Global Health Watch News Brief

February 14, 2025

This week has brought continued confusion around PEPFAR waivers, reports on the devastating impacts of the funding freeze and the fight to reverse harmful policies as the new administration attempts to dismantle USAID and shrink the federal government. These developments are threatening decades of progress in HIV prevention and treatment. Find details on these updates below.

New Developments

Global health organizations are challenging the US administration’s freeze on foreign aid and funding. AVAC and the Journalists Development Network in partnership with Public Citizen filed a federal lawsuit seeking to reverse the freeze, arguing it is unconstitutional and causes “needless death, destruction and immiseration.” This encompasses extensive harm to lifesaving HIV prevention and treatment programs. Similarly, the Global Health Council along with other large development agencies filed an additional, similar lawsuit seeking relief to protect the global health sector and ensure the continuation of vital foreign assistance.  

IMPLICATIONS: If successful, the lawsuits could result in the funding freeze being declared illegal. The new administration could face further court action if they ignore a finding of illegality. Reversing the freeze would allow PEPFAR and other vital programs to resume and protect global health initiatives from presidential overreach. 

READ:

• New lawsuit challenges US foreign aid funding freeze — Devex 
• Two nonprofits sue over Trump’s freeze on foreign aid — The New York Times 

The rollout of PEPFAR waivers has so far been mired in confusion and inconsistency. The latest tracking from amfAR and partners report that as of February 9, “most lifesaving services [from PEPFAR] remain paused”. Among PEPFAR-funded providers who were surveyed, 36% reported they had completely closed down. Only 10% had restarted offering services. As AVAC Executive Director Mitchell Warren told Science Magazine in ‘Madness’: Trump Freeze on Global HIV Prevention Efforts Sparks Disbelief and Anger, “This is not only bad politics in terms of government-to-government relationships, it is bad medicine, it is bad science, and it is dumb.” He further described the chaos to Bhekisisa, saying, “The flurry of actions really provides an unprecedented amount of whiplash, wondering each day what to do, what not to do.” Organizations are still waiting for formal certification letters, adding to the uncertainty.

A February 6 waiver from the State Department allowed some PEPFAR treatment and PMTCT programs to resume, but primary HIV prevention efforts—particularly access to PrEP and VMMC—have been explicitly blocked, except PrEP for pregnant and breastfeeding women. “People who may be at high risk, such as key populations, or were previously initiated on PrEP cannot be offered PEPFAR-funded PrEP…”. Advocates are calling for an immediate reversal.  

IMPLICATIONS: By blocking access to PEPFAR-funded PrEP for most at-risk populations, the administration is cutting off a proven prevention method. It is ignoring decades of scientific evidence and threatening to reverse progress, putting millions of lives at risk.

READ:

• The Human Cost of PEPFAR’s PrEP Restrictions — AVAC blog
• Trump’s Foreign Aid Freeze Is Severely Limiting PrEP Drugs For HIV — Huffington Post 

The National Institutes of Health (NIH) announced that it would be capping “indirect” costs—used for facilities, administrative support, and compliance—at 15%, down from an average of 30-70%. This decision threatened to impose drastic funding cuts to public research institutions. However, lawsuits and backlash ensued and on Tuesday, a temporary pause was put on these plans. In addition, NIH’s Deputy Director and Director of Extramural Research have resigned, signaling major upheaval at the NIH. While the details remain unclear, it’s increasingly evident that something major is unfolding at the NIH. 

IMPLICATIONS: Indirect spending is vital to the success of biomedical research, training and care, including support for medical staff, research and safety equipment, salaries and tuition for the next generation of nurses, doctors and researchers. A decrease to the indirect costs to a standardized rate of 15% will have a devastating and long-lasting impact on US research institutions, particularly on state universities that rely on Federal indirect costs to support the advanced medical facilities required for research and healthcare. These cuts will affect current clinical trials, force labs to close, and erode US leadership in biomedical research.

Robert F. Kennedy Jr. was confirmed Thursday as Health and Human Services (HHS) Secretary despite concerns over his vaccine skepticism, AIDS denialism, and racist views of immunology. He now oversees the CDC, NIH, FDA, and other key health agencies—impacting funding, programs, and science communication.  

IMPLICATIONS: RFK’s history of promoting HIV/AIDS denialism and spreading misinformation about vaccines could undermine trust in established HIV prevention and treatment strategies. RFK’s leadership threatens to undermine evidence-based policies and could reverse decades of progress in global health. 

READ THESE OP-EDs:

• RFK Jr is in. Is health in America on its way out?, by Ida Juste — Bhekisisa 
• When ‘Just Asking Questions’ About Science Turns Into 300,000 Dead, by Gregg Gonsalves — The New York Times 

A judge ruled that the Department of Health and Human Services (DHHS), the Food and Drug (FDA) Administration and the Centers for Disease Control and Prevention (CDC) must restore online access to websites and pages with data and guidance on HIV monitoring, health risks for youths and assisted reproductive technologies. Other websites have yet to be restored.

What We’re Reading

• Potential Clinical and Economic Impacts of Cutbacks in the President’s Emergency Plan for AIDS Relief Program in South Africa: A Modeling Analysis — Annals of Internal Medicine
• Lifesaving Aid Remains Halted Worldwide Despite Rubio’s Promise — The New York Times
• US Aid Freeze Could Set Back Africa’s Fight Against HIV by Years, Researchers Warn — The Telegraph
• To Alarm of Scientists, Federal Health Data Is Disappearing — Undark
• As Trump Attacks, the HIV Community Reels—and Starts Fighting Back — Positively Aware

Resources

• Update: Deadly Pause, an updated report from CHANGE, tracking harms from the funding freeze
• Most Lifesaving Services Remain Paused: A Rapid Assessment of the PEPFAR StopWork Order, amfAR, CHANGE, Data ETC
• Litigation Tracker: A public resource tracking the legal challenges to the Trump administration’s executive orders, Just Security
• PEPFAR Key Populations Impact Survey, GBGMC 

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