Six Resolutions and Resources for Advocates in 2026 

As we look to the year ahead, we start by taking stock of the profound disruptions of 2025 and how the field responded. We have seen partners around the world persevere, despite threats and losses, and demonstrate remarkable leadership. We look forward to another year in solidarity with all of you, bringing unflinching determination to demand and defend an equitable and effective HIV response. The cause demands grit, adaptation, and vision.

With immense challenges and historic opportunities ahead, we are making resolutions for the new year and sharing resources to advance our collective work in the months to come.

Together with our partners, 2026 will be marked by our commitment to:

1. Rethink and rebuild an architecture for global health that insists on equity. 

We launched Global Health Watch just as the new US Administration started its assault on foreign assistance and the HIV/AIDS response. This weekly newsletter breaks down critical developments in US policies and their impact on global health. Read the latest issue, and subscribe to get your weekly edition.

Click for more

2. Amplify and drive the call for effective and equitable R&D with the People’s Research Agenda (PRA).

The 2025 update of the PRA is a people-centered framework to drive equitable and accelerated HIV prevention research and development (R&D) and product introduction. This update includes an expanded online dashboard for tracking, translating, and advocating for HIV prevention R&D.

Read the PRA

3. Accelerate speed, scale and equity in access to long-acting PrEP.  

This collection of resources to accelerate access to long-acting PrEP includes infographics, advocacy guides, reports and tools that draw on lessons from oral PrEP rollout to help get injectable lenacapavir for PrEP introduction right.

Also check out this dashboard tracking long-acting PrEP for a timely snapshot of the progress towards scale-up of all long-acting PrEP products. For more on the historic opportunity LEN for PrEP represents and the profound threats that must be overcome to fulfill its promise, check out our blog: The Future of HIV Prevention Depends on Speed, Scale and Equity.

Learn All About LEN

4. Work in solidarity to champion science, evidence-based policies and investments in HIV research. 

This 24-hour program features more than 70 scientists, researchers, and advocates from around the world who give first-hand accounts of the achievements and impact of decades of federal investments in HIV research, and what’s at stake if those investments are not sustained. View the recording here, available to stream in 1-hour segments.

Learn More

5. Monitor, analyze, and document the impact of policies, programs, and investments. 

AVAC tracks and documents the impact and consequences of the US administration’s attack on science and divestment from global health institutions. 

View our Trackers

6. Empower the field with real-time updates that track and translate the pipeline of HIV prevention research, from basic science to product rollout.

PxWire is AVAC’s quarterly update on developments, challenges and opportunities in biomedical HIV prevention research. The latest issue maps the status of delivering injectable cabotegravir for PrEP, funders and countries on track for early introduction of injectable LEN, and where the new Phase 3 EXPrESSIVE efficacy trials testing MK-8527 as a monthly pill for PrEP are taking place. For more on the trials, check out The EXPrESSIVE Trials Test a Monthly Pill for PrEP: Advocates speak.

Read More

We hope these resources fortify the vital work that must continue. The year ahead promises to be no less challenging, but together we can meet the moment with a bold agenda to bring HIV prevention and equity in global health to everyone who needs it.

Global Health Watch: A Year That Reshaped Global Health

The Lancet journal ended the year with a provocative editorial – 2025: an annus horribilis for health in the USA. But sadly, it was not just in the US; it has been a year of chaos and disruption globally. This 49th issue of Global Health Watch looks back—like many news stories this week—across 2025 to highlight the most consequential decisions, disruptions, and debates that defined the year and will continue to shape what comes next.

On the first day in office, the new US Administration issued a sweeping foreign aid freeze that halted life-saving global health and HIV programs, severed active grants, research underway and cost millions of people their lives and livelihoods. In less than a month, AVAC responded suing the President, the State Department and the US Agency for International Development (USAID). The Global Health Council also led a similar lawsuit challenging the freeze as unlawful and harmful. Together, the two cases argued for months in various courts that the foreign aid freeze not only jeopardized health as a human right but also bypassed congressional authority and undermined trust in US leadership. Ultimately, the cases unlocked millions of dollars of development assistance for work done in January and February, but millions more dollars expired at the end of the fiscal year in September. The cases are ongoing and as important as ever, both to restore foreign assistance and to re-assert that it is Congress (and not the President) who has the power of the purse.

READ:  

Research Under Assault 

Science faced underfunding and systematic destabilization in 2025. In just one month under the new US Administration, the National Institutes of Health (NIH) abruptly canceled approximately 1,800 research grants. By April, mass layoffs and forced reassignments across Health and Human Services (HHS) agencies, including the Centers for Disease Control and Prevention (CDC), NIH, and US Food and Drug Administration (FDA), further crippled each agency’s capacity and expertise. A proposal to drastically cut the overall NIH budget and consolidate its 27 institutes was soon introduced along with the fiscal year 2026 budget, which proposed an $18 billion cut from the NIH and $1.5B cut in HIV prevention. Around the same time, the NIH signaled a major shift away from investments in basic science and clinical research, undermining the discovery pipeline that fuels future breakthroughs. Then, in November, HHS ordered the CDC to phase out all “non-essential” nonhuman primate research, threatening foundational preclinical studies, including those that have been pivotal to HIV PrEP and PEP, amongst many other health priorities. These actions were compounded by a pause or effective ban on some international research collaborations, a proposed cap on indirect cost rates that support core university infrastructure, and changes to the scientific review processes, together weakening the systems that sustain rigorous, independent research.

READ:  

The Cruel Irony of the Best Shot at HIV Prevention

Despite all the chaos, 2025 offered remarkable milestones in HIV prevention science, and a stark illustration of the contradictions shaping global health. Injectable lenacapavir for PrEP (LEN), the six-month injectable, which provides nearly complete protection against HIV infection, moved with unprecedented speed from regulatory approvals and guidelines to real-world introduction. South Africa and Zambia authorized LEN within months of US and EU regulatory approvals; the World Health Organization (WHO) rapidly issued guidance and prequalification; and initial LEN delivery began in Brazil, Eswatini, South Africa, and Zambia, setting the stage for expanded access in 2026. At the same time, efficacy trials began of the next promising PrEP option, the monthly oral candidate MK-8527, reinforcing what’s possible when innovation, evidence, and advocacy align.  
 
Yet, all this scientific momentum occurred alongside the deepest assault on global health and the systems that make it possible. The cruel irony of this moment is that as the science breaks barriers, the infrastructure meant to support discovery, evaluation, and equitable delivery is being weakened, threatening the very gains the field has fought decades to achieve. As AVAC has emphasized, the greatest opportunity in HIV prevention lies in speed, scale, and equity.

READ:  

Attack on Vaccine Science 

Actions in the last 11 months have eroded evidence-based policy, disrupted institutional capacities, and deepened mistrust and uncertainty in vaccine science. In May, NIH’s National Institute of Allergy and Infectious Diseases (NIAID) announced that funding for the Consortia for HIV/AIDS Vaccine Development (CHAVD) would end after the current grant cycle in June 2026 — eliminating $67 million annually and about 10% of global HIV vaccine research funding. Then, $500 million in Biomedical Advanced Research Development Authority (BARDA) grants for research and development of the mRNA vaccine platform were soon cancelled, and members of the CDC’s Advisory Committee on Immunization Practices (ACIP) were replaced. The US also stopped supporting Gavi, the vaccine alliance, and language on the CDC website was replaced with anti-science and anti-vaccine sentiment. As AVAC said in an August statement, “These actions dangerously sow vaccine disinformation and mistrust, which has proliferated since the COVID-19 pandemic. Dangerous ideology results in dangerous policymaking, putting many lives at stake and complicating efforts to both discover and implement clinical and cost-effective interventions to make America and the world healthier, safer, and more prosperous.”

READ:  

Changing Global Health Architecture 

As rising nationalism, geopolitical tensions, and funding retrenchment intensify, the architecture of global health and how countries engage in it and with one another is being fundamentally reshaped. Longstanding multilateral systems are giving way to a more fragmented, country-to-country model under the US America First Global Health Strategy. The strategy prioritizes bilateral health Memorandums of Understanding (MoUs) with individual countries in exchange for funding support, data sharing, and pathogen access, signaling a major recalibration away from traditional multilateral institutions and frameworks. Meanwhile, the US stepped back from longstanding global health platforms including an unprecedented absence at the World Health Assembly, withdrawal from the WHO, and diminishing support for joint initiatives like Gavi, the vaccine alliance. Civil society and advocates are actively debating what this means for shared goals and equity in global health, even as institutions like WHO and UNAIDS explore how to adapt in a rapidly evolving landscape.

READ:

What We’re Reading:

Global Health Watch: UNAIDS launches review, NIH GoF controversy, support for IDSA’s Jeanne Marrazzo, UK authorizes LEN for PrEP

This week the UNAIDS board approved a new Global AIDS Strategy and launched a formal review of the agency’s future; turmoil at the NIH continues over gain-of-function research; and the scientific community rallies around the Infectious Diseases Society of America’s (IDSA) appointment of Jeanne Marrazzo as its chief executive officer. Also, the UK regulatory agency approved lenacapavir for PrEP (LEN) marking its seventh regulatory approval in just six months.

UNAIDS Launches Review Process on its Future

Following last week’s intense discussions at the UNAIDS Programme Coordinating Board (PCB), the UNAIDS board this week launched a new, formal process to examine the organization’s future and potential transition pathways. This comes from within the UN80 reform initiative that proposed to sunset UNAIDS by the end of 2026. But civil society and PCB members pushed back, and the board agreed to initiate a “structured review” that explores different scenarios for UNAIDS’ role, mandate, and positioning within a changing global health architecture. This announcement came on the heels of the PCB approving the Global AIDS Strategy for 2026–2031 and alarms raised by civil society about funding cuts, service disruptions, and the risk of losing a central coordinating body at a critical moment in the HIV response. 
 
IMPLICATIONS: The launch of this process to examine UNAIDS’ future raises important questions about governance, accountability, and continuity in the global HIV response. Civil society’s strong pushback underscores that any reform must preserve UNAIDS’ core mandate and ensure that the global HIV response remains centered on those most affected — especially women, girls, and key populations — rather than being quietly dismantled at a moment of crisis.

READ:  

Continued Turmoil at the NIH – Gain-of-Function (GOF) Research 

Turmoil at the NIH continued this week as, John Beigel, a prominent influenza researcher and acting director of NIAID’s Division of Microbiology and Infectious Diseases (DMID), resigned following controversy over an NIH-supported seasonal flu virus study and how its potential risks were assessed and communicated. Beigel’s departure unfolds amid ongoing debate over how the NIH defines and oversees gain-of-function (GOF) research—work that could increase the transmissibility or virulence of pathogens with pandemic potential.  
 
Science reports that the controversy was a “‘pseudomanufactured concern’ that was meant to force him out, so officials could bring in a researcher who has strongly supported Trump.” Beigel is being replaced by an infectious disease scientist from NIH’s Fogarty International Center and who has publicly expressed support for the President and donated to his affiliated political committees.

IMPLICATIONS: Alongside last week’s revelations and Jeanne Marrazzo’s whistleblower lawsuit, Beigel’s departure heightens concerns about instability and governance at NIH at a time when scientific leadership and public trust are critical. Debates over GOF research, including its definition, oversight, and whether the White House or the NIH sets the rules show the precariousness of the agency. As Science reports, concerns about GOF work have gained momentum with the popularization of the belief that Chinese scientists who received NIH funding created the virus that caused the COVID-19 pandemic. Many Republicans have promoted this unproven theory, and Trump signed an executive order in May that called for stricter oversight of GOF work. 

READ:  

Leaders Support Jeanne Marrazzo as new CEO of the Infectious Diseases Society of America (IDSA) 

Leaders in the scientific and infectious disease communities praised the Infectious Diseases Society of America (IDSA) appointment of Jeanne Marrazzo as its next chief executive officer. Former NIAID Director Anthony Fauci called her a “superb choice,” and AVAC’s Mitchell Warren said, “It speaks to IDSA’s desire to emphasize science over politics and science over ideology, and that’s what you will get with Jeanne Marrazzo.” Virologist Angela Rasmussen, said Marrazzo’s appointment “suggests to everybody who’s a member of that professional society that they’ve got a leader who’s actually going to do something about this rather than trying to protect the institution more than its members.” Marrazzo begins her tenure January 12. 

READ:  

UK’s Medicines and Healthcare products Regulatory Agency (MHRA) Approves LEN for PrEP

This is the seventh regulatory approval of LEN for PrEP. See AVAC’s detailed map of regulatory approvals, pending decisions, and appeals, along with other LEN resources here.

Read More

What We’re Reading

30 Years of Standing for Science and Equity

This month, AVAC marked our 30th anniversary. Over three decades, the HIV field has evolved dramatically—but what we do, and why we do it, has remained constant: standing for science, equity, and community leadership, and ensuring evidence drives decisions that affect people’s lives. We’ve been able to do this work because of your partnership and support, and we are deeply grateful.

Last week, we also released the 2025 update of the People’s Research Agenda (PRA), which tracks the science, highlights where investments align—or fail to align—with community priorities, and identifies critical gaps that must be addressed to ensure the prevention pipeline meets the needs of diverse populations. After ten months of disruption and uncertainty across biomedical research and global health, we hope this agenda helps share a path forward, one that will demand sharper priorities, smarter investments, and a balanced portfolio focused on real epidemic impact.

At the same time, we are seeing real progress. In just the past month, people in Brazil, Eswatini, South Africa, and Zambia began receiving the first doses of lenacapavir for PrEP (LEN) through early implementation programs outside the US, with additional deliveries of LEN planned for Eswatini, Zambia, Kenya, Lesotho, Mozambique, Nigeria, Uganda, and Zimbabwe.

AVAC’s updated map of Global Fund and PEPFAR-supported LEN supply shows how quickly this breakthrough is moving and what’s possible when political will, funding, community engagement, and innovation align. But there is still so much more to do – as we wrote last week, science alone won’t get us there: the future of HIV prevention depends on speed, scale and equity. 

As these advances continue to develop, AVAC will continue to help make sense of the rapidly shifting global health landscape. From World AIDS Day passing with little acknowledgment by the US government, to the LEN rollout (and South Africa being left behind), to the gutting of foreign aid and impact on HIV prevention and global health, to new bilateral health MoUs under the US “America First” strategy, AVAC has shared real-time analysis and context on the most pressing issues of December. Global Health Watch, now in its 46th week, will continue providing consistent, trusted context so you can navigate the turmoil with clarity, purpose and solidarity.   

As we enter our fourth decade, your support makes it possible for AVAC to keep tracking the science, elevating community priorities, and delivering real-time analysis when it matters most. If you’re able, we invite you to consider making a year-end gift to sustain this work. 

Thank you for being part of this work, and for standing with AVAC. 

Global Health Watch: NIH turmoil + a high-profile lawsuit, future of UNAIDS, more Countries sign “America First” MoUs with US

Issue 47

This week covers the significant turmoil at the US National Institutes of Health (NIH), including a close look at the NIH deputy director’s role in disruptions in leadership and funding cuts, and a lawsuit filed by the former Director of the National Institute of Allergy and Infectious Diseases (NIAID). It also covers urgent civil society pushback against efforts to sunset UNAIDS, the rapid expansion of US “America First” bilateral health agreements across Africa, and what’s next for STI research, prevention and diagnostics.

NIH Leadership Turmoil

A new investigation by The Atlantic’s Katherine Wu examines the central role of the Deputy Director of the National Institutes of Health (NIH), Matthew Memoli, in recent leadership changes and funding cuts across the NIH, including the firing of former NIAID Director, Jeanne Marrazzo, and the reassignment of Carl Dieffenbach, longtime director of NIAID’s Division of AIDS, to another NIH center. The Atlantic’s reporting shows how these decisions have significantly weakened NIAID, with particularly acute impacts on HIV prevention and vaccine research, where programs, expertise, and long-term scientific capacity are being eroded amid broader restructuring and budget shifts.

In addition, this week, Dr. Marrazzo, the newly appointed chief executive officer of the Infectious Diseases Society of America (IDSA), filed a lawsuit against the US federal government. The lawsuit alleges that Marrazzo was illegally fired from her position and seeks to be reinstated as head of NIAID and to receive formal declarations that her rights were violated. The suit argues that her firing was retaliation for a whistleblower complaint she filed on September 3, in which she raised concerns about anti-vaccine positions held by newly appointed NIH officials; demands to halt clinical trials; and requests to cut international research collaborations. Twenty-two days after filing the complaint, Marrazzo was fired by Health and Human Services Secretary, Robert F. Kennedy Jr.

IMPLICATIONS: The developments at the NIH show instability at its leadership level and severe consequences for infectious disease research, particularly vaccine research. This comes at a time when sustained R&D investment is most critical. Without robust research support, future advances in next-generation options could stall. See the new People’s Research Agenda, which calls for a balanced HIV prevention portfolio that is optimized for impact. However, Marrazzo’s new role at the IDSA, which represents clinicians, scientists and public health experts who are driving policy and advocacy to address critical issues in combating infectious disease, will be pivotal in ensuring rigorous science, inclusion and equity in research, community engagement, and evidence-based communications remain central to tenors in global health discourse and debate.

READ:  

Future of UNAIDS 

Member states and civil society convened at the 57th meeting of the UNAIDS Programme Coordinating Board (PCB) in Brazil this week to discuss urgent decisions about the future of the global HIV response amid deep funding cuts and a shifting global health landscape. They reviewed and approved the Global AIDS Strategy 2026–2031 and assessed the impact on communities from disruptions to services for HIV prevention and treatment. Civil society representatives on the PCB shared comments, and African women leaders and other civil society groups issued statements (and sign-ons) denouncing efforts to sunset UNAIDS by the end of 2026: “Any move to sunset UNAIDS before ending AIDS as a public health threat is premature and unacceptable. No sunsetting until we finish the job. AIDS is not over.”  

The PCB also held a special thematic session on long-acting ARVs for treatment and prevention. See this clip from Yvette Raphael where she included AVAC’s latest blog in her remarks about the current context: “We cannot let cruel international policy allow historic gains to collapse, just as a few highly effective prevention options arrive. That is why rolling out LEN to all countries that need it with speed, scale and equity must be our uncompromised, uncompromising priority. If we do this, we can change the trajectory of the epidemic, but only if we act at the pace that data and science demand.”

IMPLICATIONS: As the world moves toward the June 2026 High-Level Meeting on HIV, and the rollout of the new Global AIDS Strategy, the strong pushback by civil society at the PCB underscores that any reform must preserve UNAIDS’ core mandate and ensure that the global HIV response remains centered on those most affected — especially women, girls, and key populations — rather than being quietly dismantled at a moment of crisis.

READ:  

Eswatini and Mozambique Join Growing List of African Countries to Sign “America First” Bilateral Health MoUs

Mozambique and Eswatini are the latest countries to sign the bilateral health Memorandums of Understanding (MoUs) with the United States under the America First Global Health Strategy, adding to earlier agreements with Kenya, Liberia, Rwanda and Uganda. These agreements provide 5 to 10 years of funding and health support in exchange for co-financing, health data, pathogen-specimens, and national health system data, marking a major shift in how global health cooperation is structured under US leadership.   

IMPLICATIONS: The pace of these agreements shows how quickly the Administration is moving to reshape US global health with little time for discussion and debate on transparency, consultation, and how civil society fits within this evolving framework. As the landscape shifts, civil society and non-governmental organizations must quickly reassess their roles in the hope of preserving aid delivery, accountability, and equity. 

READ:  

The Future of HIV Prevention Depends on Speed, Scale and Equity

“Every funding cut can represent at minimum, a delay. Every delay in rollout is a missed chance to prevent infections. Every un- or underfunded clinic is a barrier to access. Every policy is a choice to be inclusive or leave someone behind…”

Read AVAC's New Blog

What We’re Reading

STIs Spotlight

AVAC’s STI program looks back at 2025—and ahead to 2026—tracking rising STI rates, major HPV vaccination gains, slow but promising diagnostics, the growing role of self-care, and what’s next for STI research, prevention and diagnostics.

Read More

AVAC Board Member Jeanne Marrazzo named CEO of IDSA 

AVAC enthusiastically applauds the selection of Jeanne Marrazzo, MD, to serve as the new chief executive officer of the Infectious Diseases Society of America (IDSA). Marrazzo brings outstanding leadership and research expertise to this role. She has demonstrated decades of unwavering commitment to research and advocacy for HIV and STI prevention, and a deep understanding of the importance of equity, accountability and trust in science, research and global health.

“Jeanne Marrazzo is an extraordinary choice and perfectly suited to lead IDSA and the larger infectious disease field into the future, especially at this particularly perilous moment,” said AVAC’s executive director, Mitchell Warren. “Her deep commitment to rigorous science, inclusion and equity in research, community engagement, and accurate, evidence-based communications is unparalleled — and is needed now more than ever.”

IDSA represents clinicians, scientists and public health experts from around the world, who are driving policy and advocacy to address critical issues in combating infectious disease, from workforce development to clinical guidelines to pandemic preparedness. Marrazzo’s vision, abiding integrity and leadership at IDSA will be a boon for the field.

Marrazzo, an AVAC board member, previously served as the director of the NIH’s National Institute of Allergy and infectious Disease (NIAID). Marrazzo was put on administrative leave by the new US presidential administration earlier this year and was formally dismissed from her position in September. She has consistently displayed extraordinary commitment, courage and leadership in responding to attacks on the NIH and on science generally.

“Her actions are a model for all who believe equity and evidence are the bedrock of science, research and health. We proudly stand with Dr. Marrazzo, and we look forward to her leadership and partnership in sustaining progress against HIV and other infectious diseases and in helping re-build trust and confidence in science and public health,” said Warren.

The Future of HIV Prevention Depends on Speed, Scale and Equity 

When the US Food and Drug Administration approved lenacapavir (LEN) fro PrEP, it offered something rare in public health: a genuine turning point. We now have one of the greatest opportunities and scientific breakthroughs that we’ve had in HIV in 44 years: a twice-yearly injectable that showed near-complete protection against HIV in major trials. Science has given us a breakthrough. What happens next is up to us. 

But as AVAC Executive Director Mitchell Warren recently noted on ABC News and CNN, this moment of possibility is colliding with a moment of profound danger. The US administration’s proposed cuts to HIV prevention programs could reverse decades of progress in research, care, and rollout of new options. If that happens, even the most powerful tools like LEN will fall short. This is not a theoretical concern. It’s a warning, and one we must urgently act on.

We cannot let cruel international policy allow historic gains to collapse just as a new, highly effective prevention option arrives. That is why rolling out LEN — to all countries that need it — with speed, scale, and equity must be our uncompromising priority. If we do this right, we can change the trajectory of the epidemic — but only if we act at the pace the science demands. 

  • Speed means national programs must approve, adopt, and distribute LEN now — not after years of bureaucratic drift or pilot-project hesitation. People at risk cannot wait. 
  • Scale means strengthening and funding the infrastructure to make LEN widely available — across entire systems and communities. 
  • Equity means ensuring LEN reaches the people most affected by HIV — including and prioritizing those historically sidelined, discriminated against, or left behind — not just the communities that are easiest to reach. 

Without speed, we lose momentum. Without scale, we limit impact. Without equity, we repeat the failures of the past.  

We are in a golden moment, where innovation, evidence and opportunity align. But proposed funding cuts could undo everything. These aren’t abstract numbers on a page. These cuts would shutter clinics, slow prevention, restrict treatment, and roll back the very systems that allow new tools like LEN to reach people. Watch this powerful call-to-action from APHA Executive Director and longtime AVAC partner Yvette Raphael at the recent UNAIDS meeting.

As Mia Malan recently reported in Bhekesisa, the US government recently announced that it would, join the Global Fund to buy LEN for African countries with high HIV infection rates. She reports, “the Trump administration revealed its support was a “market-shaping initiative” with the goal to increase LEN production and uptake, and, in effect, bring down the price of the jab as fast as possible, so that countries could eventually buy the medicine themselves. But they left South Africa — with the largest market for LEN, because it has the highest number of new HIV infections in the world — off the list.”

Warren spoke with Malan about this misguided decision, saying “If you want to build large volumes of a product, whether it’s lenacapavir or Coca-Cola — because we know that large volumes will lower prices — you make sure you start off with the biggest market, because that’s how you will shape the market the fastest and most meaningfully. So South Africa is the place where you’d want to be. Economically, because that’s how you will build the market the quickest. Epidemiologically, because that’s how you will prevent the most new infections. Practically, because that’s the country with the most mature HIV prevention medication market in the world.”

It makes no sense to celebrate the arrival of a breakthrough PrEP option while simultaneously dismantling infrastructure required to deliver it. We cannot allow ideology take over epidemiology. And we cannot end HIV with half-funded programs and half-hearted commitments. We cannot end HIV by retreating just as we need to push forward. We cannot end HIV if we abandon the global leadership that have made decades of progress possible. 

This is the paradox we face: extraordinary scientific promise shadowed by political short-sightedness. To realize LEN’s potential we need urgency, not hesitation. Governments must rapidly integrate LEN into national guidelines, commit domestic funding, and remove regulatory and logistical bottlenecks. Global donors, especially the US government, must protect and expand HIV investments, not shrink them. Scaling LEN requires resources, commitment, and sustained political leadership. Community organizations must lead rollout strategies, ensuring they are people-centered, stigma-free, and grounded in lived experience. And advocates must insist that LEN is rolled out now.  

If we get this right, LEN will be a global prevention pillar: accessible, trusted, and transformative. 

Let’s be clear. Every funding cut can represent at minimum, a delay. Every delay in rollout is a missed chance to prevent infections. Every un- or underfunded clinic is a barrier to access. Every policy is a choice to be inclusive or leave someone behind. No one should face risk of HIV simply because innovations didn’t move fast enough, weren’t scaled broadly enough, or weren’t delivered equitably.

We must act like the future depends on our choices, because it does. Science alone won’t get us there. Speed, scale, and equity will.  

Global Health Watch: 4 African Countries Sign Bilateral Health MoUs with US, New People’s Research Agenda, Hepatitis B Vaccine Shift

Issue 46

This week covers fast-moving developments with new US bilateral Memos of Understanding (MoU) across Africa, including reactions from Kenya’s High Court, which suspended the agreement over the issue of sharing of health data, alongside new reporting on the adverse impact of US policy changes affecting science and research institutions, and a major reversal in US hepatitis B vaccine policy. We also track the newly updated People’s Research Agenda.

Four African Countries Signed Bilateral Health MoUs with US; Kenya’s Court Intervenes 

So far, four Africa countries have signed bilateral health MoUs with the US under the “America First Global Health Strategy”: Kenya, Liberia, Rwanda and Uganda. These agreements provide 5 to 10 years of funding and health support in exchange for co-financing, health data, pathogen-specimens, and national health system data, marking a major shift in how global health cooperation is structured under US leadership. Kenya’s agreement, which was the first and largest to date, promises about US $1.6–1.7 billion over five years and a commitment from Kenya to raise domestic health spending. Civil society groups across Africa and globally are sounding alarms about the process noting that agreements have been negotiated and signed without public consultation, parliamentary oversight, or community input. Thursday, Kenya’s High Court issued a conservatory order, temporarily blocking any transfer or sharing of sensitive health data until a full hearing in early 2026. The Court is reviewing two major petitions: one on data protection and digital rights, and another on whether the MoU bypassed constitutional requirements for parliamentary approval. 

IMPLICATIONS: These MoUs begin to reconstruct US-led global health investments, moving away from multilateral frameworks and programs informed by community and civil society input toward bilateral, government-to-government agreements. This raises critical questions about sovereignty, transparency, and equity with health data and biological samples being treated as bargaining chips, and unclear protections for privacy, benefit-sharing, or local ownership. The Kenya High Court’s ruling underscores the seriousness of these concerns. African nations with larger economies, such as Kenya, may be better positioned to push back against problematic provisions, but many other countries may not have the same leverage.  

READ:  

The Consequences of US Policy Decisions on Science and HIV Research 

A wave of new reports and commentary are showing the far-reaching impacts of recent US policy decisions on science and global health. STAT released American Science, Shattered, a multipart investigation detailing how actions taken under the US Administration have disrupted research labs, upended scientific careers, and fractured an eight-decade partnership between universities and the federal government.  

In case you missed it, scientists, researchers, and advocates participated in the Save AIDS Research Marathon sharing firsthand accounts of what decades of federally supported HIV research have delivered—and what stands to be lost. Their stories highlight how foundational US investments have driven breakthroughs in the treatment and prevention of HIV and other diseases that have saved tens of millions of lives, and how recent project terminations and budget cuts are already reverberating across the research landscape.

US Panel Votes to Change Longstanding US Hepatitis B Vaccine Policy 

Last Friday the Advisory Committee on Immunization Practices (ACIP), which was dismissed and replaced with vaccine-skeptical members, voted (contentiously) to change longstanding US hepatitis B vaccine policy. Instead of universally recommending that all newborns receive a hepatitis B vaccine at birth, without any new data or evidence, the committee now advises that a birth dose be given only to infants born to mothers who test positive for the virus or whose infection status is unknown. The panel recommended that mothers who test negative for hepatitis B delay vaccination for two months and use antibody testing to determine whether to administer a third dose, further decreasing the likelihood that infants will receive full immunization against a leading cause of liver cancer.  

IMPLICATIONS: This decision reflects broader disruptions at the US Centers for Disease Control and Prevention (CDC) that are eroding evidence-based vaccine policy in the US and raising alarm among global health advocates. Leading physician groups and public health experts issued a warning that the policy change could result in unnecessary illness and death, arguing that it departs from the robust scientific evidence that underpinned the universal birth-dose strategy. At a time when confidence in vaccine programs remains essential to strategies for the control of infectious disease, this decision brings uncertainty into routine vaccine recommendations and risks further eroding trust in public health institutions. 

READ:  

Just Launched! The 2025 update of The People’s Research Agenda

AVAC and partners released the 2025 update of The People’s Research Agenda (PRA), a people-centered framework to drive equitable and accelerated HIV prevention research and development (R&D) and product introduction. The PRA tracks the science, highlights where investments align—or fail to align—with community priorities and identifies critical gaps that must be addressed for the pipeline of HIV prevention to meet the needs of diverse populations. This year’s update includes an expanded online dashboard for tracking, translating, and advocating for HIV prevention R&D. 

CONTEXT: The past ten months have wreaked havoc on biomedical research, and the path forward now demands sharper priorities, smarter investments, and a deliberately balanced portfolio that reflects what is both needed and achievable to drive real epidemic impact. Every funding decision carries greater weight in determining whether communities will have meaningful choices in prevention. Sustaining progress requires protecting the full continuum of research: investing in basic science and early-phase discovery, supporting late-stage trials and product development, and ensuring community engagement and implementation science remain central to translating advances into access. Ultimately, the goal is a pipeline that delivers viable, effective, people-centered prevention options to those who need them most.   

READ:  

What We’re Reading

Track the Science; Advance the Priorities

The 2025 Update of the People’s Research Agenda

We are delighted to share our 2025 update of The People’s Research Agenda (PRA), offering an online, interactive dashboard for tracking, translating, and advocating for HIV prevention research and development (R&D). First developed in 2024 in partnership with global advocates and communities (and launched at the HIV Research for Prevention (R4P) conference in Lima), the PRA sets out a people-centered framework for equitable and accelerated R&D and product introduction. The PRA tracks the science, shows where investments align—or fail to align—with community-defined priorities, and spotlights critical gaps in the pipeline of prevention options needed to meet the diverse realities of all populations.

Explore the dashboard and register for our upcoming webinar, The Future of HIV Prevention: A People’s Research Agenda for Speed, Scale and Equity, on January 20, 2026, at 9am ET. With featured speaker Jeanne Marrazzo, former Director of National Institute of Allergy and Infectious Diseases and AVAC board member, we will cover what the PRA is tracking, why it matters and the advocacy priorities that will shape the future of prevention R&D.

Because HIV prevention R&D must remain a core priority in the HIV response, the PRA offers the evidence and insight needed to secure support for a community-centered research pipeline. More than a report and data tool, the PRA is a continually updated accountability mechanism that can transform information into influence.

Since the People’s Research Agenda first launched in 2024, much has happened. US funding cuts terminated an entire portfolio of critical HIV prevention research programs, including ADVANCE and BRILLIANT, which were studying African-led vaccine concepts; MATRIX, which was studying shorter-acting, user-controlled ARV-based PrEP and dual-purpose options; and MOSAIC, which was conducting an implementation science study of PrEP options. But new efficacy trials are now underway testing a monthly PrEP pill and several early-phase vaccine candidates are investigating a number of strategies.

The field must face head-on this new reality with sharper priorities and smarter investments. We invite you to dig into this 2025 update of the PRA, to join in our calls to action, and continue the fight for critical research that will finally bring the HIV epidemic to an end.

Global Health Watch: World AIDS Day advocacy, first injections of LEN for PrEP, CDC turmoil, Kenya signs US MoU

Issue 45

In 1990, the US Centers for Disease Control and Prevention (CDC) codified five principles under the late Walter Dowdle as its pledge to the American people, including a promise to ground every public-health decision in the highest-quality scientific data and to treat all people with dignity, honesty and respect. But today, as political forces undermine science and erase commitments like World AIDS Day, we are reminded just how fragile those principles have become, and how essential they remain. 

This week we track both momentum and mounting threats in the HIV response: powerful World AIDS Day advocacy even as the US refused to recognize it; first recipients of lenacapavir for PrEP in Brazil, Eswatini, South Africa and Zambia; continued CDC turmoil that threatens trust in vaccines and science-based public health; the US’ “New G20” without South Africa; and Kenya signs the first US global health Memo of Understanding (MoU).

World AIDS Day

Despite the current US administration refusing to recognize December 1 as World AIDS Day (as described here in National Public Radio’s Goats & Soda), global media coverage and action were strong. On South Africa’s eNCA evening newscast, CAPRISA’s Slim Abdool Karim and AVAC’s Mitchell Warren underscored the need for smart, strategic decisions to prevent infections and ensure access to treatment. ABC News featured additional warnings about the devastating impact of US cuts and politics, and CNN highlighted what happens when ideology trumps epidemiology.  

For additional reflection, Emily Bass and Ben Plumley offered a powerful—and sobering—conversation via the Shot in the Arm podcast about how political decisions can upend global HIV progress, and how affected countries are increasingly taking control of their responses.  

The Journal of the International AIDS Society also published two commentaries for the day. Former CDC leader and longtime HIV advocate and clinician Demetre Daskalakis penned This is not normal: a call for HIV activism, and IAS president Beatriz Grinsztejn and colleagues wrote From Kigali to Rio: advancing an evidence‐based and equitable HIV response.  

At ICASA, the Lancet published a six-paper series on Sustainable HIV prevention in Africa, which shares why epidemic control depends on shifting from fragmented, donor-led programs to country-led, integrated systems, using examples of impact from seven African countries. 

And in New York City, the #SaveHIVFunding campaign rang the NASDAQ stock market’s opening bell in recognition of World AIDS Day and a national week of action, sending a powerful message of unity, resilience, and national resolve to protect the lifesaving HIV programs that millions of people in the US and around the world rely on. 

First Injections of LEN for PrEP

This week people in Brazil, Eswatini, South Africa and Zambia received the first injections via implementation programs outside of the US of lenacapavir for PrEP (LEN). The Global Fund to Fight AIDS, Tuberculosis and Malaria anticipates additional deliveries of LEN in the coming months to both Eswatini and Zambia as well as to Kenya, Lesotho, Mozambique, Nigeria, South Africa, Uganda and Zimbabwe. See AVAC’s updated map of Global Fund and PEPFAR supplies to early introduction countries. Meanwhile, national regulatory agencies in Malawi and Zimbabwe approved LEN for PrEP, bringing the total number of approvals to six. See AVAC’s updated LEN regulatory map. 

IMPLICATIONS: These milestones signal a new dawn for HIV prevention—the speed at which LEN is being approved and delivered shows what’s possible when political will, funding, community engagement and innovation align. But this speed must now be matched by scale and equity: to truly change the trajectory of the epidemic, LEN must reach all who need it and be sustained over time. Read more about the events by advocates and partners on LinkedIn here, here and here. Also GBGMC’s Micheal Ighodaro explored the transformative potential of LEN for PrEP if countries commit to access, especially for key populations in Think Global Health. 

READ:  

Continued Chaos at the US Centers for Disease Control and Prevention (CDC)

A recent New Yorker investigation captures the political interference at the CDC under Health and Human Services (HHS) Secretary, Robert F. Kennedy Jr., which includes changes that are undermining the scientific consensus that vaccines do not cause autism. This week the Advisory Committee on Immunization Practices (ACIP), which was dismissed and replaced with vaccine-skeptical members, meets to consider delaying the hepatitis B vaccine dose at birth, which would be a major departure from decades of proven public-health practice. The Committee meets under a new chairperson, Kirk Milhoan, who has blamed vaccines for causing cardiovascular disease, and began his post just this week. Meanwhile, the CDC issued a warning to clinicians to watch for Marburg virus cases linked to an outbreak in Ethiopia, highlighting emerging global health threats amid institutional instability. 

IMPLICATIONS: By dismantling long-standing expert advisory processes and politicizing vaccine guidance, the US is undermining domestic immunization programs and also global confidence in science-driven public health. The potential delay or rollback of routine immunizations threatens to reverse decades of progress, fueling distrust that could spill over into HIV, TB, and other health areas. At such a pivotal moment for HIV prevention, cure research, and vaccine development, destabilizing vaccine policy in the US risks eroding momentum worldwide. 

READ:  

US Announces a “New G20” Excluding South Africa

Following the closure of the widely hailed G20 summit in South Africa last week where the US was notably absent, this week, the US shared plans for a “New G20” for 2026, which adds new members and excludes South Africa from the summit in Miami next December. In a statement, US Secretary of State, Marco Rubio unfairly and alarmingly called out South Africa’s current government: “Rather than take responsibility for its failings, the radical ANC-led South African government has sought to scapegoat its own citizens and the United States”. In response, South Africa signaled it will take a “commercial break” from G20 participation during the US-led presidency.  

IMPLICATIONS: The exclusion of South Africa in the US-led 2026 summit is a warning sign. South Africa has been a leading voice for African and Global South priorities, including equitable access to health, the HIV/AIDS response, and social justice. By sidelining the country with mis- and dis-information, the US risks marginalizing regions already facing unequal burden of disease and limited resources. Key funding, efforts to expand access to medicines and HIV prevention tools may suffer from fractured governance and most vulnerable communities could lose out on representation, accountability, and the collective leverage needed to secure health equity worldwide. 

READ:  

Kenya Signs MoU Under New US Global Health Strategy For $1.6B

Kenya became the first country to sign the controversial US Health Memos of Understanding (MoU) earning $1.6B in funds disbursed through the next five years in exchange for health care data and specimens for the next 25 years. US Secretary of State Rubio suggested this was the first of many countries (up to 50) to sign the MoUs. 

IMPLICATIONS: Kenya’s decision trades long-term access to health data and biological samples for short-term funding raising serious concerns about sovereignty, consent, and accountability. If this agreement becomes the model for dozens more countries, the future of global health cooperation could shift toward transactional arrangements that prioritize US geopolitical interests over community rights and health equity. 

READ:  

HIV UnWrapped

Now streaming on Hulu: HIVUnwrapped: Where Fashion Meets Science — a powerful look at how HIV researchers and fashion designers are teaming up to bring information on HIV to new audiences.

Watch!

What We’re Reading

Upcoming Webinar

Join us for a conversation on the state of HIV cure research in Africa and the opportunities to strengthen and scale Africa-led innovation with leaders from Africa Health Research Institute, KwaZulu-Natal, Root to Rise and moderated by Anna Miti.

Register