Global Health Watch: 500,000 oppose White House grant rule, CDC & PEPFAR’s future, global health transition strategy, Gawande & AIDS 2026, issue 77

July 17, 2026

More than half a million comments were submitted in response to the White House’s proposal to politicize federal research grants – with a significant majority opposing it. At the same time, questions mounted over the future of the CDC, PEPFAR, and the Administration’s vision for transitioning US global health programs. This week also features reflections from former USAID global health leader Atul Gawande on the human cost of dismantling USAID and the likely discussions ahead at AIDS 2026 on the consequences of US policy changes for HIV programs and global health.

Scientists Respond to Escalating Political Attacks

As the assault on scientific independence continues on multiple fronts, an extraordinary response came from scientists, advocates, universities, professional societies and civil society organizations. It culminated in a wave of submissions as the public comment period ended on Monday for the White House Office of Management and Budget’s (OMB) proposed regulation to give political appointees greater authority over federal grant decisions. Nearly 500,000 comments were submitted and analyses published in STAT show nearly 95% opposed the proposal, with many warning it would replace independent peer review with political and ideological oversight, thereby undermining the integrity of publicly-funded biomedical research. At the same time, hundreds of scientists, public health leaders and advocates have signed an open letter supporting former NIAID Director, Anthony Fauci and others who have come under political attack for their work, arguing that defending scientists from intimidation is essential to protecting evidence-based policymaking and the integrity of the US scientific enterprise

IMPLICATIONS: The OMB’s proposed Regulation for Federal Financial Assistance “would politicize grantmaking, dismantle merit-based peer review and severely restrict professional infrastructure necessary for quality research,” AVAC wrote in its comment. While the 500,000 submissions may not stop implementation of this regulation, they could slow the roll-out, set-up impending legal challenges and bolster congressional efforts to intervene. However, together, this all points to growing community recognition and collective action around the importance of safeguarding science now.

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CDC Leadership and PEPFAR’s Future

The US Administration’s nominee to serve as Director of the US Centers for Disease Control and Prevention (CDC), Erica Schwartz faced questions at her Senate confirmation hearing where members pressed her on vaccine science, scientific independence and the CDC’s future under Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. Schwartz was criticized for failing to provide direct answers to questions on vaccine safety, political interference in science and CDC guidance. At the same time the hearing was taking place, 84 partners submitted a letter urging Congressional leadership to intervene after the US Department of State confirmed plans to phase out or fundamentally restructure the CDC’s role in implementing PEPFAR, including allowing more than 100 CDC awards to expire without clear replacement mechanisms and transitioning the agency to a fee-for-service technical assistance model.

IMPLICATIONS: Schwartz’s testimony and inability to provide clear responses on vaccine science and scientific independence reinforces concerns about the CDC’s future in evidence-based decision making. This, plus the potential ending to long-standing transfer of PEPFAR resources to CDC, leaves many questions about the CDC’s future role and independence. As the 84 organizations wrote, “coming on the heels of USAID’s closure in 2025, this change removes the last institutional anchor of a proven, lifesaving program. This shift will pull the plug on lifesaving treatment programs serving millions of patients today and destroy public health systems keeping Americans safe from the health threats of tomorrow.”

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Eighteen Months Later: Global Health in Transition 

Just over 18 months into the new US Administration, global health leaders continue to reflect on the human and institutional consequences of the dismantling of USAID and the restructuring of PEPFAR. While greater country ownership has been a shared goal across multiple Presidential Administrations, abrupt funding cuts and weakened technical partnerships risk undermining decades of progress. As former USAID global health leader Atul Gawande said on The New Yorker Radio Hour, “We’ll halt worsening the damage, but it’ll take joint effort to actually stop it and regain our momentum.” Chris Collins of Friends of the Global Fight similarly argues that if the Administration is serious about transitioning from donor-led programs to sustainable national systems, it must pair that vision with predictable financing, stronger country capacity and a deliberate transition plan rather than an accelerated withdrawal

IMPLICATIONS: As implementation of the US Secretary of State’s US global health strategy becomes clearer and the Administration’s bilateral health agreements moves forward, focus must shift to the practical realities of achieving it without reversing gains in HIV epidemic control or weakening broader global health security. These questions will take center stage at AIDS 2026, where multiple sessions will examine the consequences of US policy changes for HIV programs and the future of global health cooperation. See AVAC’s roadmap and resources for Rio.

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AVAC’s Guide to AIDS 2026

Visit AVAC’s conference hub, which shares curated session roadmaps on prevention and AI & HIV, resource hubs on the prevention pipeline, lenacapavir and MK-8527, a schedule of key sessions, and more.

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