Avac Event
Join us Wednesday, May 20 for Inside the Decisions that Changed Global Health: An AVAC Conversation with Nicholas Enrich, author of Into the Wood Chipper and former global health lead at USAID. Enrich will share an inside perspective on the decisions that led to the dismantling of USAID and the foreign aid freeze and what they mean for global health today.
AVAC and partners are proud to share three new national sexually transmitted infections (STIs) advocacy agendas for Kenya, South Africa and Zimbabwe, providing coordinated agendas to elevate STIs as a national health priority and accelerate actions on R&D and delivery of STI vaccines, diagnostics, prevention and care. Join us Tuesday, 12 May to learn more about these country-led advocacy agendas.
STIs remain widespread, underdiagnosed and persistently underprioritized around the world. In Kenya, South Africa and Zimbabwe, gaps in awareness, surveillance data and diagnostics, along with challenges delivering essential testing and treatment services, continue to limit effective and equitable STI prevention, treatment and care. This persists despite the availability of proven prevention tools, including vaccines and diagnostics, and growing evidence of the health and economic consequences of inaction.
The country-specific agendas highlight shared priorities in response to these gaps: strengthening surveillance and data systems; expanding access to diagnostics; building health workforce capacity; and preparing health systems for emerging tools such as additional STI vaccines.
These advocacy agendas were developed by partners in Kenya, South Africa and Zimbabwe through cross-country collaborations that brought together researchers, advocates, civil society organizations and policy experts. Over several months, they analyzed the STI landscape in each country and identified the most urgent opportunities for policy change and investment.
“Together, these three agendas lay the groundwork for a new cross-country STI advocacy network in East and Southern Africa,” said Alison Footman, PhD, senior program manager of STIs at AVAC. “Each agenda reflects country-specific priorities, but, collectively, they elevate community voices, strengthen policy engagement and build regional momentum to ensure STI prevention, diagnosis and care receive the sustained attention they deserve.”
Advancing Diagnostics, Data and Community-Led Advocacy
“Kenya’s STI advocacy agenda responds to a substantial STI burden affecting both the general population and key populations,” said Felix Mogaka, MBChB, Kenya advocacy partner. “Our work and those of our partners show that a significant proportion of infections remain undiagnosed or untreated, in part because Kenya continues to rely heavily on syndromic management for STI treatment, an approach that relies on self-reported symptoms and can miss many asymptomatic infections.”
Kenya’s advocacy agenda calls for updating national STI policies, strengthening health workforce capacity and ensuring that community organizations play a central role in advocacy and awareness.
Bridging Research, Policy and Implementation
“STIs in South Africa have too often been treated as a side issue in public health discussions,” said Alex de Voux, PhD, South Africa advocacy partner. “Our vision is to build a stronger, more coordinated response, one where communities are informed and empowered, health providers are supported with the right tools, and sexual health is recognized as a fundamental part of public health.”
South Africa’s agenda identifies opportunities to expand access to credible STI information, strengthen advocacy capacity across communities, healthcare providers and policymakers, and promote a positive, rights-based approach to sexual health that improves prevention, diagnosis and care.
Strengthening Evidence, Integration and Investment
“Zimbabwe has an opportunity to strengthen its STI response by bringing greater alignment between national leadership, healthcare providers and communities,” said Chido Dziva Chikwari, PhD, epidemiologist and global health practitioner in Zimbabwe. “When national policies, frontline care and lived experience are connected, Zimbabwe will be far better positioned to improve STI prevention, diagnosis and care.”
Zimbabwe’s agenda calls for increased advocacy, expanded diagnostic testing, greater integration of STI services with other health programs and stronger domestic financing for STI prevention and research.
The launch of these agendas marks the start of a sustained cross-country STI advocacy network in East and Southern Africa to raise the profile of STIs within national and global health agendas.
AVAC and its partners will continue working together to amplify the agendas, engage policymakers and mobilize greater investment in STI prevention and care.
“These agendas show what is possible when advocates, researchers and communities come together to define solutions,” said Footman. “We are incredibly proud of the leadership and commitment of our partners who developed these priorities. The next step is ensuring that governments, donors and global health partners act on them.”
Press Release
Contact: [email protected]
New York, NY, April 1, 2026 — Mitchell Warren, Executive Director of AVAC, issued the following statement on the passing of Stephen Lewis:
“Stephen Lewis was a politician and diplomat who deeply valued the essential role of communities in the HIV response. He was a very rare and impactful role model, and all of us at AVAC are deeply saddened by his passing.
He reminded us every day that HIV was not just a virus and that the HIV/AIDS response was never just about science. He put people first in all his efforts — not just in his rhetoric, which was brilliant and electrifying, but in his actions.
His life was defined by an unwavering commitment to creating a better, more just world. Stephen brought moral clarity, urgency, and humanity to the global response to HIV and AIDS, insisting that the voices and leadership of affected communities be at the center of action. His advocacy helped transform how the world understands equity, access, and accountability in global health. His insistence on justice will continue to guide and inspire all of us working to end epidemics and advance human rights.”
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About AVAC
AVAC is an international non-profit organization that provides an independent voice and leverages global partnerships to accelerate ethical development and equitable delivery of effective HIV prevention options, as part of a comprehensive and integrated pathway to global health equity. Follow AVAC on Bluesky and Instagram. Find more at www.avac.org and www.prepwatch.org.
View the slides from AVAC Executive Director Mitchell Warren plenary presentation at SYNChronicity 2026.
Avac Event
Join AVAC and partners for the launch of STI Advocacy Hubs and the introduction of new country-led advocacy agendas from Kenya, South Africa, and Zimbabwe. This webinar will highlight the key challenges shaping STI prevention, diagnostics, and care in each country, and outline priority actions to strengthen national responses. Speakers from partner organizations will share how these agendas aim to drive policy change and improve access to STI prevention tools.
Moderator: Alison Footman
Speakers:
2025 underscored the vital role that AVAC plays in the global health ecosystem, and why our work and our partnerships have never been more essential.
This report highlights AVAC’s role as a trusted voice, a translator of science and catalyst for action and advocacy. It reflects an organization ready for the future: supporting African leadership, strengthening bridges from R&D to delivery and preparing for a new chapter as we move forward into our fourth decade as an organization. Read the PDF below or view as a webpage.
Today marks one year since AVAC and the Journalism Development Network worked with the Public Citizen Litigation Group to sue the US President, the State Department, the US Agency for International Development (USAID), and others, seeking emergency relief from a sweeping freeze on foreign assistance issued by the incoming administration that abruptly halted life-saving global health and development programs. A parallel case was brought by Global Health Council and partners and assigned to the same District Court judge, underscoring the broad concern across the global health community.
Twelve months later, these cases have come to symbolize a much larger question: whether the executive branch can override Congress’s constitutional authority over federal spending and dismantle decades of bipartisan foreign policy with the stroke of a pen, and whether the courts and Congress will fulfill their responsibilities to serve as checks on unbridled executive power.
The past year has laid bare the real-world consequences of unchecked executive action, threatening lives, destabilizing global partnerships, and undermining the United States’ credibility as a reliable partner.
An early ruling in AVAC’s case successfully unlocked nearly $2 billion in US government payments for work already completed, affirming that the executive branch cannot refuse to spend money appropriated by Congress. But over the course of 2025, appeals by the administration, ultimately backed by the US Supreme Court, ran down the clock on $4 billion in already-appropriated funds for the 2025 fiscal year, allowing them to expire.
While the Supreme Court’s ruling did not resolve the underlying constitutional questions, the decision was narrow and the Court left open the opportunity for further argument on the merit of the questions involved. In November 2025, a joint statement to the District Court requested to pause the cases, awaiting the outcome of other relevant court decisions.
The AVAC and GHC cases remain active, but lawsuits alone cannot restore what was lost—or undo the long-term harm caused by the sudden dismantling of global health systems.
The actions by this administration demand more than concern. This moment demands public accountability, sustained Congressional oversight, and durable legislative safeguards. Global health and equity require champions willing to fight for lives and livelihoods, and for what’s right. We cannot accept this as the new normal, and we must insist that Congressional authority, democratic governance, and the lives they protect still matter.
If you’d like to support AVAC in its continued work, please consider making a donation, https://donatenow.networkforgood.org/donate-avac.
This week marks 365 days of disruption and chaos across global health, with many organizations and journalists reflecting on one year after the foreign aid freeze and what the future of global health looks like. This week also saw the US Congress beginning to reassert its role on health funding, ongoing US disengagement from WHO, and new reporting on the hepatitis B vaccine trial in Guinea-Bissau.
We are also watching closely for news of an expanded Global Gag Rule, that is reportedly coming out later today, just as this issue goes to press. It is anticipated that this new gag will include a dramatic expansion beyond abortion and now underscore the US administration’s war on gender, diversity, equity and inclusion. We’ll cover this in next week’s Global Health Watch; the struggle, most definitely, continues.
This week marks one year since the US Presidential administration issued a deeply cruel executive order freezing foreign assistance, halting billions of dollars in already-approved funding under the bad-faith claim of a “90-day review”. What followed was not a brief pause, but a drawn-out, chaotic disruption that stopped life-saving work across the globe, shutting down valuable organizations, and harming lives, health, and livelihoods. And that was just the beginning of a year of chaos. Many organizations and media coverage noted a growing recognition that the past year’s disruptions to global health were not just destructive, but catalytic, forcing a reckoning with how systems are built and for whom. Reporting from Bhekisisa reflected on how the sudden halt in US HIV funding exposed deep vulnerabilities in over-reliance on external aid, while also accelerating conversations about domestic financing, integration, and sustainability in the HIV response moving into 2026. At the same time, analyses from Health Policy Watch, Science, Nature, and The Lancet laid bare the human and scientific costs of abrupt policy shifts, shuttered programs, fractured research networks, and lost trust, while underscoring that simply restoring old funding streams will not be enough to meet future challenges.
IMPLICATIONS: Together, these stories and analyses point to the need to rethink and rebuild with stronger country ownership, diversified and predictable financing, resilient research institutions, and governance structures that prioritize equity, accountability, and community leadership. Rather than recreating the same architecture, reimagined global health systems must be less dependent on external donors and political ideology. As Global Health Watch has tracked for 52 weeks, the path forward is not about returning to the pre-foreign aid freeze status quo, but about using this period of disruption to construct a more durable, equitable, and responsive global health architecture. As Canadian Prime Minister, Mark Carney, said so clearly at this week’s World Economic Forum in Davos, Switzerland, “Nostalgia is not a strategy.”
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The US Congress is beginning to reassert its constitutional role in shaping federal spending. The joint House and Senate FY26 funding bill released last week covering foreign operations would maintain funding for core global health priorities, including HIV, tuberculosis, malaria, polio, family planning and reproductive health, neglected tropical diseases, Gavi, and UN agencies such as UNAIDS, UNICEF, and UNFPA. This week, legislators rejected nearly $2 billion in proposed cuts to US domestic HIV and related programs through the Labor, Health and Human Services Education and Related Appropriations Act (LHHS), a “major victory” credited to sustained advocacy by people living with HIV, advocates, and service providers. The proposed bill largely preserves funding for domestic public health and biomedical research. As AVAC’s Suraj Madoori said in a statement, “These crucial wins for global and domestic HIV now require us to not hold back, and urge Congress to swiftly approve all the FY26 bills, push the President to sign them, and for us to ensure accountability in the administration to spend and implement this lifesaving funding as instructed by the people and those who represent us in Washington D.C.”
IMPLICATIONS: Together, these bills signal a return to a bipartisan appropriations process and, if enacted, provide a basis to push back against unilateral cuts by the administration. They also signal bipartisan pushback against attempts to cut health and scientific research investments. By rejecting the steep cuts proposed by the administration, they stabilize lifesaving programs and protect the research enterprise. The House passed the bills on Thursday, and the focus now shifts to the Senate, which must pass the bills by January 30. Then onto the President to sign, and, most critically, for the administration to actually spend all Congressionally appropriated funds.
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This week also marks one year since the US announced its intended departure from World Health Organization (WHO). Debate over its future and the US’ role within it intensified as pressure from parts of the administration collided with growing concern over the consequences of disengagement. US officials and policymakers aligned with the “America First” strategy call for WHO to be fundamentally reformed or replaced. Analysts note that the US remains a formal member of WHO until debts are paid. Meanwhile, the US administration continues to withhold funding and delay payments, leaving millions of dollars in unpaid US obligations.
IMPLICATIONS: The current state, where the US remains technically engaged but substantively absent, poses serious risks for global health governance, disease surveillance and pandemic preparedness. As analyses from CSIS underscores, WHO reform is both necessary and possible, but meaningful reform requires constructive engagement, predictable financing, and political leadership, not abandonment.
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Reporting this week is exposing a pattern of US actions that show deep disregard for African public health leadership, ethical research standards, and sovereignty. The US-funded hepatitis B vaccine trial in Guinea-Bissau is at the center of this. As we reported in previous weeks, the unethical trial would delay birth-dose vaccination for thousands of newborns despite overwhelming evidence, and WHO guidance, that immediate vaccination saves lives. According to Rolling Stone, the study was championed by US officials aligned with anti-vaccine ideology and advanced even as Africa CDC officials raised alarm and indicated the trial should be halted. At the same time, the US administration has been marginalizing Africa CDC more broadly, cutting engagement, undermining its authority, and sidelining African institutions in favor of unilateral decision-making. This is being reinforced, as The Guardian reports, by members of the US administration urging US diplomats to emphasize American “generosity” to African leaders even as USAID programs are shuttered and health funding withdrawn.
IMPLICATIONS: Together, these developments signal a dangerous erosion of respect for African expertise, autonomy, and ethical authority in global health. Pushing forward research designs that would withhold proven interventions—while dismissing objections from Africa CDC and African scientists—revives patterns of extractive and unethical research long condemned by the global health community. Undermining Africa CDC while advancing ethically dubious trials weakens trust, damages partnerships, and threatens progress against hepatitis B, HIV, and other diseases where Africa has led with scientific excellence.
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This five-part series reflects on the tumultuous events of the past 365 days across five global health issues: the erosion of US foreign aid; dismantling of the research enterprise; attacks on vaccine policy; and shifts in the global health architecture.
As new IDSA CEO, Jeanne Marrazzo warned in a webinar this week, rising HIV infections threaten progress, but “this is not a time to despair. It’s a time to fight.” Watch the recording and explore the 2025 People’s Research Agenda, which tracks the science, flags gaps, and centers community priorities to keep HIV prevention moving forward.
“The last year has been one of chaos, anger, panic, and frustration. I think the coming year has to be one of strategic rebuilding and building something different—not building back but building forward. That means a different architecture at the country level, community level, regional level, and global level. A year from now, I suspect we’ll see fewer acronyms, but hopefully the ones that remain will be stronger than ever.” —AVAC’s Mitchell Warren, Bhekisisa podcast
This week marks one year since the US Presidential Administration issued a deeply cruel executive order freezing foreign assistance, halting billions of dollars in already-approved funding under the bad-faith claim of a “90-day review”. What followed was not a brief pause, but a drawn-out, chaotic disruption that stopped life-saving work across the globe, shutting down valuable organizations, and harming lives, health, and livelihoods. And that was just the beginning of a year of chaos.
To mark this moment, AVAC’s One Year Later series reflects on the impact of the past 365 days on five key areas of global health and development:
These pieces show how the field navigated a year defined by disruption and resilience—and how policy decisions reverberate through science, programs, and communities.
The year has been a profoundly transformative one for AVAC. The Devex in-depth retrospective, Fighting for Billions: The legal battle to keep US foreign aid alive, chronicles the ongoing lawsuits brought by AVAC, the Global Health Council and partners challenging the foreign aid freeze. The piece highlights how legal action became a critical line of defense against the dismantling of lifesaving programs and why the outcome still matters.
“For me, the best message I can say is a year later, we as a community are still standing. And that is a resilience in its own right. We are going to succeed in global health and development. Not because of what happened in the last year, but in spite of it.” —AVAC’s executive director Mitchell Warren on Bhekisisa’s new podcast, One year after Trump: The day HIV funding changed forever—and what came next
As Jeanne Marrazzo, the new CEO of the Infectious Diseases Society of America (IDSA) shared on our webinar earlier this week showcasing the 2025 update of the People’s Research Agenda (PRA), “We cannot yell it from the rooftops loud enough that new infections are going to rise and undermine efforts to end AIDS as a public health threat. But this is not a time to despair. It’s a time to fight. It’s a time to dig in and recognize not just what we’ve accomplished and why we need to protect that, but why we need to continue to move forward.” See the recording here and learn more about the PRA, which tracks the science, highlights where investments align—or fail to align—with community priorities and identifies critical gaps that must be addressed to ensure the prevention pipeline meets the needs of diverse populations.
The past year has reshaped global health—and AVAC—in ways that will be felt for years to come. The events of the past year also show that advocacy, evidence, and community leadership matter. Some courts provided the necessary check on power; advocates rallied; and scientists and civil society raised their voices and documented what was lost—and what must be protected (see 24 Hours to Save AIDS Research).
With your support, AVAC’s weekly Global Health Watch newsletter, now in its 52nd week, continues to track what happens, elevate what’s at risk, and help all of us navigate what comes next. Thank you to our community which stops at nothing to safeguard hard-won progress against HIV and in advancing global health equity.
The Lancet journal ended the year with a provocative editorial – 2025: an annus horribilis for health in the USA. But sadly, it was not just in the US; it has been a year of chaos and disruption globally. This 49th issue of Global Health Watch looks back—like many news stories this week—across 2025 to highlight the most consequential decisions, disruptions, and debates that defined the year and will continue to shape what comes next.
On the first day in office, the new US Administration issued a sweeping foreign aid freeze that halted life-saving global health and HIV programs, severed active grants, research underway and cost millions of people their lives and livelihoods. In less than a month, AVAC responded suing the President, the State Department and the US Agency for International Development (USAID). The Global Health Council also led a similar lawsuit challenging the freeze as unlawful and harmful. Together, the two cases argued for months in various courts that the foreign aid freeze not only jeopardized health as a human right but also bypassed congressional authority and undermined trust in US leadership. Ultimately, the cases unlocked millions of dollars of development assistance for work done in January and February, but millions more dollars expired at the end of the fiscal year in September. The cases are ongoing and as important as ever, both to restore foreign assistance and to re-assert that it is Congress (and not the President) who has the power of the purse.
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Science faced underfunding and systematic destabilization in 2025. In just one month under the new US Administration, the National Institutes of Health (NIH) abruptly canceled approximately 1,800 research grants. By April, mass layoffs and forced reassignments across Health and Human Services (HHS) agencies, including the Centers for Disease Control and Prevention (CDC), NIH, and US Food and Drug Administration (FDA), further crippled each agency’s capacity and expertise. A proposal to drastically cut the overall NIH budget and consolidate its 27 institutes was soon introduced along with the fiscal year 2026 budget, which proposed an $18 billion cut from the NIH and $1.5B cut in HIV prevention. Around the same time, the NIH signaled a major shift away from investments in basic science and clinical research, undermining the discovery pipeline that fuels future breakthroughs. Then, in November, HHS ordered the CDC to phase out all “non-essential” nonhuman primate research, threatening foundational preclinical studies, including those that have been pivotal to HIV PrEP and PEP, amongst many other health priorities. These actions were compounded by a pause or effective ban on some international research collaborations, a proposed cap on indirect cost rates that support core university infrastructure, and changes to the scientific review processes, together weakening the systems that sustain rigorous, independent research.
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Despite all the chaos, 2025 offered remarkable milestones in HIV prevention science, and a stark illustration of the contradictions shaping global health. Injectable lenacapavir for PrEP (LEN), the six-month injectable, which provides nearly complete protection against HIV infection, moved with unprecedented speed from regulatory approvals and guidelines to real-world introduction. South Africa and Zambia authorized LEN within months of US and EU regulatory approvals; the World Health Organization (WHO) rapidly issued guidance and prequalification; and initial LEN delivery began in Brazil, Eswatini, South Africa, and Zambia, setting the stage for expanded access in 2026. At the same time, efficacy trials began of the next promising PrEP option, the monthly oral candidate MK-8527, reinforcing what’s possible when innovation, evidence, and advocacy align.
Yet, all this scientific momentum occurred alongside the deepest assault on global health and the systems that make it possible. The cruel irony of this moment is that as the science breaks barriers, the infrastructure meant to support discovery, evaluation, and equitable delivery is being weakened, threatening the very gains the field has fought decades to achieve. As AVAC has emphasized, the greatest opportunity in HIV prevention lies in speed, scale, and equity.
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Actions in the last 11 months have eroded evidence-based policy, disrupted institutional capacities, and deepened mistrust and uncertainty in vaccine science. In May, NIH’s National Institute of Allergy and Infectious Diseases (NIAID) announced that funding for the Consortia for HIV/AIDS Vaccine Development (CHAVD) would end after the current grant cycle in June 2026 — eliminating $67 million annually and about 10% of global HIV vaccine research funding. Then, $500 million in Biomedical Advanced Research Development Authority (BARDA) grants for research and development of the mRNA vaccine platform were soon cancelled, and members of the CDC’s Advisory Committee on Immunization Practices (ACIP) were replaced. The US also stopped supporting Gavi, the vaccine alliance, and language on the CDC website was replaced with anti-science and anti-vaccine sentiment. As AVAC said in an August statement, “These actions dangerously sow vaccine disinformation and mistrust, which has proliferated since the COVID-19 pandemic. Dangerous ideology results in dangerous policymaking, putting many lives at stake and complicating efforts to both discover and implement clinical and cost-effective interventions to make America and the world healthier, safer, and more prosperous.”
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As rising nationalism, geopolitical tensions, and funding retrenchment intensify, the architecture of global health and how countries engage in it and with one another is being fundamentally reshaped. Longstanding multilateral systems are giving way to a more fragmented, country-to-country model under the US America First Global Health Strategy. The strategy prioritizes bilateral health Memorandums of Understanding (MoUs) with individual countries in exchange for funding support, data sharing, and pathogen access, signaling a major recalibration away from traditional multilateral institutions and frameworks. Meanwhile, the US stepped back from longstanding global health platforms including an unprecedented absence at the World Health Assembly, withdrawal from the WHO, and diminishing support for joint initiatives like Gavi, the vaccine alliance. Civil society and advocates are actively debating what this means for shared goals and equity in global health, even as institutions like WHO and UNAIDS explore how to adapt in a rapidly evolving landscape.
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