pipeline of prevention options needed to meet the diverse realities of all populations.

Pre-conferences, Satellites, Sessions and Workshops Featuring AVAC and Partners

  • Pre-conference: Advancing HIV prevention science and access
    08:00 – 19:00
    Hosted by the International AIDS Society, this pre-conference features six sessions showcasing the latest advances in HIV prevention science and access—including the Global Forecast of Long-Acting PrEP Need for Key Populations (2025–2030), developed jointly by GBGMC and AVAC. AVAC board, staff and partners will also explore the science behind next-generation HIV vaccine candidates and how to translate.

Monday, 27 July

Tuesday, 28 July

  • Symposium: bNAbs for cure: Hope or hype?
    10:30-11:30
    AVAC Board Member Marina Caskey will present in this symposium exploring the promise—and limitations—of broadly neutralizing antibodies (bNAbs) for HIV cure.

Wednesday, 29 July

Thursday, 30 July

  • Workshop: Skills Lab: Community-led monitoring
    12:00 – 13:30
    Facilitated by the International Treatment Preparedness Coalition (ITPC), NACOSA, the Network of Journalists Living with HIV (JONEHA) and community monitoring experts, including AVAC Senior Advisor Maureen Luba, this interactive workshop will strengthen practical skills in community-led monitoring (CLM).
  • Symposium: From community to innovation to scale
    16:30 – 17:30
    AVAC’s Grace Kumwenda will join community leaders, researchers, clinicians, policymakers and funders to discuss the partnerships, inclusive research and implementation strategies needed to accelerate innovation and ensure equitable access from the outset.
  • Satellite: From choice to impact: Long-acting and multipurpose HIV prevention technologies
    18:00 – 19:30
    Hosted by IPM South Africa, AVAC and Access Bridge’s Kate Segal and Ascend Futures Foundation’s Chilufya Kasanda will join researchers, advocates, implementers and policymakers to examine the latest scientific advances, implementation strategies and pathways to equitable access for long-acting options and MPTs.

Friday, July 31

Follow Us

AVAC will be covering conversations and events at the conference. Be sure to follow along on social and find updates on our AIDS 2026 page.

Global Health Watch: Latest on White House OMB Federal Rx Grant Proposal, Global Fund Gains Stability, New Model for GH Partnerships

Issue 76

As the comment period to oppose the White House Office of Management and Budget’s (OMB) proposal to give political appointees greater authority over federal research grants closes next Monday, the Global Fund avoided new ideological restrictions on US funding even as it prepares for a new Executive Director. And new articles and analyses of US bilateral health agreements under the “America First Global Health Strategy” suggest the Administration’s vision for global health is shifting from supporting epidemic control to managing country transitions.

The Latest on the White House OMB’s Proposal Politicizing Federal Grants

The last day to submit comments opposing the OMB’s proposal to give political appointees greater authority over federal research grant decisions is Monday, July 13. The proposal has drawn major and widespread opposition from scientists, advocates, universities, associations, former government officials, the biotechnology industry and members of Congress, all calling out the weakening of a long-standing scientific peer-review process and injection of political considerations into federal funding. The proposal has already drawn more than 93,000 public comments and submissions opposing the rule. See AVAC’s submission. The US Administration aims to finalize the rule by October 1.

IMPLICATIONS: These rules, if adopted, would mandate that federally-funded science align with a politically motivated “America First” agenda aimed at dismantling decades of transformative global collaboration. These rules have the potential to dramatically reshape how federal dollars are spent and who decides, replacing evidence-based decision-making with political priorities. Notably, the published proposed rule specifically and falsely references PEPFAR as justification for increased political scrutiny of federal grants, linking HIV and global health programs to a broader debate over federal spending, oversight and executive authority. For the HIV field, these changes could affect the entire research-to-rollout continuum and global partnerships, at a time when scientific collaboration is necessary to achieving 2030 HIV targets and advancing global health equity.

TAKE ACTION: The proposed rule is still open for public comment through July 13. Click here to comment or see  AVAC’s Action Alert for more instructions. Submitted comments could slow implementation of any changes to the process because the OMB must reply to them all. The outpouring of comments could also persuade Congress, which has repeatedly rejected the Administration’s previous proposals to gut research funding, to use its power to stop these changes. Comments also put into the public record that are not adequately addressed, could be raised again in lawsuits to stop the changes.

READ:

Global Fund Gains Stability Amid Leadership Transition

The US government will continue funding the Global Fund without imposing its expanded global gag rule or other ideological funding conditions to US contributions. This will allow US funding to continue without restrictions related to abortion, diversity, equity and inclusion policies. At its Board meeting this week, the Global Fund also confirmed that its search for a new Executive Director will proceed as planned despite reports that the confidential nomination process might be restarted following media leaks. The Board is expected to appoint its next Executive Director in October.

IMPLICATIONS: While the decision not to impose the expanded global gag rule removes one immediate challenge, the Fund still faces significant financial uncertainty. Its next Executive Director will inherit an organization facing the major challenges of constrained resources, evolving donor expectations and increasing pressure to sustain impact in a changing global health landscape.  

READ: 

The New Model for US Global Health Partnerships 

PEPFAR and US bilateral health agreements continue to evolve. This week, Think Global Health expanded its tracker of the US Administration’s bilateral health agreements, showing that 31 countries have now signed five-year agreements that increasingly shift financing and implementation responsibilities to national governments through co-investment and country ownership models. Andrew Green focuses on one country, South Sudan, in a Devex piece that looks at the country’s new three-year, $166 million MoU with the US, noting that while it preserves support for HIV and disease surveillance, funding may be insufficient to offset recent aid reductions and the country may struggle to meet its own financial commitments. 

In a separate analysis, Jirair Ratevosian broke down what five reports from the US Department of State to Congress reveal about the Administration’s vision for global health. He writes, “Read together, these excerpts are overwhelmingly about the mechanics of transition: MOUs, implementation plans, co-investment, funding adjustments, corrective actions, benchmarks, workforce transfer, and reductions in US assistance. There is much less discussion of incidence, viral suppression, advanced disease management, prevention gaps, community systems, or epidemic control… It suggests they are no longer the organizing principle.”  

IMPLICATIONS: These pieces reflect a move toward implementation of the new global health agreements. As implementation continues, we’ll be watching whether the financing assumptions, implementation systems and country commitments that are the foundation of these agreements are sufficient enough to sustain HIV and broader health gains. As Ratevosian notes, “Every Administration has its own priorities. But organizing principles matter because they determine what leaders measure, what they reward, and ultimately what they protect. When transition becomes the primary frame, there is a risk that epidemic control becomes something assumed rather than something actively managed.” 

In a separate analysis, Jirair Ratevosian broke down what five reports from the US Department of State to Congress reveal about the Administration’s vision for global health. He writes, “Read together, these excerpts are overwhelmingly about the mechanics of transition: MOUs, implementation plans, co-investment, funding adjustments, corrective actions, benchmarks, workforce transfer, and reductions in US assistance. There is much less discussion of incidence, viral suppression, advanced disease management, prevention gaps, community systems, or epidemic control… It suggests they are no longer the organizing principle.”

READ

What We’re Reading

Presenting at AIDS2026?

Access AVAC’s latest infographics on the research and development pipeline, prevention options, and the impact of US funding cuts.

Access the Graphics

Best of AVAC’s Advocacy Guides

The AIDS 2026 conference is fast approaching. To help advocates stay informed and engaged, AVAC has curated a collection of its Advocates’ Guides covering the science, policy, implementation and advocacy conversations shaping the future of the HIV/AIDS response. Developed with partners across the field, these guides help translate complex science and policy to help inform advocacy before, during and after the conference.

For those presenting at AIDS 2026, please check out AVAC’s slide deck containing the latest infographics on the research & development pipelines, the delivery of new prevention options and the impact of US funding cuts on foreign assistance and on research and science. We will be continuously updating it, so be sure to check back for updates as the conference approaches.

The introduction of injectable lenacapavir for HIV PrEP (LEN) is underway–in some places at least. To ensure communities remain at the center of LEN rollout, this new Advocates’ Checklist for Lenacapavir for PrEP Introduction is an immediate, actionable blueprint. And read more in this blog by the co-chairs of the Civil Society Caucus of the Coalition to Accelerate Access to Long-Acting PrEP and AVAC staff.



Planning For MK-8527

Expanding prevention choice means investing in a diverse pipeline of HIV prevention options. MK-8527 is an investigational antiretroviral (ARV) once-monthly oral PrEP pill that is currently in Phase III clinical trials. If proven safe and effective, it could offer another important PrEP option. This resource provides advocates with an overview of the MK-8527, the science behind it and the latest on its clinical development.  


Podcast: The Future of PrEP

AVAC’s Executive Director Mitchell Warren joined ITPC’s Make Medicines Affordable podcast to discuss the future of PrEP. While Lenacapavir is a transformative option for HIV prevention, Warren shares what it will take to ensure it reaches the people who need it most.


Download the Latest Infographics from AVAC


Presenting at AIDS 2026?

These graphics are updated regularly, so be sure to check back.  


Additional Resources

  • People’s Research Agenda: This people-centered framework guides equitable and accelerated HIV prevention research, development and product introduction. It tracks scientific progress, assesses whether investments align with community-defined priorities, and identifies critical gaps in the prevention pipeline needed to meet the diverse needs and preferences of all populations 
  • HIV Prevention Product Overview: The graphic provides an overview of PrEP products currently available and in late-stage clinical trials. 
  • Lenacapavir Resource Hub: Your one-stop resource for all things lenacapavir, this page brings together the latest news, advocacy resources, scientific updates, implementation tools and infographics to help advocates stay informed and ensure LEN rolls out with speed, scale and equity. 

P.S. On Tuesday, July 14 AVAC and partners will share the impact stories of ten years of the Coalition to Accelerate and Support Prevention Research (CASPR). We hope you’ll join us

Global Health Watch: Global Governance Shifts, ACIP Charter + Vaccine Policy, PEPFAR Transition

Issue 75

As many in the United States pause to commemorate Independence Day – and, hopefully, re-commit to the fundamental principles of democracy – the global health community continues to navigate the far-reaching effects of US policy decisions. Institutions are changing, governance is being redefined and the systems that have underpinned the global HIV response are being reshaped. This issue covers developments in global health governance, the continued restructuring of US vaccine policy and growing concerns that PEPFAR’s transition is outpacing the systems needed to sustain it.

Global Governance Shifts

The last two weeks, and the week ahead, mark key moments for global health governance with implications for the HIV response. Last week, for the first time in 25 years, UN Member States adopted a new Political Declaration on HIV/AIDS with a vote (with the US voting no), as opposed to the historic consensus of all past declarations. This week, both the UNAIDS Programme Coordinating Board (PCB) and the Unitaid Executive Board met against the backdrop of financial strain and uncertainty. Conversations and debates about their future roles continued, including questions about UNAIDS’ future structure within the UN system. Next week, the Global Fund Board will meet as it prepares to select its next Executive Director who is expected to shape the Fund’s strategic direction during one of the most challenging periods in its history.

IMPLICATIONS: In all these meetings, there is a reassessment of each entity and a reenvisioning of how global health organizations will coordinate, finance and sustain the HIV response in an era of constrained resources and shifting geopolitical priorities. As countries work toward the 2030 goal of ending AIDS as a public health threat, the decisions made by these governing bodies in the coming weeks will help determine whether and how the HIV response maintains the leadership, financing, accountability, collaboration and civil society engagement needed to carry the response forward.

READ:

US HHS Rewrites ACIP Charter, Further Reshaping US Vaccine Policy

The US Department of Health and Human Services (HHS) issued a new charter for the CDC’s Advisory Committee on Immunization Practices (ACIP), broadening the Committee’s mandate and reducing the qualifications required for membership. Previously, vaccine expertise was a requirement, but the revised charter states that members should collectively represent a “balanced range of scientific, clinical, and public health expertise”. The new charter also expands the Committee’s focus beyond reviewing vaccines to considering alternative approaches to disease prevention.

IMPLICATIONS: This is the latest step in the restructuring of ACIP. By broadening the Committee’s remit and redefining membership qualifications, vaccine policymaking is further politicized and vaccine confidence continues to erode. This creates further instability and uncertainty for vaccine manufacturers, healthcare providers and immunization programs worldwide.

READ:

PEPFAR In Transition

Two commentaries this week recognize the breaking point to which PEPFAR is nearing. The Health Security Policy Academy argues that despite the temporary extensions, which have kept and continue to keep parts of PEPFAR operating, the US Department of State has not yet built a viable implementation system to keep HIV treatment, supply chains, laboratories and community programs working. At the same time, Emily Bass, Yvette Raphael, Nono Eland and colleagues at Physicians for Human Rights argue in Think Global Health that the planned phase-out of all US PEPFAR support for South Africa by early 2027 is not a routine transition to country ownership, and caution that this accelerated withdrawal risks severed disruption to HIV prevention, surveillance, research and community programs that have long depended on US partnership.

IMPLICATIONS: Without a clear implementation strategy and carefully managed country transitions, these abrupt changes to PEPFAR threaten essential HIV services. A more deliberate, evidence-based approach that preserves critical infrastructure while supporting long-term country ownership is needed. “The dismantling of USAID showed what happens when the Administration destroys an operating system before a replacement exists. That chaos was not an accident, but it was sudden,” writes the Health Security Policy Academy. It remains even less clear what happens next with leadership transitions at the State Department: Jeremy Lewin who has led the State Department’s foreign aid bureau for the last year is heading to the National Security Council, and is being replaced by Andrew Veprek, who has pushed immigration and refugee restrictions at the State Department – and confirmation hearings are yet to be scheduled for Johnny Figueroa as the ambassador-at-large for global health security and diplomacy and PEPFAR.

READ:


What We’re Reading

Protecting Science. Advancing HIV Prevention. Preparing for What’s Next | New AVAC Resources

Global health is being reshaped by rapid geopolitical shifts, scientific breakthroughs and the growing role of artificial intelligence — creating both new opportunities and new challenges. Translating scientific breakthroughs into impact requires protecting research, advancing equitable access and ensuring communities are at the center. Explore AVAC’s latest resources to help navigate and shape what comes next.

Think Global Health: NIH Budget Cuts Threaten HIV Research

AVAC’s Stacey Hannah and Mitchell Warren remind us in Think Global Health that “at a moment when scientific progress is advancing, advocates, researchers, policymakers, and communities should push back against politically motivated, fringe, antivaccine sentiments that threaten decades of investment to develop the tool that would finally break the back of the epidemic.” 


From Anticipation to Action: The Civil Society Advocates’ Checklist for Lenacapavir for PrEP 

The introduction of injectable lenacapavir for HIV PrEP (LEN) is underway–in some places at least. To ensure communities remain at the center of LEN rollout, this new Advocates’ Checklist for Lenacapavir for PrEP Introduction is an immediate, actionable blueprint designed to help civil society organizations (CSOs) and global health advocates pressure-test government commitments, map implementation bottlenecks and demand equitable access. The checklist is designed to support faster, community-centered rollout ahead of broader generic availability in 2027, as described by the co-chairs of the Civil Society Caucus of the Coalition to Accelerate Access to Long-Acting PrEP and AVAC staff.


The Future Won’t Build Itself: Sustaining the Movement CASPR Started

Tuesday, 14 July @ 9:00am EDT  16:00 EAT 

Join AVAC and partners to hear the impact stories of ten years of the Coalition to Accelerate and Support Prevention Research (CASPR). Established in 2016, CASPR was funded by the United States Agency for International Development (USAID) and designed by AVAC with leading civil society partners to influence HIV prevention research, policy and implementation. With attacks on global health and shrinking resources dismantling hard-won gains, the lessons from CASPR are a call for continued action: strong, community-led advocacy is indispensable to safeguard the future of HIV prevention.


Community First: Practical Strategies for Inclusive Implementation Science

Wednesday, 15 July @ 11:00am EDT  18:00 EAT 

Join The Choice Agenda and Hunter College’s Sarit Golub for a participatory discussion on implementation science – including opportunities, pitfalls and ways in which community leadership is essential to success. What are the different types of implementation science, and how do we move forward with community and front-line implementers at the helm? 


AI & HIV Newsletter

ICYMI, AVAC launched the AI & HIV Newsletter, a new quarterly resource highlighting the latest tools, research, policy developments and news at the intersection of AI and HIV. Designed for advocates and the global community and guided by an expert advisory board, the newsletter provides readers with the information and resources to engage with AI in ways that strengthen equity, protect individuals and communities and prioritize their inclusion, and ensure that technological innovation advances the HIV response. 


12 Days Remain: Add Your Voice to Stop OMB’s Attack on American Science

DEADLINE: JULY 13: Proposed new regulations by the White House Office of Management and Budget (OMB) would use budgetary and regulatory tools to bypass longstanding scientific peer-review and congressional processes, including withholding appropriated funds, restructuring federal agencies, and proposing rules that would give political appointees greater influence over research funding decisions. Public comments are due by July 13th – please consider taking action and visit Stand Up for Science’s STOP OMB portal now.


The pace of change in global health is not slowing and neither is the need for informed, coordinated advocacy. Look out for our AIDS 2026 conference roadmap and more resources coming soon! 

From Anticipation to Action: The Civil Society Advocates’ Checklist for Lenacapavir for PrEP 

By Co-Chairs of the Civil Society Caucus of the Coalition to Accelerate Access to Long-Acting PrEP Chilufya Kasanda, Kenneth Mwehonge, Numan Afifi and AVAC staff supporting the Caucus Navita Jain & Bridget Jjuuko

The landscape of HIV prevention is shifting beneath our feet. We have officially moved from the anticipation of long-acting options to the gritty, urgent work of early implementation, and translating biomedical options into actual choices for people.

The most recent new option is injectable lenacapavir (LEN) for PrEP – a six-monthly subcutaneous injection that offers near perfect protection from HIV. With LEN implementation ongoing in nine African countries as part of Global Fund and PEPFAR support to 24 “Early Adopter” countries, the question is no longer if LEN will arrive, but how fast we can get it to the communities who need it most and build a sustainable, scalable market.

To ensure community leadership sits at the center of this rollout, the Advocates’ Checklist for Lenacapavir for PrEP Introduction was designed as an immediate, actionable blueprint to help civil society organizations (CSOs) and global health advocates pressure-test government commitments, map implementation bottlenecks and demand equitable access. Whether your country is currently on the early adopter list or you are fiercely campaigning for its inclusion, this checklist outlines the essential questions we all need to be asking our Ministries of Health, technical partners and funders.

Why This Checklist? Why Now?

While the field eagerly prepares for the entry of generic LEN supplies into the market in 2027, we cannot afford to simply wait for that eventuality. The demand and need for LEN is immediate – and the sooner we create demand, the sooner generics will make larger volumes at lower prices. Advancing LEN rollout now, as quickly and as large as possible, translates directly into preventable HIV infections and signals strong demand to generic manufacturers as they prepare to enter the market and to donors as they plan for larger-scale procurement. Advocates need to push for speedy and equitable access to LEN right now, while simultaneously preparing national systems for a multi-producer generic market tomorrow.

The checklist breaks down advocacy targets into five critical pillars:

  • Regulatory & Policy Alignment: Moving LEN from regulatory approval to formal integration into National HIV Prevention Guidelines alongside oral PrEP, long-acting injectable cabotegravir (CAB-LA) and the Dapivirine Vaginal Ring (DVR).
  • Financing & Procurement: Holding funders accountable to the “3 Million in 3 Years” target for providing access to LEN for prevention, and treating that commitment as a floor, not a ceiling. Ensuring robust demand forecasts are developed and financing plans reflect both procurement and program needs.
  • Supply Chain & Site Readiness: Using technical tools to track whether orders sitting at the Global Fund are actually reaching central warehouses and frontline clinics.
  • Demand Generation & Community Leadership: Fighting back against the “slow rollout” narrative and embedding LEN into comprehensive, integrated choice campaigns rather than letting it be siloed.
  • Accountability & Monitoring: Securing dedicated civil society seats on National Technical Working Groups and deploying Community-Led Monitoring (CLM) to track stock-outs and document real-world access barriers.

Working together, partners from Ascend Futures Foundation, APCOM, HEPS Uganda and AVAC, representing members of the Civil Society Caucus of the Coalition to Accelerate Access to Long-Acting PrEP, lent their expertise and localized insights to create this tool for the global community. It is the newest in a suite of resources available on PrEPWatch to support LEN rollout, including the LEN Resource Toolkit and the Long-Acting PrEP Status Dashboard.

With this tool in hand, now is the time to turn high-level commitments into real choices at the clinic level. For questions or comments about the checklist, contact us at [email protected].


Get Involved: Download and Share the Checklist: Access the full PDF tool to start auditing your country’s readiness. 

Track Progress Live: Keep an eye on global efforts and view continuously updated, country-specific progress trackers on PrEPWatch.

“Lenacapavir has the potential to transform HIV prevention, but its true impact will depend on whether it expands choice rather than replaces it. No single prevention method will work for everyone. Ending new HIV infections requires a prevention ecosystem where every individual can choose the option that best fits their needs, preferences and circumstances.”

Chilufya Hampongo
Executive Director of Ascend Futures Foundation and co-chair of the CS Caucus

“Asia and the Pacific account for nearly one in six people living with HIV globally. For us, global access is about ensuring that new prevention tools do not remain available only in a handful of countries but can reach the millions of people across our region who could benefit from them. That’s how scientific innovation translates into public health impact.”

Numan Afifi
Senior Policy and Research Officer at APCOM and co-chair of the CS Caucus

“Lenacapavir has the potential to transform HIV prevention in high-burden countries. For governments, it is more than a new product—it is an opportunity to prevent infections more effectively, expand choice, reach underserved populations, and reduce the long-term social and economic costs of HIV. If introduced equitably and at scale, LEN could become one of the most important tools in accelerating progress towards ending AIDS as a public health threat.”

Kenneth Mwehonge
Executive Director of HEPS Uganda and co-chair of the CS Caucus

The Future Won’t Build Itself: Sustaining the Movement CASPR Started

On Tuesday, July 14, AVAC and partners discussed the impact stories of ten years of the Coalition to Accelerate and Support Prevention Research (CASPR). Established in 2016, CASPR was funded by the United States Agency for International Development (USAID) and designed by AVAC in collaboration with leading civil society partners to influence HIV prevention research, policy and implementation.

CASPR was paused in early 2025 amidst sweeping cuts to US federal funding for foreign assistance and the dismantling of USAID. Yet the Coalition’s impact did not end there, it built an intergenerational movement that continues today.

And with attacks on global health and shrinking resources dismantling hard-won gains, the lessons from CASPR are a call for continued action: strong, community-led advocacy is indispensable to safeguard the future of HIV prevention.

Coalition members from APHA and Internews shared how they transformed HIV prevention – helping to shape ethical research practices, amplifying community leadership, influencing policy, and ensuring that the voices of those most affected by HIV help guide research and access agendas – as well as their action plan for the future.

We hope you’ll join us.

Global Health Watch: New Political Declaration on HIV/AIDS, End of US PEPFAR Support for South Africa + Treatment Declines

Issue 74

UN member states adopted a new Political Declaration on HIV/AIDS reaffirming global commitments to end AIDS by 2030, but for the first time since 2001, the declaration was not adopted by consensus – and with the US notably voting against it. At the same time, last week’s news that the US Department of State is assuming greater control over PEPFAR is followed this week by the phase-out of US PEPFAR support for South Africa and new analyses showing PEPFAR-supported HIV treatment declined in 2025, following the US Administration’s foreign aid freeze. Also, for organizations in the US, please consider signing Partners in Health’s Letter to Protect CDC PEPFAR Programs.

UN HIV Declaration Adopted Amid Deep Political Divisions

The UN General Assembly adopted a new Political Declaration on HIV/AIDS this week reaffirming global commitments to end AIDS as a public health threat by 2030. However, for the first time since political declarations on HIV began in 2001, the declaration was not adopted by consensus. And importantly, the US delegation voted against the declaration. Deputy US Representative to the UN, Tammy Bruce, said in a comment rejecting the declaration that it strayed too far from the targets for ending AIDS “by including divisive topics”. The declaration acknowledges that progress toward the 2030 goal is off track, highlighting widening funding gaps, disruptions to HIV services, and persistent barriers faced by populations at high risk of HIV. Advocates and civil society played an important role in ensuring the declaration included commitments to evidence-based, rights-based HIV responses and renewed calls for sustained investment in prevention, treatment and community-led services.

IMPLICATIONS: The divided vote underscores how geopolitical tensions and domestic politics in the US are shaping global health policy at a moment when the HIV response faces its greatest financing crisis. While the declaration provides an important political framework for countries and advocates, it carries no binding obligations and offers few concrete answers to address the growing funding shortfall as nationalism rises and development assistance falls. The US government’s opposition marks an insular, ideologically driven retreat from longstanding consensus for rights-based HIV programming, particularly for key populations who continue to bear a disproportionate burden of HIV. This is consistent with the harmful policies and positions the US Administration has taken against communities vulnerable to HIV including the Promoting Human Flourishing in Foreign Assistance (PHFFA) and the invisibility of vulnerable populations in the most recent PEPFAR data.

In response, global civil society groups led by Health GAP have elevated the People’s Declaration on HIV/AIDS as a counter to the resulting Political Declaration. Over 400 organizations signed onto the People’s Declaration, illustrating a major show of power and call for action by governments to reaffirm commitments, rights, and investments to end HIV for everyone, everywhere.

READ:

US Ending PEPFAR in South Africa

The US Administration abruptly announced its intention to end PEPFAR support in South Africa, with funding expected to terminate by early 2027. The decision is part of the Administration’s broader retrenchment from foreign assistance and is related to political disagreements with the South African government. South Africa receives more than $400 million annually through PEPFAR, which supports health workers, prevention programs and service delivery. This decision marks one of the most consequential changes to PEPFAR since its creation in 2003, with significant implications in envisioning an end to the HIV epidemic – in South Africa and globally. This news follows the Administration’s Executive Order in February 2025, which made baseless claims about South Africa, and the March 2025 decision to “hold all research awards” for South Africa after designating it a “country of concern”. At the time, AVAC told Bhekisisa, “It is very clear that the President is using budgets and terminations of previously agreed to programmes to redefine agendas… that defy science and are clearly political and ideological.”

IMPLICATIONS: The PEPFAR withdrawal from South Africa reinforces the shift away from evidence to ideology, moving from long-term global health partnerships toward a more transactional foreign policy model. These short-sighted decisions come despite the historical South Africa-USA partnership that has catalyzed scientific research and program impact for HIV prevention and treatment, where the country plays a vital role in clinical research, development of cutting-edge prevention technologies, and implementing models for treatment, care and prevention. Although South Africa finances its own antiretroviral medicines, PEPFAR supports important aspects of the health workforce, community-based prevention and services for key populations. A rapid withdrawal will disrupt testing, prevention and services, placing additional strain on the country battling the largest HIV epidemic. Furthermore, the end to PEPFAR funding along with the severance of National Institutes of Health (NIH) research partnerships, cuts off a country that is central to ending the global epidemic and one that continues to inform the science of HIV and tuberculosis treatment and prevention.

READ:

New Analysis Shows Decline in PEPFAR-Supported HIV Treatment

A new analysis published in Nature Health finds that PEPFAR-supported HIV treatment declined in 2025 following the US Administration’s foreign aid freeze, with approximately 2 million fewer people reported as receiving PEPFAR-supported antiretroviral therapy than in 2024 (a 10% decrease). Of the 26 countries examined, treatment support fell across all, though some of the decline reflects changes in how PEPFAR classifies and reports treatment support rather than patients losing access to care. South Africa was called out in the analyses, accounting for most of the treatment declines—individuals previously counted as receiving direct PEPFAR support were reclassified as benefiting from broader health system investments, resulting in a net treatment decline of about 95,000 people (1.8%). The authors conclude a “decline of ∼1.73 million individuals on direct PEPFAR-supported treatment and an increase of ∼1.64 million individuals on treatment benefitting solely from the programme’s broader support to health systems, yielding a net treatment loss of 94,881 (−1.8%)”.

IMPLICATIONS: As the authors conclude, “while the analysis cannot determine whether and to what extent declines will translate into reduced individual- or population-level treatment outcomes, a reduction in PEPFAR-supported treatment of this scale within a single fiscal year raises concerns.” The data underscore the significant disruptions caused by funding uncertainty and restructuring across the program.

READ:

Add Your Voice to Stop OMB’s Attack on American Science

Proposed new regulations by the White House Office of Management and Budget (OMB) would use budgetary and regulatory tools to bypass longstanding scientific peer-review and congressional processes, including withholding appropriated funds, restructuring federal agencies, and proposing rules that would give political appointees greater influence over research funding decisions. Public comments are due by July 13th – please consider taking action and visit Stand Up for Science’s STOP OMB portal now.


What We’re Reading

Global Health Watch: Restructuring PEPFAR, Political Control Over Science; FDA + African Medicines Agency MoU

Issue 73

This week, the US Administration continues to move to consolidate control over science, restructure the systems that underpin PEPFAR and global health security, and redefine US global health engagement through regulatory influence rather than long-term public health partnerships.

Restructuring PEPFAR and Weakening the US CDC

The US Administration is moving forward with its plan to significantly reduce the US Centers for Disease Control and Prevention’s (CDC) vital role in PEPFAR and global health programs, shifting much of the authority and funding to the US Department of State, which many argue, does not have the expertise or capacity to manage the programs. In contrast to CDC’s historical role in implementing PEPFAR in-country programs, the plan would require countries to “purchase” CDC technical assistance services (ranging from disease surveillance to laboratory support) through new bilateral agreements in a “fee-for-service” public health model. The future of in-country CDC offices and technical staff is uncertain under this new plan.

The Administration already significantly weakened PEPFAR’s infrastructure by shutting down USAID last year and delaying HIV funding in an interagency transfer to CDC. This new proposal could further undermine the CDC from much of the work that helps deliver HIV services and supports disease detection around the world. As eight former CDC directors – appointed by both Republican and Democratic presidents – warned previously, the proposed restructuring could disrupt not only HIV services but also the laboratory networks, surveillance systems, trained workforce and trusted relationships with ministries of health that support outbreak detection and response worldwide.

IMPLICATIONS: “This will completely destabilize HIV work abroad,” former CDC official Michele Montandon told the New York Times. “We’ve seen service disruptions, deaths and babies born with HIV after shuttering USAID, and we can expect more to come if CDC is also shut out of this work.” The rapid restructuring of PEPFAR could decimate HIV programs, complicate the transition to country ownership, and fracture global disease surveillance and outbreak-response systems built through decades of US investment. While there is broad stakeholder agreement about the importance of increasing country ownership and transitioning away from donor dependence, the accelerated pace and structure of the proposed changes makes technical expertise and relationships precarious before sustainable alternatives are in place. These changes come at a time of a rapidly unfolding Ebola epidemic in Central Africa, complicating current crises and creating doubt in response capacity for future epidemics.

READ:

Political Control Over Science Moves Ahead

The proposed new regulations that would significantly expand political interference in federal funding decisions across all US government grants by the White House’s Office of Management and Budget (OMB) remains at the center of current controversy. In a recent New England Journal of Medicine editorial, editors warned that this Administration is increasingly using budgetary and regulatory tools to bypass longstanding scientific peer-review and congressional processes, including withholding appropriated funds, restructuring federal agencies, and proposing rules that would give political appointees greater influence over research funding decisions. At the same time, Hal Duncan, the nominee to serve as the Deputy Director of the OMB, defended the “pocket rescission” strategy during his confirmation hearings this week in front of Senate leaders. This strategy would allow the Administration to use additional spending cuts through “pocket rescissions,” which would allow funds to expire before Congress has an opportunity to act.

IMPLICATIONS: The moves by OMB signal increasing efforts to shift decision-making authority away from Congress and scientific peer review and toward the Executive Branch, giving the President more control over how federal money is spent and what research and programs get funded in alignment with ideology. For the last 18 months, the question of who gets to decide what scientific research and public health programming are funded and whether Congress’s decisions are carried out as intended continues to be raised, and the answer increasingly appears to be the White House rather than Congress or the broader scientific and public health community.

Scientists Issue Bethesda Declaration: One Year Later

Nearly 40 former and current staff at the National Institutes of Health (NIH) authored a new report, The Bethesda Declaration One Year Later, Continuing Harms to the NIH Mission, which outlines nine deepening concerns at the NIH over the last year along with proposed solutions. This report comes one year after hundreds of NIH employees accused the Administration of politicizing biomedical research through the original Bethesda Declaration. The new report notes that the Administration is slowing medical research, disrupting international collaborations, weakening ethical safeguards, driving away experienced staff and undermining public trust in science. Approximately 24% fewer NIH research projects were funded in 2025 than in 2024 and more than 5,500 peer-reviewed grants were terminated. The report also warns that the White House’s proposed Office of Management and Budget (OMB) rule, which would subject federal grants to greater political review and require alignment with presidential priorities, would institutionalize many of the changes researchers have opposed in the last year.

IMPLICATIONS: The updated Bethesda Declaration shows growing concern from the scientific community about the politicization of science. The NIH has served as the foundation of HIV research, from supporting basic science, vaccine development, implementation of new prevention technologies and global research partnerships. As political oversight expands and international collaboration is deconstructed, the US risks undermining the scientific infrastructure that has fueled decades of innovation and partnership.

US FDA and African Medicines Agency Enter Into New Partnership

The US Food and Drug Administration (FDA) and the African Medicines Agency (AMA) have signed a new Memorandum of Understanding (MoU) to create a shared framework for information sharing and regulatory cooperation. The agreement could allow African regulators to draw on FDA assessments and regulatory decisions when evaluating medical products, while also facilitating greater cooperation on inspections, scientific reviews and regulatory capacity building.

IMPLICATIONS: This agreement between two stringent regulatory authorities (SRAs) is another example of the Administration’s evolving approach to global health and in-line with the US government’s recent “America First” global health strategy. This partnership could be interpreted as a regulatory harmonization effort that would allow for the rapid influx of American-made health technologies for emerging markets in Africa. The expansion and procurement of US-made health commodities is a central feature to the US government’s new transactional approach to global health. However, this comes in stark contrast as the US cuts funding for global health programs, reduces the CDC’s international role and restructures PEPFAR, it is replacing long-term public health partnerships with narrower bilateral agreements focused on regulation and innovation. The disconnect between developing new health technologies and supporting the health systems needed to deliver them complicates the vision for greater regulatory cooperation between SRAs that is required for scale-up and access to the latest treatment and prevention modalities.

READ:

A ‘perilous moment’ for the response to HIV

A new UNAIDS report released ahead of next week’s United Nations General Assembly’s High-Level Meeting on HIV/AIDS shows that external funding cuts, a strong push back on human rights and under investment and under prioritization of HIV prevention and community services are threatening to reverse years of gains in the AIDS response. Read AVAC’s UN High-Level Meeting on HIV/AIDS: What to Watch.

Read More

What We’re Reading

UN High-Level Meeting on HIV/AIDS

What To Watch


UN member states and agencies will meet next week, June 22 and 23 for the 2026 UN High-Level Meeting on HIV/AIDS (HLM) with the goal of charting a path toward ending AIDS as a public health threat by 2030. HLMs on HIV/AIDS have been held every five years since 2001—the meeting that energized the HIV/AIDS response and led to the creation of the Global Fund and PEPFAR. However, this year’s meeting arrives at a time of shrinking HIV budgets, disruptions to prevention and treatment programs, under investment, and questions about the future of multilateral cooperation.

See the new UNAIDS report published last week, which shows that external funding cuts, a strong push back on human rights and under investment and under prioritization of HIV prevention and community services are threatening to reverse years of gains in the AIDS response. UNAIDS also has resources for the HLM here. Read more below for what’s at stake and how to engage in the process.

The HLM will test whether governments are prepared to match innovation with the political commitment, financing, human rights protections and community leadership needed to continue moving forward. With or without a declaration, the HIV movement must continue pushing forward based on the scientific evidence and human rights.

What To Watch

At the center of the meeting is a political declaration to guide the global HIV response for the next five years. Civil society organizations outlined a range of priorities in the lead-up to the HLM, and negotiations on this declaration have already become contentious. Advocates and many delegations raised concerns about efforts to weaken commitments on key populations, human rights, community leadership, access to medicines, financing, and discriminatory laws.

All eyes will be on New York next week as country delegations, advocates, policymakers and journalists monitor the negotiations. Stay tuned for more: AVAC will summarize the latest developments in our weekly Global Health Watch newsletter.


Why the HLM Matters

As AVAC’s Mitchell Warren told Global Dispatches podcast, “[Progress] all stems from shared strategy that these high-level meetings and that the multilateral system have codified… this high-level meeting is not just a check-in on progress and a forward-looking strategic declaration. It’s a test of the concept. It is a test of the will of political leaders and of civil society. Are we still in a global discourse about ending an epidemic? Or are we closing borders and shutting down and leaving every country and every community to do it themselves? Because if we are, the end of this epidemic is going to be pushed out many, many years. And that’s the test of concept ahead of us.”


In New York? Join Us

Delivering the HIV Prevention Ambition: Partnership, Country and Community Leadership, and Shared Accountability
Monday, June 22, 2026; 1:15-2:30pm EDT
On the sidelines of the HLM, AVAC will join UNAIDS, UNFPA and the Global HIV Prevention Coalition for a discussion on how to achieve the global 40+20 prevention targets to reach 20 million people with prevention services by 2030.

Accelerating Progress Towards Ending HIV, TB, Hepatitis and STIs New Approaches to End Major Epidemics
Monday, June 22, 2026; 1:15-2:30pm EDT
The WHO and UN Member States will convene partners for an HLM side event focused on accelerating progress against HIV, TB, viral hepatitis and STIs. During this event, AVAC and partners will explore new approaches to sustain gains, address persistent inequalities and advance the global effort to end these major epidemics.

Future-Proofing the AIDS Response: Harnessing the Power of Innovation and Communities
Tuesday, June 23, 2026; 8:00-9:30am EDT
The UNDP, UNFPA, WHO, UNODC, UNICEF, UN Women, UNHCR — in collaboration with GNP+, AVAC, women’s organizations, and key population networks — will bring UN organizations and civil society partners together to discuss the role of communities in advancing the AIDS response.

The HLM will test whether governments are prepared to match innovation with the political commitment, financing, human rights protections and community leadership needed to continue moving forward. With or without a declaration, the HIV movement must continue pushing forward based on the scientific evidence and human rights.