This toolkit for researchers shares key messages, practical advocacy guides, and resources to help move our collective efforts forward.
Research Matters Advocacy Toolkit
Global Health Watch: Tariffs, NIH Cuts, Black-led HIV Research Agenda & PEPFAR’s Legacy
This week brought major developments for global health: new tariffs on pharmaceuticals are pending, a court blocks the cap on NIH indirect costs, and worries a leadership vacuum at the CDC is a cause for yet more concern. Amid the chaos, advocates rallied—defending PEPFAR’s legacy in Congress and launching a national Black-centered, Black-led HIV research agenda.
Read on for highlights and implications and be sure to check out the What We’re Reading section, which is full of great pieces this week.
Tariffs and HIV
As the administration created even more chaos with the on-again, off-again sweeping tariffs and threats of major trade wars, a new report highlights concern and potential effects on health systems—including HIV prevention and care. Finished pharmaceuticals are temporarily exempt, but essential components like diagnostic tests, syringes, excipients and other medical supplies may not be protected, raising alarms about cost increases and supply chain delays. And on Tuesday, the President announced at a dinner that new tariffs targeting pharmaceuticals are now officially “coming soon.”
IMPLICATIONS: If global pharmaceutical manufacturers move their operations to avoid tariffs, FDA inspections—with many fewer resources in the wake of last week’s mass layoffs—could delay approval of new products. Clinics, hospitals and other health systems may face increased costs, limited availability of products and a more fragile supply chain.
READ:
- How Will Trump’s Tariffs Impact Medicine and Healthcare?—Medpage Today
- Trump Defends Tariffs, Announces Pharmaceutical Levies Coming Soon—The Wall Street Journal
NIH Overhead Cuts Blocked by Court
A federal judge issued a permanent injunction blocking an administration policy that would have capped indirect cost payments at 15% for both new and existing NIH grants. The policy threatened to cut billions in support for universities, academic centers, and research institutions—jeopardizing infrastructure, staff, and ongoing studies. While the administration may appeal the ruling, it marks an important step in what could be a long legal battle over the future of federal research funding. At the same time, massive uncertainty remains at NIH, given the numerous staff and grant terminations.
READ:
- Federal judge issues permanent injunction on Trump cuts to research overhead payments—STAT
- A closer look at the nationwide impact of NIH cuts—Axios
- How Trump 2.0 is slashing NIH-backed research — in charts – Nature
US CDC Uncertainty
Internal memos reported by Inside Medicine indicate that the US CDC currently has no legally-required Acting Director, which leaves the agency in a leadership vacuum at a critical time. Dr. Susan Monarez, who previously served in an acting capacity, became ineligible for that role after being nominated for the permanent position on March 24. In the meantime, scientists and advocates are calling on federal and state health leaders to protect the nation’s only STD reference laboratory and reinstate over 30 scientists affected by the recent reduction in force (RIF) amid a growing public health crisis of rising STDs and drug-resistant infections. Colleen Kelley, chair of the HIV Medicine Association (HIVMA) testified before Congress Wednesday advocating for the CDC’s prevention division, continued funding in HIV care, prevention and research.
IMPLICATIONS: Without a legally authorized director, decisions normally reserved for CDC leadership—including the acceptance of upcoming vaccine recommendations by the Advisory Committee on Immunization Practices (ACIP)—must now be made by HHS Secretary Robert F. Kennedy Jr., a known vaccine skeptic. This raises urgent concerns about legal compliance, scientific integrity, and public trust, particularly as thousands of CDC staff have been laid off and critical public health decisions loom.
READ:
- Scoop: CDC has no Acting Director, sources confirm—Inside Medicine
- A Federal Lab That Tracked Rising S.T.I.s Has Been Shuttered—New York Times
Making the Case for PEPFAR
On Tuesday, EGPAF’s Catherine Connor and Ambassador Mark Dybul testified at the US House Appropriations Subcommittee hearing on PEPFAR, issuing powerful affirmations of the program’s life-saving impact—and the bipartisan commitment to its future. Lawmakers from both sides showed strong support for PEPFAR. They also shared an interest in innovation—including the promise of long-acting PrEP—to strengthen the program’s next phase. Their testimony came at the same time that Michel Sidibe and colleagues published new data in a Lancet Correspondence underscoring PEPFAR’s legacy—in saving an estimated 26 million lives, and also in catalyzing a 212% increase in domestic health investment across PEPFAR-supported African countries, since 2004. In the same issue, Lucie Cluver published updated modeling of the impact of potential PEPFAR cuts.
READ/WATCH:
- Hearing – Assessing the President’s Emergency Plan for AIDS Relief (PEPFAR)—House Appropriations Committee
- Accelerating domestic investments to end AIDS in Africa—The Lancet
- Protecting Africa’s children from extreme risk: a runway of sustainability for PEPFAR programmes—The Lancet
- Impact of PEPFAR Stop-Work Order on PrEP—AVAC
A Black-led Agenda for HIV Research
PrEP in Black America (PIBA) and more than 80 Black researchers, scientists, and community leaders, launched the first-ever national Black HIV Prevention Research Agenda this week, a call to action and a blueprint to end HIV in Black communities. The agenda centers Black voices, leadership, and lived experience to influence how HIV prevention research is conducted, funded, and implemented. AVAC’s John Meade described the launch as a moment of “reckoning and resistance,” pointing to the urgent need to protect public health infrastructure, advance equity, and resist political threats to HIV research and LGBTQ+ rights. This domestic research agenda importantly complements the People’s Research Agenda that AVAC and global partners released last October. The two documents provide a truly global, community-led perspective on the future of HIV prevention research.
READ:
- Advancing the Movement: HIV Prevention Research For Black Communities—PIBA
- Advancing the movement: 100 Black researchers, scientists unveil agenda to support HIV Prevention Research—The Atlanta Voice
The Future of Injectable Lenacapavir for PrEP
Clinical Infectious Diseases covered two viewpoints offering different perspectives on the future of injectable lenacapavir for PrEP—and the future of HIV prevention more broadly.
- The Need for Lenacapavir Compulsory Licences in Ending the HIV Epidemic
- Lenacapavir for Human Immunodeficiency Virus (HIV) Prevention: A Commitment to Equitable Access and Partnership by Gilead Sciences
What We’re Reading
- Is This the Beginning of a New H.I.V. Crisis?—The New York Times
- Undermining HIV Prevention Now Will Cost Billions Later—Contagion Live
- Who Will Care for Infants With H.I.V. Overseas—The New York Times
- A refusal to abandon HIV science—AIDS
- The Effects of Reductions in United States Foreign Assistance on Global Health—SSRN (pre-print)
Update on AVAC vs. Department of State
Two months ago, AVAC sued the US government over an Executive Order that froze all foreign assistance.
Since then, the court has ordered the government to restart certain payments and uphold its legal obligations. But delays, resistance, and appeals continue—putting global health, HIV prevention, and US credibility on the line.
Read our update on the case and watch our latest episode of PxPulse Live where AVAC’s Executive Director Mitchell Warren and Public Citizen litigator Lauren Bateman unpack the latest legal developments.

Resources
- The Status of PEPFAR’s USAID Programming—amfAR
- Tracking the Freeze:Real-Time Impact on Key Populations--GBGMC
- The impact of suspensions and reductions in health official development assistance on health systems—WHO
- The Best Investment You Didn’t Know You Made: How NIH Funding Fuels Innovation and Economic Growth— amfAR
- Quick Take: HIV Research Matters for America—O’Neil Institute and amfAR
- What Do Federal Staffing Cuts and HHS Restructuring Mean for the Nation’s HIV Response?—KFF
- Domestic Funding Contributions to Health: Comparing Changes in Domestic Financing in PEPFAR and Non-PEPFAR Supported Countries—amfAR
- The USAID List of Terminated Global Health Awards – What Does it Tell Us—KFF
A Fight for Global Health and Justice: An update on AVAC vs. US State Department
Just two months ago, AVAC led other organizations to sue the US government including the President, the US State Department and USAID, seeking emergency relief from an Executive Order that inhumanely froze all funding for foreign assistance. This case may well help to determine the future of foreign assistance, executive overreach, and the role of evidence, facts, and values in US policy.
“[This lawsuit] is among the first cases litigating the increasingly important issue of the government’s power to issue mass terminations of grants. We’ve seen the administration employ this strategy across a host of agencies. And we’re proud to be in the fight to establish that these sort of careless, reasonless, mass terminations are illegal.” — Public Citizen’s Lauren Bateman
Upon filing the case, the US District Court judge immediately granted a temporary restraining order requiring the government to reinstate frozen foreign aid and, shortly after, ruled that it must pay for work already completed by NGOs and other contractors. Despite the court’s clear directive, the government delayed compliance for weeks. It wasn’t until mid-March that payments began to trickle out. Several thousand payments for past work have been processed over the past several weeks, but the government reported to the court on Friday that 6,000 payments for overdue invoices are still to be processed.
The judge also ordered the government to spend congressionally appropriated funds for foreign assistance – an action they are actively resisting. And last week, they appealed to a higher court, seeking reversal of the order they must spend the full amount of funds that Congress appropriated.
In the latest episode of our PxPulse Live, our video podcast, AVAC’s Executive Director Mitchell Warren and Lauren Bateman, litigator at Public Citizen, which is representing us in the case, unpack the latest developments in this landmark case, including early wins, legal hurdles, and what lies ahead.
New: PxPulse Live – Lawsuit Wins and What’s at Stake

This case stands not only for the principle of fair process but for the belief that global health is a public good worth protecting, funding, and fighting for.
We hope you will listen and share our video widely. The world is watching—and we won’t back down.
AVAC Condemns HHS Mass Layoffs
AVAC condemns the US administration’s ongoing reduction in force (RIF) of the US Department of Health and Human Services (HHS), which oversees 13 agencies, including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the National Institutes of Health (NIH). In a strategically blind and callous move, the administration has begun to dismiss 20,000 public servants and leaders across every domain of global health research, policies and programs—without any clear plan to sustain life-saving work across these agencies.
Among the thousands of colleagues removed from their positions are two stalwart leaders in HIV, sexually transmitted infections (STI) and sexual and reproductive health: the CDC’s Jonathan Mermin and NIAID’s Jeanne Marrazzo. These two professionals epitomize the best in scientific leadership—unyielding commitment to evidence, rights, community engagement, and to translating science into policy, programs and practice.
“What we’re witnessing is a true ‘brain drain’ at the highest levels of government. Losing Drs. Marrazzo and Mermin is a loss for everyone dedicated to advancing human health in the US and around the world,” said Mitchell Warren, Executive Director at AVAC. “By removing these leaders and defunding the work that has led to breakthroughs in HIV prevention and treatment, this administration is setting the US back decades. These personnel changes aren’t just numbers on an organizational chart, but the removal of dedicated public health leaders who have helped build what so many of us rely on. These illegal actions will make America and the world poorer and sicker.”
As the world’s largest funder of biomedical research, decades of NIH investments have driven the discovery and development of therapies and preventive interventions for HIV, tuberculosis, STIs, viral Hepatitis and other infectious diseases. The Adolescent Trials Network (ATN)—created in 2001—revolutionized research by generating data to develop and deliver life-saving HIV and STI interventions for adolescents, an often-excluded group in research. However, recent cuts have gutted the ATN, undermining decades of investment by NIH and American taxpayers to advance healthcare for adolescents. Just as important, the role of the CDC is absolutely essential, by preventing, detecting and responding to emerging health threats. Together, NIH and CDC drive research, policy and programs that lead to groundbreaking discoveries and safeguard human health. These ill-informed decisions risk not only the economic stability of our scientific workforce but also a resurgence of diseases like HIV and TB, reversing years of scientific advancement.
“The advancements of science have given the world lifesaving options in HIV and many other diseases,” said Stacey Hannah, Director of Research Engagement at AVAC. “The wholesale dismantling of research infrastructure is a reckoning for the field. We cannot—and will not—stand by as science, which has delivered products, programs, and services that combat diseases and empower communities, is systematically dismantled. Once, bipartisan support fueled excellence in public service and research; science has only grown stronger since then, and now we need leadership that matches its promise.”
“It’s devastating that this is happening now—when in four decades of battling the HIV epidemic we’ve never had the opportunity that we have now with long-acting injectable PrEP to put the world on track to end the AIDS epidemic,” Warren added. “Years of investment, collaboration, and community engagement, with leadership from CDC and NIH, had begun to break down longstanding barriers. Now, this momentum has been abruptly halted. Without urgent, coordinated action, the hard-won gains in HIV prevention will be reversed, leaving communities more vulnerable and deepening inequities.”
AVAC urges Congress to take action in stopping the wanton destruction and assault on science being waged by the administration. Without federally funded public health research, the US risks losing its place as a global leader in biomedical research and becoming more vulnerable to the next infectious disease threats.
Self-Care Advocacy for HIV and STI Prevention
Self-care, the ability of people to promote and maintain health, prevent disease, and cope with illness and disability with or without the support of a healthcare worker is especially critical now, as the new US administration’s sweeping funding cuts and policy shifts threaten to erode support for traditional healthcare services, including HIV and STI programs.
By putting testing, prevention, and treatment directly into people’s hands, self-care can help communities maintain vital health services despite reduced funding, limited access to healthcare, and diminished government support. Read our new guide, Self-Care Advocacy for HIV and STI Prevention, on STIwatch.org.
Avac Event
WHO-Lancet Global Health Series: Shaping the Future of Clinical Trials
We’re Going Back to Court
Three weeks ago, AVAC, as well as the Global Health Council and partners, sued the U.S. State Department and government officials including the President, to end the freeze on foreign assistance funding that is harming global health and development programs, including lifesaving HIV prevention efforts.
On February 13, a US federal district court immediately granted a temporary restraining order and directed the government to lift the freeze and restore funding while our lawsuit progresses. Since then, the administration has repeatedly refused to restart funding, and the court has made clear more than once that the continued freeze is unlawful.
“The government comes to this Court with an emergency of its own making,” our lawyers wrote in a filing.
The lengths that the government is willing to go to flout a court order, all for the goal of ending life-saving humanitarian assistance, is staggering,” they said.
Now we have a court date: this Thursday, March 6 at 2pm Eastern Standard Time, we will be in Washington, DC, to make the case for human rights, health and dignity – and the government paying its bills.
This fight is far from over, and your support has been instrumental in reaching this point, and together, we can continue to champion the rights and health of communities worldwide.
How you can stay connected:
- Follow: For updates on our case and one filed by Global Health Council, visit AVAC vs. Department of State. For the latest on the policy environment in the US, subscribe to our weekly Global Health Watch.
- Donate: Your financial contributions are vital to fund our legal actions and advocacy efforts! Give here.
- Advocate: For the latest breaking news on US government developments, Join Community Health & HIV Advocates Navigating Global Emergencies (CHANGE) for briefings and advocacy strategizing. You can keep a close eye on implications at PEPFARWatch and the PEPFAR Impact Tracker.
- Share: Help us spread the word! Share Global Health Watch and other AVAC updates with your networks.
These are immensely challenging times for all of u, and it is easy to be paralyzed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.
Avac Event
CROI 2025 Community Breakfast Meetings
The Community Breakfast Clubs are virtual webinars coordinated by the CROI Community Liaisons, the European AIDS Treatment Group, AVAC, and their global collaborators. They feature researchers and advocates discussing some of the most consequential science being presented at CROI.

Session Recordings
Breaking New Ground: The latest advances in HIV cure
March 10, 2025
AVAC, the CROI Community Liaison Subcommittee and European AIDS Treatment Group hosted the first virtual Community Breakfast Meeting (CBMs) for the 2025 CROI meeting. Speaker details and recording below:
Moderator: Michael Louell, University of Washington-Seattle, Fred Hutch Center for AIDS research
Speakers
- Dr. Katie Bar, University of Pennsylvania, CROI Scientific Program Committee
- Dr. Marina Caskey, Rockerfeller University
- Dr. Steven Deeks, University of California, San Francisco (UCSF)
- Ms. Doreen Mora Moracha, HIV Cure Advocate- Kenya, CROI Community Educator Scholar
The End of AIDS — Near and Far? (40 Years of HIV)
March 11, 2025
AVAC, the CROI Community Liaison Subcommittee and European AIDS Treatment Group hosted the second virtual Community Breakfast Clubs (CBCs) for the 2025 CROI meeting. Speaker details and recording below:
Moderator: Grace Kumwenda, AVAC
Speakers:
- Dr. Chris Beyrer, Duke Global Health Institute
- Chilufya Kasanda, Treatment Advocacy and Literacy Campaign – Zambia, CROI Community Educator Scholar
- Dr. Mitch Matoga, UNC, Malawi
Still Here! Living with HIV Long-Term
March 12, 2025
AVAC, the CROI Community Liaison Subcommittee and European AIDS Treatment Group hosted the third and final virtual Community Breakfast Clubs (CBCs) for the 2025 CROI meeting. Speaker details and recording below:
Moderator: Sean Hosein, European AIDS Treatment Group – Canada
Speakers:
- Kennedy Mupeli, Center for Youth of Hope – Botswana, CROI Community Educator Scholar
- Dr. Peter Hunt, University of California San Francisco, CROI Scientific Program Committee
- Dr. Laura Waters, The Mortimer Market Centre – London
Global Health Watch: Africa Rises, Legal Battles Mount, and NIH in Turmoil
This week’s issue covers African governments’ efforts to address the gaps left by the US foreign aid freeze, escalating legal battles, policy changes at NIH and communities mobilizing against it all.
African Governments Stepping Up to Lead
Over the years, AVAC-supported projects such as CASPR and COMPASS have been advocating for African governments to invest more in health. Now, in response to the US foreign aid freeze and the dismantling of USAID, African governments are beginning to address the enormous challenges ahead. This week, Nigerian lawmakers approved $200 million for its health sector; the Ministry of Health in Zambia committed to ensure uninterrupted HIV, TB and Malaria services despite the freeze; and health departments in South Africa are implementing contingency plans by offering HIV patients six-month supplies of medication to cope with freeze of US-funded HIV projects. Some leaders are arguing that the rollback of critical programs like PEPFAR, expose a long-standing dependence imposed by the Global North and see the crisis as an opportunity for African nations to invest in their own healthcare, research, and collaborative networks.
READ: This commentary from the president of the South African Medical Research Council Ntobeko Ntusi: US aid cuts are an opportunity to reimagine global health.
AVAC vs. Department of State
In new developments in the AVAC vs. Department of State case against the foreign aid freeze, last Thursday, the US judge granted AVAC’s request for a “temporary restraining order” (TRO) that theoretically would restart funding. This week, the US government, in a court filing, argued it had the authority to suspend the foreign aid freeze, despite the restraining order issued by the judge. Public Citizen’s Litigation Group that is representing AVAC, filed a further motion on February 19 to hold USG officials in contempt for ignoring the order and to fully enforce the TRO. Read more about it in this Politico story. In the government’s response on February 20, they say they are following the TRO. We’ll see what the judge says!
And perhaps the most interesting part of our motion on the 19th is the exhibit from a “Jessica Doe”, the alias for a USAID whistleblower whose story in her declaration describes the toll in human suffering of the freeze. It is alarming.
IMPLICATIONS: Regardless of the court’s ultimate ruling, many programs will likely be eliminated or redesigned according to the State Department’s waiver process—one that excludes primary prevention beyond PMTCT and eliminates rights-based, science-driven advocacy.
FOLLOW ALONG: You can follow along with progress on the case at, https://avac.org/avac-vs-dept-of-state/.
JOIN US: Today at 9:00am ET / 17h00 EAT where the lead lawyer from Public Citizen, Lauren Bateman, and Mitchell will discuss the case on a Public Citizen call that’s open to all; you can join here.
Reduced NIH Workforce and Indirect Cost Cap
The US administration significantly reduced staffing across the Department of Health and Human Services (HHS), firing approximately 3,600 employees. Many of those dismissed worked at the National Institutes of Health (NIH) and on emergency preparedness and at National Institute of Allergy and Infectious Diseases (NIAID).
Later today, Friday, a judge will review another lawsuit challenging the executive order which would cap indirect costs at the NIH at a far lower level—a temporary restraining order was granted last weekend pausing this action. However, if the government is successful in executing the order, the new cap is expected to result in the loss of billions of dollars to support NIH-funded research at academic campuses around the country, forcing labs closures and significant job losses among researchers around the world.
IMPLICATIONS: Reducing NIH’s workforce and indirect cost rates could cripple critical biomedical research and compromise the nation’s ability to address both chronic and emerging health threats. While the administration defends these actions as necessary streamlining and cutting wasteful spending, critics argue that the indiscriminate nature of the firings jeopardizes vital health initiatives and undermines public trust in government support for scientific innovation.
READ: Mass firings decimate US science agencies–Science
USAID Employees’ Lawsuit
In the latest legal challenge against the administration’s dismantling of USAID, 26 former and current USAID employees have filed a lawsuit against Elon Musk. They allege that Musk, through his leadership of the Department of Government Efficiency (DOGE), decimated the agency without proper authority, acting without a formal appointment or congressional nomination.
IMPLICATIONS: This case, the fourth of its kind targeting actions against USAID, underscores the chaotic and reckless nature of these measures, which are dismantling decades of progress in global health and humanitarian aid.
Communities Respond to Executive Orders
Civil society advocates across global health continue to organize and drive action through the new Community Health & HIV Advocates Navigating Global Emergencies (CHANGE) coalition, developing resources for advocates and organizing to protect access to HIV treatment and prevention. Find their resources featured in Global Health Watch and contact them at [email protected]. Community-led organizations are also mobilizing rapidly in response to the foreign aid funding freeze and the immediate disruptions they are experiencing—clinics closing, staff layoffs, and shortages of critical supplies like ARVs and HIV testing kits. Emergency meetings, such as those convened by UNAIDS, are underway to assess the damage and coordinate mitigation measures.
The science and academic communities are also mobilizing, articulating the impacts of NIH’s cap on indirect costs, filing class action lawsuits to stop the firings, and organizing the March 7 event, Stand Up for Science, in Washington, D.C.
IMPLICATIONS: With policies changing overnight, legal decisions being ignored, and funding being abruptly halted, there’s an urgent need for health systems that do not rise and fall with political whims. This crisis is an opportunity to create a stronger, more sustainable and more resilient global health framework that truly protects and empowers communities.
Resources
- The Impact and Implications of Recent US Government Federal Funding Reductions on Health Programmes, The Steve Biko Centre for Bioethics at The University of the Witwatersrand event recording
- Most Lifesaving Services Remain Paused: A Rapid Assessment of the PEPFAR StopWork Order, amfAR, CHANGE, Data ETC
- Litigation Tracker: A public resource tracking the legal challenges to the Trump administration’s executive orders, Just Security
- Tracking the Stop Work Order, PEPFAR Watch
What we’re reading:
- Early impacts of the PEPFAR stop-work order: a rapid assessment—JIAS
- US Science in Peril—JAMA
- As HIV Activists Disrupt PEPFAR Hearing, an Expert Explains the Damage Trump Has Already Done to the U.S. Global AIDS Fight–Positively Aware
- The mess inside Rubio’s ‘lifesaving’ waivers—Devex
- What Trump’s freeze in federal funding means for the global fight against AIDS—NPR
- Health Department green-lights longer supply of antiretroviral medicine amid US aid freeze—Daily Maverick (SA)
- How the health department will deal with Pepfar’s near collapse—Bhekisisa
- I Used to Run the N.I.H. Here’s What Worries Me—New York Times (opinion)
- The future of PEPFAR and U.S. HIV programs—Positively Aware
- Emergency Food, TB Tests and H.I.V. Drugs: Vital Health Aid Remains Frozen Despite Court Ruling—New York Times
In other news, there was more progress in HIV prevention: the US FDA agreed to an expedited review of the new drug application of lenacapavir for PrEP. Read Gilead’s press release. The FDA has until June 19 to issue its decision. The Lancet also published new data from the B-PROTECTED clinical trial, finding the dapivirine vaginal ring is safe to use during breastfeeding. And The 8th replenishment of the Global Fund has launched.
Donate today to help fund our efforts. Every contribution helps us keep the pressure on!
Avac Event
Can Africa Finance its Own Non-profit Sector?
The webinar will explore whether shifts in the US government’s funding is a setback or an opportunity to rethink Africa’s reliance on Western aid.
Featuring:
- Angelo Katumba — Senior Program Manager: AVAC
- Yvette Raphael — Executive Director of Advocates for the Prevention of HIV in Africa
- Dr. Michael Kiragu — AICS Associate & Grant Fundraising Expert