August 21, 2026
The US National Institutes of Health (NIH) lifted research funding restrictions on South Africa; the DRC’s Ebola outbreak grows, exposing the consequences of weakened outbreak-response systems; and leadership changes at the World Health Organization (WHO) and the US Food and Drug Administration (FDA) raise questions about the future of global health decision-making.
NIH Reopens Research Funding to South Africa
The US National Institutes of Health (NIH) lifted its ban on funding research in South Africa. This comes after 18 months of “holding all research awards” for NIH research partnerships with South African institutions as the country was designated a “country of concern” alongside China. As Science reports, an internal memo notes that the “[NIH] decided it was exempt from a February 2025 executive order…that halted ‘foreign aid or assistance’ to South Africa” because “the Foreign Assistance Act of 1961 does not govern NIH funding.” The lift of this order reopens the door to new grants. However, the NIH also announced that South African scientists will no longer be eligible to receive training grants from its Fogarty International Center, because the country is upper middle-income and part of the G20. This follows last month’s announcement from the Department of State that it will phase out PEPFAR support to South Africa.
IMPLICATIONS: South Africa is one of the world’s most important HIV, TB and infectious disease research centers – built through decades of diplomacy and partnership with the NIH and US State Department, with numerous South African scientific leaders of today partnering with the Fogarty International Center. This is part of a wider unraveling of this decades-long scientific partnership spanning HIV research, treatment and prevention, emanating from false accusations made by the White House against the South African government for “not doing enough” to address unfounded claims of discrimination purportedly against the country’s white Afrikaner community. While this week’s reversal of the ban restores an important piece of that scientific collaboration, the larger relationship remains strained, including the planned PEPFAR phase out. US investments in PEPFAR and NIH partnerships in South Africa have resulted in significant contributions and innovations in the treatment and prevention of HIV, TB and other infectious diseases for people around the world, including in the US. For the HIV field especially, this reversal shows the interconnectedness of the research partnerships and bilateral programs and why both research and programmatic funding matter. The simple restoration of scientific collaboration, while continuing to withdraw and erode programmatic infrastructure will stifle scientific progress when it relies on strong public health infrastructure and partnerships made possible through PEPFAR.
READ:
- NIH lifts ban on funding research in South Africa—Science
- US agency lifts ban on South Africa research funding after 17-month freeze, $450 million loss—Business Insider (SA)
- NIH Lifts Ban on Research in South Africa—Health Policy Watch
DRC Ebola Outbreak Illustrates Impact of Foreign Aid Restrictions
The ongoing Ebola Bundibugyo outbreak in the Democratic Republic of the Congo (DRC) is now the country’s deadliest Ebola epidemic and the second deadliest ever recorded. At an emergency WHO meeting, Director-General Tedros Adhanom Ghebreyesus said, “We must be frank: The epidemic is far from being under control… It had a big head start, and we are still playing catch-up.” WHO says it could still be brought under control within approximately three months, but only if resources and response capacity are rapidly scaled up. WHO figures report that only 60 percent of the $115 million needed to finance the response has been raised. Currently, there is no licensed vaccine or treatment for the Bundibugyo strain. Many new cases are appearing outside known transmission chains, which indicate infections are continuing to spread undetected.
READ:
- DR Congo’s Ebola outbreak ‘global emergency’ as infections pass 5,000: WHO—Al Jazeera
- WHO and Africa CDC welcome the allocation of Ebola vaccines to the Democratic Republic of the Congo—World Health Organization
- The Guardian view on the Ebola outbreak in the DRC: a case study in why international aid matters—The Guardian
- WHO says Congo Ebola outbreak can still be brought under control within three months—Reuters
Leadership Shifts at WHO and US Food and Drug Administration
The WHO and US Food and Drug Administration (FDA) are undergoing leadership changes. WHO’s chief scientist and Assistant Director-General for health promotion and disease prevention and control Jeremy Farrar will leave at the end of September. This latest departure comes amid WHO’s challenge to continue charting its future in the face of reduced donor funding, a smaller senior leadership structure, and the end of Director-General Dr. Tedros Ghebreyesus tenure later this year. Meanwhile, in the US, White House adviser on the Domestic Policy Council, Dr. Heidi Overton was nominated to lead the FDA as commissioner. She helped shape several of the Administration’s health initiatives, including its recent overhaul of childhood vaccine recommendations and is a proponent of the government’s anti-abortion policies. Her nomination comes after months of turmoil and a leadership vacuum at the FDA, which saw Marty Markary depart from the role in May after a short tenure of 13 months. Some Senators who are now debating her nomination are questioning her role in the recent vaccine order as they prepare for confirmation hearings.
IMPLICATIONS: As WHO is being forced to redefine its role and priorities amid shrinking resources, the US FDA is facing significant scrutiny and political pressure over vaccines and scientific decision-making. For global health and HIV, leadership stability and scientific independence at both agencies matter beyond the internal structure as WHO normative guidance and FDA regulatory decisions will determine which products move forward, how quickly they reach countries and communities who need them. Many national regulatory authorities around the world rely heavily on FDA’s rigorous regulatory review and approval processes to inform their decision-making in local approval, procurement, and implementation of new and emerging biomedical innovations. Similarly, countries without the capacity or expertise to independently develop treatment and prevention guidelines rely heavily on WHO’s normative guidance to ensure health policies are grounded in the latest evidence. The looming question at the FDA is whether its leadership and decisions will continue to be guided by evidence, as political pressure increasingly shapes the ideologues may potentially helm the world’s premier regulatory agency. as political pressure increasingly shapes the agency’s leadership and priorities.
READ:
- High-Profile Departures Shake Up WHO Leadership, ‘Controversial’ Appointee Returns—Health Policy Watch
- New CDC director tells staff she is prepared to speak ‘truth to power’—STAT
- Senate Health Panel Chairman Voices Strong Reservations About F.D.A. Nominee—New York Times
- Trump to Nominate Heidi Overton, a Top Domestic Policy Aide, for F.D.A. Commissioner—New York Times
- Dr. Jeremy Farrar to leave WHO—Devex
What We’re Reading
- SA and Zambia’s HIV shot dilemma: Demand versus supply—Bhekisisa
- The post-PEPFAR playbook is already being written—Lights. Camera. Equity! Substack
- Graveyard for Grants’: NIH Is Holding Up Medical Research Funding—Notus
- The State of HIV Prevention: Big News, Big Moves: Reflections from AIDS 2026 in Rio de Janeiro, Brazil—AVAC
- Trump 2.0 has deleted or altered nearly 400 US datasets, endangering public health, education and more—The Guardian
- Exclusive: NSF set to issue lowest number of new grants in four decades—Nature
- Senators Criticize Trump Administration’s Demands to Access Health Data as a Condition for Lifesaving Aid—ProPublica
- USAID fallout: In Nepal, when the aid workers stopped coming, the women and babies started dying—Associated Press
- Fauci: The Oracle Who Went Silent At The Wrong Time – Health Policy Watch—Health Policy Watch
- Ex-Fauci adviser pleads guilty to plotting to conceal COVID-19 research records during pandemic—Associated Press
- The Wrong Kind of American—The Atlantic
- US policies are making a resurgence of vaccine-preventable diseases inevitable—BMJ
- WHO Officials Condemn Trump’s Vaccination Changes—Health Policy Watch
- More than 210 leading medical, health and patient advocacy groups oppose recent executive order on childhood vaccines—IDSA
- The global health aid architecture is collapsing. The faith economy isn’t—STAT
- Big Ideas in Brief: State Strategies to Sustain HIV Prevention, Care, and Treatment—O’Neill Institute
- Scientists Scramble for Private Cash in Response to Fresh Funding Turbulence—Wall Street Journal