February 28, 2025
This week has been marked by a further flurry of intense developments in global health, with aggressive political and legal actions by the new presidential administration and implications for PEPFAR, research, global health and more. Below is a roundup of the key issues and events shaping our work this week.
AVAC vs. Department of State
Court cases against the US administration’s foreign aid freeze, including AVAC vs. Department of State, saw a lot of activity this week. Tuesday, the Federal Court ordered the administration to pay all invoices submitted and ensure reimbursement for work by midnight Wednesday. In response, the administration sought a temporary stay from the US Supreme Court. Chief Justice John Roberts, who handles emergency requests like this, granted the stay, allowing the Court more time to review the case and relieve the USG of its obligation to meet the February 26 payment deadline set by the lower court. At the same time, the overall case is still proceeding, and the lower court will hold a hearing of AVAC’s case (in combination with the related case brought by Global Health Council and partners) early next week (by March 4).
IMPLICATIONS: The temporary stay issued by the Supreme Court does not imply how the Court will rule next week, and this is just one of a flood of cases challenging the new administration’s many questionable executive actions. We are witnessing a time when the US judicial system will be tested by the sheer volume of unconstitutional acts, and if the administration will comply with the rulings.
FOLLOW ALONG: You can follow along with progress on the case at, https://avac.org/avac-vs-dept-of-state/.
READ:
- Chief Justice John Roberts pauses order for Trump admin to pay $2 billion in foreign aid by midnight—CNN
- Chief Justice Allows U.S. to Continue Freeze on Foreign Aid Payments—The New York Times
Global Health Contracts Terminated
Nearly 10,000 contract awards from USAID and the State Department were terminated on Wednesday, impacting a wide range of global programs. These cuts affect not only HIV programs, but also tuberculosis research and treatment access, malaria prevention, food and nutrition aid, and many other vital humanitarian assistance projects and programs worldwide.
These cuts, affecting over 90% of the agency’s work and tens of billions of dollars in Congressionally approved spending, could bankrupt many implementing partners and shutter lifesaving programs, including critical components of PEPFAR.
IMPLICATIONS: By cutting 90% of USAID’s work, including programing for HIV, like PEPFAR, many implementing partners do not have capacity to deliver live-saving HIV treatment and prevention programming, services and supplies. Tens of thousands of in-country health workers are unemployed; clinics shuttered; trust and confidence of patients, partners and governments are now gone. While the administration insists that foreign aid, which represents roughly 1% of the federal budget, has become wasteful and detached from US interests. However, these actions dangerously undermine the US’ global influence and soft diplomatic power.
READ:
- US Terminates Thousands of Life-Saving Health Grants Including For HIV and Malaria—Health Policy Watch
- The Trump administration kills nearly all USAID programs—NPR
- Trump administration ends funding for UN program fighting HIV/AIDS—The Guardian
- US Terminates Funding for Polio, H.I.V., Malaria and Nutrition Programs Around the World—The New York Times
PEPFAR in Jeopardy
PEPFAR, the US government’s flagship HIV/AIDS program, is confronting unprecedented challenges under President Trump’s second term. The executive order to pause foreign aid, the dismantling of USAID, which implements approximately 50% of PEPFAR’s investment, and intensified political scrutiny of PEPFAR, have all destabilized the program’s once-stalwart support, with reauthorization coming in late March.
IMPLICATIONS: Jirair Ratevosian, who previously was PEPFAR’s chief of staff and Legislative Director for former US Congresswoman Barbara Lee of California, explores what a post-Trump global HIV response might look like with Mia Malan on this must-listen Bhekisisa podcast. “I think where all this is leading is to a State Department-led foreign assistance effort that will be implemented through partnerships that are not going to be as diverse and complicated as there were before. And there are some consequences…I think that we’re going to an era where the operating part will look very different, but I think we have to look at it as an opportunity…I’m hopeful this is one of those bright spots where, when you reduce the number of intermediaries, so to speak, you could actually save some money, give more of it to the program itself, and then that can hopefully lead to more productivity at the country itself.”
READ:
- The Outlook for PEPFAR in 2025 and Beyond—KFF
- Envisioning the Future for a Celebrated Global AIDS Program—Duke University Global Health Institute
LISTEN: Would Pepfar survive Trump — and what would it look like?—Bhekisisa
NIH Research Funding Concerns
NIH funding continues to be at a standstill as final funding decisions remain in limbo—research grants are still frozen amid ongoing legal battles. In the meantime, an investigation suggests that individuals connected to Elon Musk’s Department of Government Efficiency (DOGE) task force now have access to the NIH’s financial systems, raising fresh concerns about the agency’s internal oversight.
READ:
- Revealed: NIH research grants still frozen despite lawsuits challenging Trump order—Nature
- DOGE is Inside the National Institutes of Health—Wired
Mobilizing Amid Attacks on Science
As scientists and advocates are confronted with the new administration’s assaults on scientific integrity, many are mobilizing.
At the nation’s capital this week, protestors staged a “die-in,” to spotlight the dismantling of USAID and foreign aid, and the impact on countless lives and livelihoods under the new administration’s orders. A recent editorial in Science detailed how scientific leaders, universities, and professional organizations are organizing—through lawsuits, public statements, and advocacy efforts—to defend the integrity of science. “We will not change the principles and processes by which we serve the scientific community; those outside the United States should not have to alter their research agenda or methods because of bad decisions about science policy in the US.”
The Community Health & HIV Advocates Navigating Global Emergencies (CHANGE) coalition is developing resources for advocates and organizing to protect access to HIV treatment and prevention. Find their resources featured in Global Health Watch and contact them at [email protected].
READ:
- Lay low or mobilize? HIV researchers agonize over how to respond to Trump administration’s attacks on science—Positively Aware
- Fired USAID workers and HIV activists hold ‘die-in’ to protest Trump and Musk—The Guardian
- Come together, right now—Science
Resources
- PEPFAR Watch Funding Freeze Tracker
- Project 2025 Tracker
- Funding Freeze Fallout: Tracking Furloughs, Layoffs, and Cuts, Devex
- Overview of President Trump’s Executive Actions Impacting LGBTQ+ Health, KFF
- Overview of President Trump’s Executive Actions on Global Health, KFF
- Litigation Tracker: A public resource tracking the legal challenges to the Trump administration’s executive orders, Just Security
- CHANGE South Africa Press Conference
What We’re Reading
- As the U.S. Exits Foreign Aid, Who Will Fill the Gap?—New York Times
- By executive order: The likely deadly consequences associated with a 90-day pause in PEPFAR funding—JIAS
- NIH ban on renewing senior scientists adds to assaults on its in-house research—Science
- Q&A: How Trump’s USAID freeze halted the effort to develop an effective HIV vaccine in Africa—STAT
- Statement from Global Health Council on the Mass Termination of USAID and State Department Grants—Global Health Council statement
- Lifesaving Services Terminated for 10,000 Children and 10,000 Pregnant Women—EGPAF statement