Anxiety in Paradise: Highlights From the 26th International AIDS Conference in Rio de Janeiro

Following AIDS 2026 in Rio de Janeiro, TheBody reflected on the stark disparities on display. “There were all of these tensions there,” AVAC’s Executive Director Mitchell Warren said. “Between the amazing science and the difficult political and economic time we’re in. Between the opportunity of new, long-acting prevention tools and the fact that we were in a region of the world where access to them doesn’t exist. And between what could be and what currently is.”

Global Health Watch: Exec Order Changes Childhood Vaccine Recs, $2B in Faith-based Aid, NIH Restricts Policy Rx

Issue 81

This week, the US Administration announced $2 billion in global health funding for faith-based organizations; US Congress intensified oversight of PEPFAR and the bilateral global health agreements; the NIH moves to restrict policy-focused research; and – perhaps most alarmingly – the US President issued an executive order rewriting longstanding, evidence-based childhood vaccine recommendations.

US President Issues Executive Order Changing US Childhood Vaccine Recommendations 

The US President issued an executive order to overhaul the US childhood vaccination recommendations. The order bypasses the longstanding scientific review process traditionally led by expert advisory bodies including the CDC’s Advisory Council on Immunization Practices (ACIP), which has historically informed this process, before being politicized by the current Administration. The order reduces the number of vaccines recommended for all children; calls for the combined measles, mumps and rubella (MMR) vaccine to be administered as three separate shots; shifts several vaccines—including hepatitis A and B and COVID-19—to “shared clinical decision-making”; and expands exemptions for school immunization requirements. Public health leaders and clinicians immediately condemned the order, warning that it contradicts decades of scientific evidence, creates confusion and raises new barriers for vaccine access.

IMPLICATIONS: The latest executive order is another divergence from evidence-based public health policymaking and toward politically driven decision-making. Public health experts warn that replacing established scientific review with executive action could erode confidence in childhood immunization, increase vaccine hesitancy and reduce vaccination coverage, leading to more outbreaks of vaccine-preventable diseases. A New York Times article profiles Japan as a “cautionary tale” after the government modified its vaccine schedule for MMR in 1993, making the measles and rubella single shots and the mumps component entirely voluntary. Consequently, coverage of mumps vaccination plummeted, and cases then soared – resulting in deaths among unvaccinated children in Japan. The changes by the federal government also signal how vaccine policy is being developed in the US, raising concerns that scientific expertise is being sidelined in favor of political priorities, and driven by misinformation and skepticism in vaccines.

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US Administration Awards $2 Billion to Faith-Based Organizations 

The US Department of State awarded $2 billion in global health and humanitarian assistance to faith-based organizations (FBOs), the largest allocation of foreign aid to these groups in more than 20 years. Under its “America First” Global Health Strategy, the funding, a majority spread over five years, will support faith-based hospitals and clinics in 17 countries and emergency humanitarian response, with major awards going to a consortium of Christian FBOs including World Vision, Samaritan’s Purse and Compassion International. Of the $2 billion awarded, approximately $1.4 billion will be for healthcare programming primarily in Africa.

IMPLICATIONS: News of global health funding is welcome after such sweeping cuts and months of delay, but it marks a major shift in how the US is delivering its foreign aid. The Administration claims the awards reflect a more efficient, results-driven approach and were not based on religious affiliation. However, former USAID officials and global health experts question whether the decisions were guided by evidence. FBOs historically are critical partners in delivering critical care and global health programming in countries that receive US foreign assistance. However, prioritizing a smaller group of FBOs over a broader range of implementing partners, where funding has been frozen or contracts terminated, could reshape HIV prevention and global health programs, and these large FBOs have many of the same administrative and overhead costs as other international NGOs, which were heavily criticized by the Administration in closing down USAID. Concentrating resources in fewer organizations also raises questions about whether diverse, community-led approaches to HIV prevention and health equity will continue to receive the support needed to reach the populations most affected. Moreover, representatives from recipient FBOs contend that the new money does not easily supplant or replace funding lost from the cuts and dismantling of USAID, when many FBOs were adversely affected and forced to reduce programming or shutdown services.

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US Congress Continues to Take Oversight Actions on Global Health Programs

Democratic members of the US Congress continued oversight of the US Administration’s global health policies this week with new inquiries into PEPFAR and the Administration’s “America First” Global Health Strategy. California Representative Robert Garcia, the ranking Democratic member of House Oversight and Government Reform Committee, requested in a letter answers from the US Secretary of State following disruptions to PEPFAR and emerging data showing how they have contributed to the deaths of hundreds of thousands of people and the closure of at least 1,700 HIV service sites. Separately, Democratic Senator Raphael Warnock of Georgia led colleagues in a separate inquiry, questioning the Department of State’s reported requirement that African countries grant US officials direct access to sensitive national health data systems as a condition of receiving global health assistance through the bilateral memorandum of understanding (MOUs) agreements that are currently being negotiated with recipient countries. As part of the inquiry, Senate signatories requested a formal briefing from the State Department to answer these questions and provide updates on the data conditionalities present in these agreements.

IMPLICATIONS: The escalation of these congressional inquiries reflects mounting concern in both chambers of Congress over the Administration’s continued restriction and termination of congressionally appropriated global health funding, the lack of transparency surrounding its bilateral Memoranda of Understanding (MOUs), and the need for greater accountability in how the Administration is unilaterally reshaping US global health policy and using foreign assistance as leverage. These latest requests for information also suggest that sustained advocacy by the global health community is beginning to influence policymakers, as new evidence continues to document lives lost and the erosion of global health infrastructure resulting from this accelerated restructuring. While congressional oversight alone will not reverse these policy changes, it demonstrates that coordinated advocacy is elevating global health issues and helping shape the debate around future policy.

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US Senate Blocks White House OMB Rule as NIH Faces New Policy Research Restrictions

Following the US Senate’s official vote to temporarily block the White House Office of Management and Budget’s (OMB) proposal to give political appointees greater authority over federal grant decisions (until December 11), Nature reported this week that the National Institutes of Health (NIH) has begun turning away grant applications for research where the primary purpose is to shape and inform policymaking. This, coupled with the Administration’s attempt to weaken the role of scientific review through the blocked OMB regulation, demonstrates increasing intention to politicize federal research priorities in line with political ideology and not evidence. Internal NIH documents reportedly state that policymakers are no longer considered “mission-relevant stakeholders”, placing dozens of health policy research grants in question.

IMPLICATIONS: Efforts to reshape the US research enterprise are extending beyond a single OMB proposal to influence what research is funded, who can use it and how scientific evidence informs public policy. While advocacy from the scientific community is gaining traction, the temporary block does not resolve overall concerns about political influence over research funding. And restricting support for policy-focused research would weaken the evidence base that informs decisions on HIV, infectious diseases, pandemic preparedness, and public health, making it more difficult for policymakers to respond to emerging health challenges with rigorous scientific evidence guiding decision-making that is aimed towards saving lives.

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Dr. Anthony S. Fauci Should be Celebrated as a Public Health Hero, Not Harassed and Persecuted by Anti-Science Bigots

What We’re Reading

Aids is no longer exceptional. What happens now?

Following AIDS 2026, Bhekisisa’s Mia Malan reflects on the annual conference that took place amid an unprecedented funding crisis and the dwindling political will to address HIV. As AVAC Executive Director Mitchell Warren said, “What comes out of a conference [or movement] is more important than what happened at the conference. Three to six months from now, we need to ask: are we working differently because we gathered in Rio? …I hope the answer will be clear: coming together and planning together strengthened our Aids response. That’s the measure of success.”

The Second Injection

In her Substack, Skye Grove unpacks the distance that still lies between products and services and the people who need them. Reflecting on AIDS 2026 conversations and sessions, she shares insights from AVAC’s Executive Director Mitchell Warren, Access Bridge’s Executive Director Wawira Nyagah, and AVAC partners like Yvette Raphael and Adaobi Lisa Olisa.

Global Health Watch: Fauci in Contempt + New NIAID Director, Senate Blocks OMB’s Grant Proposal, New CDC Director, AIDS 2026 Highlights

Issue 80

This week, the US Senate Committee on Homeland Security & Governmental Affairs voted along party lines to hold Anthony Fauci in contempt of Congress for his refusal to answer questions during last week’s hearing on the COVID-19 response testimony – while it was rumored that Steven Quay, a lab-leak proponent, is in line for Fauci’s old job. At the same time, the US Senate Appropriations Committee did step up to stop the White House OMB’s politicization of federal research grants. There’s also – finally – a new leader of the US Centers for Disease Control and Prevention (CDC). And the HIV/AIDS community is unpacking major themes emerging from the AIDS 2026 conference.

Anthony Fauci and the Future of NIAID

The US Senate Committee on Homeland Security & Governmental Affairs voted Thursday to hold former NIAID Director Anthony Fauci in contempt of Congress, raising a years-long political campaign against him just a week after he was grilled by Republican Senators for hours over the COVID-19 pandemic and its origins. Much of the scientific and public health community rallied around him after his appearance: “Dr. Fauci is a public health pioneer, who has saved more lives than anyone sitting in the Senate today. He has dedicated his life to public service. Because of Tony Fauci, science has moved faster, lives have been saved and communities are more engaged in every phase of infectious disease research,” wrote AVAC’s Executive Director in a statement. “[Fauci’s] career was built on evidence, intellectual rigor and an unwavering commitment to improving people’s lives,” wrote American Society for Microbiology CEO Stefano Bertuzzi in a letter to the committee, calling Fauci’s scientific record “the gold standard.”

Following the hearing, Health and Human Services Secretary (HHS), Robert F. Kennedy Jr. (RFK Jr.) appeared in media interviews targeting Fauci and pushing misinformation on vaccines and medical information, all while preparing to appoint Steven Quay, a pharmaceutical executive and prominent advocate of the COVID lab-leak theory (and longtime Fauci critic) to lead NIAID, the agency Fauci and then Jeanne Marrazzo directed for nearly four decades and which oversees $6.5 billion in annual research funding. Quay was not even among the finalists interviewed for the role, but Kennedy selected him nonetheless, according to Politico. Quay—a physician and pathologist—could become the first NIAID director drawn from the pharmaceutical industry rather than academia or the NIH, despite lacking formal training in infectious diseases.

IMPLICATIONS: Quay’s expected appointment would mark a major shift in the leadership and direction of NIAID, which is arguably the world’s most influential biomedical research agency. This, along with the Senate Committee’s decision to hold Fauci in contempt of Congress signals that alignment with the Administration’s ideology is more important than scientific expertise in setting US research priorities and public health policy. Together, the message is clear: if you dare to challenge political ideology, it has consequences. This will likely have a chilling effect on researchers and scientists reluctant serve in government and speak out during health crises.

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US Senate Blocks White House OMB’s Grant Proposal Temporarily

This week US Senators on both sides of the political aisle moved to temporarily block the White House Office of Management and Budget’s (OMB) proposal to give political appointees greater authority over grant decisions and weaken the role of scientific peer review. In a stopgap spending bill released by Senate appropriators, Democrats and Republicans joined in adding a provision that would prevent the OMB rule from taking effect until at least December 11, while Congress negotiates broader government funding measures. The proposal was originally slated to go into effect on October 1, but opposition from appropriators, including Senate Appropriations Chair Susan Collins, slowed the path forward.

IMPLICATIONS: This development suggests that months of public opposition and advocacy from the advocacy and scientific community may be beginning to influence policymakers. The Senate’s intervention is one of the first signs that resistance to the OMB proposal extends beyond the scientific community and into both parties in Congress. However, the delay is only temporary, and, if implemented, the rule could fundamentally reshape the US research enterprise by injecting political considerations into grantmaking, weakening peer review and undermining the international collaborations that drive progress against HIV, emerging infectious diseases and other global health challenges.

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US Senate Confirms New Centers for Disease Control and Prevention Leader

The US Senate confirmed Erica Schwartz as the next director of the Centers for Disease Control and Prevention (CDC), after a year without a confirmed leader. Schwartz is a former deputy surgeon general and chief medical officer of the US Coast Guard. During her controversial confirmation hearing, she agreed to uphold scientific integrity and transparency, but did not challenge or speak to RFK Jr.’s position on vaccines and other controversial health policies.

IMPLICATIONS: Schwartz will take over the agency, which has seen a major reduction of its workforce, political battles over vaccine policy and mounting public health threats. While her appointment to the leadership post may bring some stability, many public health leaders question whether she is able to lead an independent CDC outside of the Administration’s political pressure as RFK Jr. continues to attempt to reshape federal health policy. Will Schwartz defend scientific evidence, particularly on vaccines, infectious diseases and outbreak preparedness? That is the question the many advocates and leaders are waiting to answer.

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International AIDS Conference Wraps Up: Rising Above to Meet the Moment

The International AIDS Conference (AIDS 2026) concluded last Friday. It was marked by extraordinary scientific progress and growing political and financial uncertainty. New data showed the consequences of the US Administration’s retreat from global health leadership, with nearly 2,000 HIV service sites closed and prevention programs for key populations severely disrupted following cuts to PEPFAR and other foreign-aid programs. While delegates applauded Merck’s decision to license its investigational monthly oral PrEP pill, alimatravir, to generic manufacturers before Phase 3 trials are complete, leaders warned that supply shortages threaten the rollout of injectable lenacapavir for PrEP (LEN) and called attention to the exclusion of Latin America in access agreements despite its central role in clinical research. Other major advances in prevention, treatment and cure, including innovative community-based and pharmacy delivery models for long-acting prevention and news of two more patients with HIV and cancer were cured following stem cell transplants for cancer treatment were presented showing the promise of new technologies, but the conversation focused on whether they can be developed and deployed feasibly and at scale.

IMPLICATIONS: AIDS 2026 underscored a stark reality: the greatest barriers to ending HIV are increasingly political rather than scientific. Across sessions on prevention, vaccines, cure research, artificial intelligence and service delivery, one theme emerged repeatedly: innovation alone is not enough. As AVAC’s Mitchell Warren shared in a commentary, translating scientific breakthroughs into public-health impact will require sustained political commitment, financing, supply chains and delivery systems that can move with speed, scale and equity. As governments cut funding and retreat from longstanding partnerships, the conference made clear that communities are not merely beneficiaries of the HIV response, they are its leaders, and the future of the epidemic will depend on their ability to shape the research, policies and programs that come next.

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What We’re Reading

#Aids2026: Three HIV announcements South Africa made in Rio

Bhekisisa unpacks three announcements from the International Aids Conference in Rio could mean for the future of HIV prevention in South Africa. Following the announcement that Merck has granted generic licenses for the monthly HIV prevention pill alimatravir before trials are complete, AVAC’s Executive Director Mitchell Warren commented on the news. “We don’t yet know if the medicine will work, so Merck is taking a risk. But, in my opinion, it’s a wise strategic risk,” Warren said.

Mitchell Warren on HIV service integration amid cuts | AIDS 2026

Mitchell Warren, AVAC’s Executive Director, says that HIV programs adapting to steep funding cuts are drawing on service delivery innovations that were already underway before the cuts hit, not because of them. “The success stories right now are not the responses to the destruction of what had been. They are representing the kinds of programmatic iterations that, frankly, you could actually do even faster and better if we hadn’t broken the system.”

The Human Pain Behind Global HIV Funding Cuts

At AIDS 2026, advocates reflected on the human impact of HIV funding cuts. Navita Jain, a Senior Program Manager at AVAC, explained, “We were in year eight of a 10-year project, really getting momentum going and accelerating prevention research, and the cuts had a massive effect, with no guidance provided or a plan for a way forward.”

Beyond science: the AIDS 2026 debate argues that curing HIV also involves confronting stigma.

Agência Aids reflected on the Beyond Science: What Does a Cure Mean for Our Community session held in AVAC’s HIV Cure & Prevention Research Networking Zone at the AIDS 2026 conference.

Fauci praised as ‘hero’ by public health experts after Senate hearing

In response to the Senate Homeland Security and Governmental Affairs Committee subponeaing and questioning Dr. Anthony Fauci, AVAC submitted a letter of support for Dr. Fauci. “We implore the committee to cease its erroneous investigations and harassment of renowned scientists and public servants such as Dr. Fauci, whose career, track-record, and devotion to public health research and development has changed the very course of the HIV epidemic at home and abroad,” AVAC Executive Director Mitchell Warren wrote to the Committee.