Critical Advocacy: How Civil Society is defending the HIV Response and Global Health 

The upending of US policy by the new presidential administration has collapsed the foundation for global health and the HIV response at every level, from research to program delivery.  

It’s been a desperate scramble for everyone who cares the lives and wellbeing of those impacted by HIV. Wading into the chaos, all over the world are advocates who began organizing within days, even minutes—as soon as the US government federal executive orders started coming down.  

Positive change depends on fierce and effective community leadership, and pressuring powerbrokers to do the right thing.) 

Two veteran global health leaders from civil society join us to talk about how civil society is responding. Amanda Banda is Strategic Advisor to the COMPASS Coalition and Asia Russell is Executive Director of Health Gap, and both are members of CHANGE, a coalition with more than 1,500 people, from organizations in nearly every continent, working in coordination to defend global health and the HIV response.

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Lawsuit Wins and What’s at Stake

AVAC v The US Department of State

On February 10, 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.

AVAC’s Executive Director, Mitchell Warren and Public Citizen Litigator, Lauren Bateman explain these lawsuits and why they matter.

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Global Health in the Lurch: What’s happening now and who is pushing back?

 KFF’s Jen Kates and AVAC’s John Meade break it all down on PxPulse Live.

A snapshot of global Health in the first weeks of the Trump Administration, this episode covers the impact of the US freeze on foreign aid to critical federal agencies and the HIV research pipeline and explores action in Congress and among civil society to push back.

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Community-Led Monitoring: Transforming the HIV response in Malawi

For several years now, Community-Led Monitoring has been on the rise in the HIV response, and particularly in East and Southern Africa. Known as CLM for short, it’s a tactic being championed and implemented to ensure that communities play a direct role in monitoring and improving HIV services.

In this episode of PxPulse: The Advocacy Chronicles we delve into CLM in Malawi, where civil society and communities are successfully using this approach to connect government decision makers to the gaps in HIV services and to what people really need. Thanks to persistent advocacy, both PEPFAR and Global Fund now recognize, through their funding, the critical role of CLM.

The episode features David Kamkwamba, a journalist and health advocate and the former chair of the Civil Society Advocacy Forum on HIV and related diseases, commonly known as CSAF tells us what advocates have accomplished in Malawi and just how they did it. CSAF and AVAC are partners in the Coalition to Build Momentum, Power, Activism, Strategy & Solidarity (COMPASS) which has supported extensive work on community-led monitoring in Malawi and across the region.

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Download the full podcast (19:55) or listen below.

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An Advocacy Chronicle on Universal Healthcare in Tanzania, with Atuswege Mwangomale of Sikika

In this episode of PxPulse: The Advocacy Chonicles, Atuswege Mwangomale goes deep on the advocacy work behind the passage of Tanzania’s Universal Healthcare Law. Atu serves as Head of Health Programs for Sikika, a Tanzania-based advocacy organization with a long track record of promoting best practices in governmental financing in the health sector, and advocating for improved health outcomes. Sikika, along with AVAC, is also a member of the COMPASS coalition, which uses data and coalitions across Africa to identify strategic campaigns to advance the HIV response. 

Sikika’s advocacy has been crucial to the ultimate passage of Tanzania’s Universal Health Insurance Bill in 2023, but full funding must still be secured for the law to achieve full impact.  

Atu explains the promise of UHC in Tanzania, how Sikika won the trust of government allies, and why working in coalition was essential to success.

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PxPulse: The Votes are In — What’s next for the US’ role in global health and HIV prevention

KFF’s Jen Kates and AVAC’s Suraj Madoori lay out the challenges and the priorities in 2025 and beyond. 

In the days, months and years ahead under a new US Presidential Administration, advocacy for choice, freedom, science, and rights will require intentional strategies to protect hard fought gains in HIV treatment and prevention and in global health generally, and to safeguard policies and programs that advance it. And there will be major implications for the global AIDS response.

Navigating through the work ahead involves assessing the potential impact on PEPFAR and Global Fund support; on USAID, NIH, CDC and the FDA; on the US relationship to WHO and other UN agencies; and on evidence- and rights-based policies and programs generally. Joining us to begin those efforts and better understand the landscape for advocacy are Jen Kates from KFF and our own Suraj Madoori.

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PxPulse: The Advocacy Chronicles with Danielle Campbell from PrEP in Black America

In this episode of the Advocacy Chronicles, we’re putting the spotlight on the US, on the dismal statistics on access to PrEP in Black communities, on the state of HIV prevention among Black Americans overall, and the work of one advocacy group— PrEP in Black America (PIBA). Danielle Campbell is one of the founders of PIBA and a long-time advocate for HIV prevention and health equity. She joins the Advocacy Chronicles to talk about PIBA’s call to action for an HIV research agenda that prioritizes the needs of Black communities. And we also explore the tactics that have led this group to quickly rise as a powerhouse, bringing together communities and government to find solutions that improve the US HIV response.

Danielle is a member of the research faculty at the Charles R. Drew University of Medicine and Science and a member of the community scientific subcommittee for a global HIV research network. She is an experienced clinical research manager who integrates principles of health equity and implementation science into biobehavioral research into HIV treatment, prevention and cure research and she is a past Chair of the HIV/AIDS Section of American Public Health Association (APHA) and has served as Chair of the Science Board and Co-Chair of the Joint Policy Committee.

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Lenacapavir: The case for investing in delivering HIV prevention

The promise of long-acting PrEP has been super-charged this year by studies showing the powerful efficacy of an antiretroviral known as lenacapavir (LEN).

This episode of PxPulse goes deep on LEN for PrEP. Recorded just days before Gilead’s announcement that PURPOSE 2 also found very high efficacy, Dr. Flavia Kiweewa, a principal investigator of PURPOSE 1, the first trial to announce efficacy, lays out the research findings and what they mean. And Chilufya Kasanda Hampongo of Zambia’s Treatment Advocacy and Literacy Campaign and Mitchell Warren of AVAC talk about how to change a long history of squandered opportunities to get rollout right.

The PURPOSE1 trials announced findings in June that a twice-yearly injection of LEN was 100% effective among cisgender women, with zero new cases of HIV. And the PURPOSE 2 trial among cisgender men, and trans and non-binary people, was shown to reduce the risk of HIV by 96%.

LEN now enters a select category, one of five ARV-based options for PrEP that all protect against HIV if you take them. But many of the people applauding the results from PURPOSE 1 and 2 will tell you that breakthrough science like this is, as hard as it is, is still the easy part. To break the back of the HIV epidemic demands overcoming an altogether different challenge—coordinating and accelerating every step in rolling out new products so that everyone who needs HIV prevention can get it.

Listen to this podcast to learn what must be done to finally deliver on the promise of highly effective HIV prevention, from pills to rings to injectable PrEP and beyond.

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PxPulse: An Advocacy Chronicle on U=U in South Africa with Mandisa Dukashe

On this episode of PxPulse: The Advocacy Chronicles, Mandisa Tyadi Dukashe, Treatment Technical Lead at the South African National AIDS Council (SANAC) describes her work in helping to inspire and launch a National U=U Campaign in South Africa in 2024.

What is U=U? Undetectable equals Untransmittable refers to a major breakthrough in the science and understanding of HIV treatment. From data published in 2019, researchers confirmed that people living with HIV who have an undetectable viral load and take medication as prescribed have zero risk of transmitting HIV to their sexual partners.

This evidence galvanized a worldwide campaign, with the hope that spreading the word, Undetectable equals Untransmittable, would reduce stigma around HIV and inspire people to maintain their treatment. 

The WHO released guidance in 2023 on how to monitor viral load, which provided supportive global policy for ministries of health. But WHO action is not enough to set public health policy or fulfill the promise of U=U.

Mandisa has long list of credentials behind her: She’s the co-founder of the U=U Africa Forum, part of the U=U Global Community Advisory Board, an alumnus of the AVAC Cure Research program and the AVAC Advocacy Fellows Program. Among many accolades, she has also been recognized as a 2021 Amazing People Living with HIV by HIV Plus Magazine.

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PxPulse: The Advocacy Chronicles with Ruth Akulu

On this episode of the Advocacy Chronicles: a look at advocacy in Uganda for the Dual Prevention Pill (DPP), a new product combining oral PrEP and oral contraception.

Ruth Akulu is a Youth Representative of the Uganda Country Coordinating Mechanism Board for Global Fund, member of the DPP Civil Society Advisory Group, and a 2022 AVAC Advocacy Fellow. Akulu talks about her work to mobilize regulatory authorities to prepare for the DPP. And while she was at it, the establishment of a groundbreaking new initiative, the Product Regulator’s Engagement Committee, which is supporting ongoing engagement between government regulators and young women representing their communities.  

Listen to learn why the DPP is a priority for young women and HIV prevention, the challenges Ruth confronted and tactics that supported the success of this advocacy.

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