Global Health Watch: UNAIDS launches review, NIH GoF controversy, support for IDSA’s Jeanne Marrazzo, UK authorizes LEN for PrEP

December 26, 2025

This week the UNAIDS board approved a new Global AIDS Strategy and launched a formal review of the agency’s future; turmoil at the NIH continues over gain-of-function research; and the scientific community rallies around the Infectious Diseases Society of America’s (IDSA) appointment of Jeanne Marrazzo as its chief executive officer. Also, the UK regulatory agency approved lenacapavir for PrEP (LEN) marking its seventh regulatory approval in just six months.

UNAIDS Launches Review Process on its Future

Following last week’s intense discussions at the UNAIDS Programme Coordinating Board (PCB), the UNAIDS board this week launched a new, formal process to examine the organization’s future and potential transition pathways. This comes from within the UN80 reform initiative that proposed to sunset UNAIDS by the end of 2026. But civil society and PCB members pushed back, and the board agreed to initiate a “structured review” that explores different scenarios for UNAIDS’ role, mandate, and positioning within a changing global health architecture. This announcement came on the heels of the PCB approving the Global AIDS Strategy for 2026–2031 and alarms raised by civil society about funding cuts, service disruptions, and the risk of losing a central coordinating body at a critical moment in the HIV response. 
 
IMPLICATIONS: The launch of this process to examine UNAIDS’ future raises important questions about governance, accountability, and continuity in the global HIV response. Civil society’s strong pushback underscores that any reform must preserve UNAIDS’ core mandate and ensure that the global HIV response remains centered on those most affected — especially women, girls, and key populations — rather than being quietly dismantled at a moment of crisis.

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Continued Turmoil at the NIH – Gain-of-Function (GOF) Research 

Turmoil at the NIH continued this week as, John Beigel, a prominent influenza researcher and acting director of NIAID’s Division of Microbiology and Infectious Diseases (DMID), resigned following controversy over an NIH-supported seasonal flu virus study and how its potential risks were assessed and communicated. Beigel’s departure unfolds amid ongoing debate over how the NIH defines and oversees gain-of-function (GOF) research—work that could increase the transmissibility or virulence of pathogens with pandemic potential.  
 
Science reports that the controversy was a “‘pseudomanufactured concern’ that was meant to force him out, so officials could bring in a researcher who has strongly supported Trump.” Beigel is being replaced by an infectious disease scientist from NIH’s Fogarty International Center and who has publicly expressed support for the President and donated to his affiliated political committees.

IMPLICATIONS: Alongside last week’s revelations and Jeanne Marrazzo’s whistleblower lawsuit, Beigel’s departure heightens concerns about instability and governance at NIH at a time when scientific leadership and public trust are critical. Debates over GOF research, including its definition, oversight, and whether the White House or the NIH sets the rules show the precariousness of the agency. As Science reports, concerns about GOF work have gained momentum with the popularization of the belief that Chinese scientists who received NIH funding created the virus that caused the COVID-19 pandemic. Many Republicans have promoted this unproven theory, and Trump signed an executive order in May that called for stricter oversight of GOF work. 

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Leaders Support Jeanne Marrazzo as new CEO of the Infectious Diseases Society of America (IDSA) 

Leaders in the scientific and infectious disease communities praised the Infectious Diseases Society of America (IDSA) appointment of Jeanne Marrazzo as its next chief executive officer. Former NIAID Director Anthony Fauci called her a “superb choice,” and AVAC’s Mitchell Warren said, “It speaks to IDSA’s desire to emphasize science over politics and science over ideology, and that’s what you will get with Jeanne Marrazzo.” Virologist Angela Rasmussen, said Marrazzo’s appointment “suggests to everybody who’s a member of that professional society that they’ve got a leader who’s actually going to do something about this rather than trying to protect the institution more than its members.” Marrazzo begins her tenure January 12. 

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UK’s Medicines and Healthcare products Regulatory Agency (MHRA) Approves LEN for PrEP

This is the seventh regulatory approval of LEN for PrEP. See AVAC’s detailed map of regulatory approvals, pending decisions, and appeals, along with other LEN resources here.

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