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

WHO and partners will convene to launch the Lancet Global health series: Shaping the Future of Clinical Trials. Details and registration link below.

We’re Going Back to Court

New developments in our legal battle against the United States government

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:

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

What we’re reading:

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

Avac Event

The Impact and Implications of Recent US Government Federal Funding Reductions on Health Programmes

The University of the Witwatersrand‘s Steve Biko Centre for Bioethics presented a webinar featuring:

  • Mia Malan, founder and editor-in-chief of the Bhekisisa Centre for Health Journalism – an independent media organisation that specialises in narrative, solutions journalism focusing on health and social justice issues across Africa.
  • Dr Ntombifikile Nokwethemba Mtshali, Chief Executive Officer of Shout-It-Now, an organisation focused on providing sexual and reproductive health and rights services
    to youth in the Gauteng and North-West provinces.
  • Mitchell Warren, Executive Director of AVAC – an advocacy organisation focused on accelerating access to effective HIV prevention options and ensuring access to everyone who needs them. Mitchell also worked with Population Services International (PSI) designing and implementing social marketing, communications and health promotion activities, including five years running PSI’s project in South Africa.

Avac Event

Updates to the PEPFAR Stop-Work Order and the Role of CCM

Join AVAC, COMPASS and other partners to update CCMs on the PEPFAR freeze.

Global Health Watch News Brief

New guidance, confusion, and advocacy in action

The sustained attacks on global health and the dismantling of critical infrastructure by the US government continued this week. Here is an overview of developments in US policies and their implications for the HIV response and global health equity.  

New Developments

  • Humanitarian Aid, PEPFAR Freeze and HIV Prevention 
    A pause on all US foreign assistance was announced January 20, leading to layoffs and halted delivery of life-saving medication and services, with severe consequences for communities. Last weekend, PEPFAR finally received a waiver for some treatment and programs for the prevention of mother-to-child transmission (PMTCT). However, guidance has been lacking as to which programs can resume. On Thursday, the US Department of State issued guidance allowing for the continuation of HIV testing for all populations and HIV care and treatment for all people living with HIV. But primary prevention and key population programming was excluded, and the guidance goes so far as to state: “people other than pregnant and breastfeeding women who may be at high risk of HIV infection or were previously initiated on a PrEP option cannot be offered PEPFAR-funded PrEP during this pause of US Foreign Assistance or until further notice”. In the meantime, almost all USAID staff were put on administrative leave and all contract staff at PEPFAR were laid off on Wednesday. Advocates and implementers in dozens of countries are already reporting significant setbacks, including closed drop-in centers and halted PrEP distribution. In an attempt to fight back and advance HIV prevention as core in the global HIV response, the African Women Prevention Community Accountability Board issued a powerful Call to Action for Sustaining HIV Prevention Gains for Women and Girls in Africa.

    IMPLICATIONS: The situation remains deeply concerning and riddled with confusion: while some waivers are being granted, many implementing partners continue to face stop-work orders, stalling critical services. Most alarmingly, disallowing individuals already on life-saving PrEP from continuing these services threatens to reverse hard-won progress in controlling the HIV epidemic. As Kenneth Ngure explains in the New York Times article on the USAID withdrawal’s impact on clinical trials: “Without regular [PrEP] injections or a carefully-managed discontinuation, the participants will not have enough cabotegravir to stop a new infection, but there will be enough in their systems that, if they were to contract the virus, it could easily mutate to become drug-resistant.” 

    READ
    Abandoned in the Middle of Clinical Trials, Because of a Trump Order – New York Times
    Too little, too late: What a PEPFAR waiver can’t do – Bhekisisa  
    The Status of President Trump’s Pause of Foreign Aid and Implications for PEPFAR and other Global Health Programs – KFF
  • USAID Shutdown and Dismantling 
    The majority of USAID staff and contractors were fired or placed on administrative leave and locked out of their accounts and out of the building in Washington, DC. Most essential functions of the agency have been stopped. Many lawmakers on both the Democrat and Republican sides have opposed these orders, but attempts to pass resolutions supporting USAID have been blocked in the Senate. Also, Secretary of State Marco Rubio informed lawmakers that he would also serve as Acting USAID Administrator and has given Peter Marocco, a political appointee at the State Department, additional responsibility at USAID. This allowed Marocco to start reviewing and possibly restructuring USAID’s programs. The State Department also began a review of USAID’s foreign aid activities, with the goal of potential reorganization. Reports late on Thursday were that USAID would have less than 300 staff left (down from over 10,000) and 800 awards and contracts were being canceled. Labor groups representing employees at USAID brought a lawsuit against the new administration over efforts to freeze foreign assistance and HIV advocates protested in Washington, DC Thursday demanding that the administration fully restore PEPFAR funding. So much for a 90-day pause and review – all done in two weeks? 

    IMPLICATIONS: This dismantling includes efforts to completely dissolve USAID, raising significant concerns about the future of global health and development programs. Many argue that a shutdown of the agency undermines US power and global influence, especially as China and Russia look to fill in the foreign aid gaps. As we wrote last week, contractors at USAID and the State Department Bureau of Global Health Security and Diplomacy (GHSD) are essential to the Bureau’s operations, and their expulsion paralyzes USAID, GHSD and PEPFAR. 

    READ:
    USAID may be reorganized, absorbed by the State Department, Rubio says – Devex 
    USAID Workforce Slashed From 10,000 to Under 300 as Elon Musk’s DOGE Decimates Agency – Wired 
  • New Gender Policy
    The US CDC, NIH and other federal health agencies removed hundreds of HIV-related web pages on 8,000+ websites following executive orders targeting “gender ideology” and “DEI.” This week, many of the pages have been restored, but without reference to transgender individuals. The restored pages show a rushed revision to content on HIV, STIs and sexual and reproductive health and important information for key populations has been removed. This censorship is further exacerbated by instructions from the new administration demanding that scientists at the US Centers for Disease Control and Prevention (CDC) retract scientific articles that include “forbidden terms” such as gender, transgender, LGBT, or transsexual. 

    The recent removal of HIV- and LGBTQ-related content undermines public health and health equity. Key resources, including HIV PrEP guidance and transgender-focused materials, were deleted or revised, leaving significant gaps in data and care recommendations. Though some information has been restored, critical omissions jeopardize effective HIV prevention, care, and outreach, particularly for marginalized populations at higher risk of infection. In response to the censorship of scientific publications, at least the British Medical Journal editors stood up in their editorial: Medical journal editors must resist CDC order and anti-gender ideology: “The US was considered a world leader in public health and research. With one repressive stroke that reputation risks being shattered and broken. If anything is forbidden now, it is that medical and science journals, whose duty is to stand for integrity and equity, should bow to political or ideological censorship.” 
  • Robert F. Kennedy Jr. Confirmation Hearings  
    The Senate Finance Committee voted to advance Robert F. Kennedy Jr.’s nomination for Secretary of Health and Human Services (HHS). His nomination now moves on to the full Senate after a 14-13 vote. Senator Bill Cassidy, a medical doctor and Republican from Louisiana, who voiced support for PEPFAR previously, ended up voting for Kennedy.  

    IMPLICATIONS: Despite concerns over Kennedy’s vaccine skepticism, AIDS denialism and racist views of immunology, his confirmation appears likely with a full Senate vote imminent. As HHS Secretary, Kennedy would have control over the US CDC, NIH, FDA and other important health agencies, including how funding is spent, how programs are administered and how science is communicated.  

Seeking Visuals and Videos

Leading groups in Washington, DC are urgently trying to collect videos and photos of what’s happening “on the ground” because of the freeze, such as clinic closures despite the waiver. Non-professional phone videos and photos are welcome. Contact or send to [email protected] for more details.

Contact or send to [email protected] for more details

What we’re reading

Resources

  • Litigation Tracker: A public resource tracking the legal challenges to the Trump administration’s executive orders, Just Security 

Tracking the impact

  • USAID Stop-Work, a resource tracking the impact of the stop work order to USAID 

In other news, there was progress in HIV prevention: Gilead Sciences submitted lenacapavir for PrEP to the European Medicines Agencies (EMA) for review, both to market in Europe as well as for an EU-Medicines for All (EU-M4all) application that would facilitate availability of LEN for PrEP in low- and lower-middle-income countries. This marks a big step toward ensuring injectable PrEP reaches those who need it most, which was also highlighted in this week’s Lancet HIV editorial: Steps toward quick and equitable roll-out of lenacapavir. This makes fighting to restart PEPFAR-supported PrEP programs all the more important, so the world can prepare for LEN introduction. If we can’t drive down new infections with all options, we can’t imagine a sustainable HIV response.