July 25, 2025
This week’s issue covers what’s next with PEPFAR, including new reports that the US State Department is planning to dismantle the program, and a new bill in the US Congress that aims to restore its prevention programs. It also highlights a new funding bill that supports global health R&D and spotlights the shocking destruction of contraception and vaccines bound for Africa. Plus: key takeaways from IAS 2025 in Kigali and what they mean for the future of HIV prevention.
What’s Next for PEPFAR
Following last week’s partial victory against the President’s rescissions package, with PEPFAR spared from a $400 million proposed clawback, the HIV community is calling for sustained pressure and bipartisan support to preserve the program’s core budget and fully restore prevention services. This comes as a new report from The New York Times reveals that State Department officials are quietly developing plans to shut down PEPFAR entirely in the coming years.
IMPLICATIONS: This new reporting confirms what many advocates have warned: PEPFAR is being systematically undermined. Funds are still frozen at FY23 levels, no long-term reauthorization has been secured, and critical program components like PrEP scale up, and community-led service delivery remain unfunded.
READ:
- US Quietly Drafts Plan to End Program That Saved Millions From AIDS—New York Times
- Small win for activists, but SA’s HIV projects won’t get reopened—Bhekisisa
- PEPFAR’s funding survived — now what?—Washington Post
- PEPFAR’s been saved—for now. What’s next?—Positively Aware
- We Are Fumbling the Fight Against AIDS—Bulwark
New Legislation to Expand Access to HIV Prevention Through PEPFAR Proposed
New legislation to guarantee access to HIV prevention through PEPFAR, the HIV Medication Access Act, was introduced by US Representative Yassamin Ansari (AZ-03). The bill would amend the Foreign Assistance Act to include HIV prevention in the definition of ‘life saving humanitarian assistance’ and to ensure all at-risk populations can receive these services. The legislation comes in response to the State Department restricting PrEP to pregnant and breastfeeding women only under the February waiver that supposedly resumed lifesaving foreign aid in the wake of the DOGE fiasco.
IMPLICATIONS: This new proposed legislation would help protect and restore global access to HIV prevention tools. Advocates are rallying around this bill as a much-needed safeguard against ideologically driven health policies. As AVAC’s Mitchell Warren said, “When access to the fruits of science is dictated by politics rather than evidence, we paralyze progress.” However, the bill faces an uphill battle in the current Congress.
READ:
- Rep. Yassamin Ansari Introduces HIV Medication Act to Enhance Access to Prevention Treatments—Press Release
New Bill Proposes Strong Funding Levels for Global Health
A proposed bill and report for global health programs in Fiscal Year 2026 (FY26) was introduced Wednesday by the US House Appropriations Subcommittee on National Security, Department of State and Related Programs (NSRP, formerly SFOPs) as part of the annual bipartisan appropriations process. The NSRP subcommittee has jurisdiction over foreign assistance funding, and their report recognizes global health as essential to national security and strongly supports research, innovation, and new technologies to fight HIV, TB, malaria (including positive language on expanding access to microbicides, long-acting PrEP, and PEPFAR). And the bill proposes strong funding levels for key global health priorities including investments in maternal and child health ($528M), Gavi ($300M), TB ($394.5M), malaria ($800M), and neglected tropical diseases ($114.5M). However, it cuts funding for family planning by 24% and includes harmful policy riders that would codify the global gag rule (aka the Mexico City Policy) and bans funding to WHO and UNFPA.
IMPLICATIONS: While the proposed funding is stronger than expected, it is unclear if the House bill will pass, what the Senate version will look like, and whether the administration would implement the funding. This bill is a positive signal that global health R&D and innovation are being recognized as priorities, which is a testament to the unrelenting advocacy of the HIV community.
READ:
Contraception and Vaccines Destroyed and Wasted
The new US administration ordered millions of contraceptives including condoms, IUDs and emergency pills intended for sub-Saharan Africa to be destroyed. The Guardian reports that this was $9.7 million worth of contraception. Earlier this month, US Senators Jeanne Shaheen (D-NH) and Brian Schatz (D-HI) introduced the Saving Lives and Taxpayer Dollars Act, legislation to prevent the State Department from destroying family planning commodities instead of donating them to intended beneficiaries. This action is part of the larger destruction of foreign aid. Meanwhile, Politico reports that hundreds of thousands of vaccines purchased by the US for African countries have expired and been wasted due to political delays and a breakdown in coordination. Advocates are working with members of Congress to urge the State Department to act immediately to ship remaining viable mpox vaccines.
IMPLICATIONS: The destruction of contraception and wasted vaccines reflect a dangerous ideology that is undermining global health and reversing decades of progress. Clinics across Africa are reporting shuttered services and rising unmet need for contraception, while stalled vaccine delivery weakens trust and preparedness in the face of ongoing disease threats. These actions jeopardize integrated HIV prevention strategies and broader sexual and reproductive health goals.
READ:
- US has wasted hundreds of thousands of vaccines meant for Africa, health officials there say—Politico
- Trump administration to destroy nearly $10m of contraceptives for women overseas—The Guardian
- Meeks, Frankel, Meng Introduce Legislation to Prevent Destruction of Foreign Aid Commodities—House Foreign Affairs Committee
International AIDS Society 2025: From Crisis to Resolve
Coverage from last week’s International AIDS Society (IAS) Conference in Kigali, Rwanda, has highlighted the lessons and insights from the shift from a crisis response to the dismantling of foreign aid to collective resolve. The global community is calling for political accountability, funding commitments, streamlined pathways to access, and a pipeline of products that people want and need.
AVAC’s sessions and resources capture this pivotal moment in the field. Explore AVAC’s full IAS 2025 resource page.
READ:
- From Kigali: At IAS 2025, the HIV response rallies to face the crises—AVAC
- Does six-monthly PrEP have a future following the collapse of global HIV funding?—aidsmap
- The US cuts challenge African funders and governments to provide new models of PrEP access—aidsmap
- Why ‘integration’ has become a ‘dirty word’ in HIV programming—Devex
- Is HIV integration a response or a death sentence? Communities demand answers—aidsmap
Join Us at the STI & HIV 2025 World Congress
The global community will gather next week in Montreal, Canada, for the STI & HIV 2025 World Congress, which comes at a pivotal moment as global STI rates are rising, but investment in prevention, diagnostics and care remain far below what’s needed.
Save the Date! August 14, 2025 @ 7:00am ET
PrEP Implementation — What’s worked and what are we learning
Join AVAC and the South-to-South Learning Network for a webinar exploring lessons from countries that have successfully scaled up oral PrEP and how to apply them to introduce and expand access to long-acting HIV prevention options like CAB, DVR, and LEN.
What We’re Reading
- How US aid can appeal to ‘America First’ Republicans—Devex
- Employees’ protests against Trump science policies spread to NSF—Science
- US rejects WHO pandemic changes to global health rules—Reuters
- WHO’s Tedros: US Rejection of International Rules on Health Threats is Based on ‘Inaccuracies’—Health Policy Watch
- The Demographic and Health Surveys brought crucial data for more than 90 countries — without them, we risk darkness—Our World in Data
- We can’t win the fight to end HIV if we cut funding and access to medication—The Hill
- The imperative for increased investment for an HIV cure—Lancet HIV
- Trump Forced to Restore $6.2 Million in Funding for 9 LGBTQ+ Nonprofits Across the US—Them
- WHO projects up to 40% cut in health aid in 2025—Devex
- How economic resilience projects are helping HIV patients survive aid cuts—Devex
- Help save 2 million lives: close the vaccine funding gap—Nature
- The Trump Administration’s Foreign Aid Review: Status of PEPFAR—KFF