Advocating for Health Equity Archives

It’s been 22 weeks since the US president issued the executive orders that began the chaotic dismantling of USAID. See recent, remarkable, and much-needed New York Times coverage on the destruction of USAID. And check out this new episode of the This American Life podcast on the aftermath of shutting down USAID.

We at AVAC took a public stand against this attack on global health and development in our court case, AVAC v. United States Department of State, filed by Public Citizen on February 10. We took this step because we understood the devastation that would come from such drastic and sudden divestment in the HIV response and global health. We also believe it was illegal and unethical.

In March, US District Court Judge Amir Ali ruled the foreign aid freeze was, indeed, unlawful, and that the administration had “usurped” the authority of Congress. Since that time, some 400 grants have been restored and the government is slowly complying with the Judge’s order to pay all invoices for work conducted through February 13. It’s a mere fraction of USAID’s former self, but each of these restored programs and payments represent an attempt to make America and the world stronger, safer and more prosperous. Just as important, our court case, along with a related one brought by the Global Health Council and colleagues, has forced into the public record the administration’s cynical maneuvers to dismantle global health; information that empowers advocates to fight and, we hope, finally spurs Congress to do its job.

“We cannot cede ground gained against HIV and other global health threats out of fear or paralysis in the face of these reckless actions. It is imperative to hold this administration responsible. And it’s imperative to invest in global health and sustain the gains in HIV. Global health advocates know this better than anyone, and we are fighting back,” said AVAC Executive Director, Mitchell Warren.

Watch AVAC’s Executive Director, Mitchell Warren’s video explaining how this court case is one of many critical steps to safeguard global health and the HIV response.

Nowhere is that fight to safeguard and advance HIV prevention more important than work to rollout injectable lenacapavir (LEN) for PrEP, just approved by the US Food and Drug Administration. LEN approval signals what could be a turning point in the epidemic – but only if the field invests in bold, strategic action.

“The science is remarkable, and the FDA approval is in. But it’s what happens next that makes the science count. It’s whether or not the technology is made available and becomes truly accessible that will bring impact. Will the world get it right this time? Because for 15 years we’ve squandered the potential of PrEP. That hope depends on fierce and effective advocacy,” said Warren.

HIV prevention advocates around the world are demanding and preparing for injectable LEN to reach the communities that need it most with speed, scale and equity. Watch this video for more on status of LEN rollout and advocacy priorities.

“Scientific progress has been made over the years, and we celebrate them, but without truly having a prevention story to tell…yet. Now it’s time for that story to be told,” said APHA Executive Director Yvette Raphael.

Read this report from Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, Principles of a responsible transition of American leadership to end AIDS: Strategic transition or pandemic resurgence?, on how PEPFAR and US leadership can play an instrumental role in reaching epidemic control.

“There’s much work advocates are doing, and much work ahead. Some donors have come forward, but it’s only a start. We also need to advocate with regulatory authorities at the country level, not to mention pushing for an affordable price, and a big enough supply from Gilead now to support demand creation at scale in order to build a sustainable market, which in turn will support generics and further reductions in price. Advocates are now and will continue to be fighting at the country level and the global level to move all this forward,” said HEPS Uganda Executive Director Kenneth Mwehonge and co-chair of the Civil Society Caucus of the Coalition to Accelerate Access to Long-Acting PrEP.

Check out the Caucus statement on priorities for LEN rollout, and these resources to support our collective advocacy:

Recent news headlines, including the just published New Yorker magazine article by Science reporter Jon Cohen, capture the power of this moment to reshape the HIV response and finally control the epidemic. As advocates, we know the stakes very well.

“What all of us working together have tried to do for years and years and years, is to overcome the barriers from stigma to disinformation, that we’ve seen with oral PrEP, and with treatment 20 years ago. It will take Gilead, working with all of us advocates, to collectively ensure that this drug is accessible to all, so that the success depends not on the politics but on the product. We have to hold everyone, including ourselves, to account for keeping on task and for making sure that we do not squander this opportunity. So, let’s do this together and lay the groundwork for all future innovations to go faster, with speed, with scale and with equity for all,” Warren said.

The field is at a major inflection point, punctuated by both political challenges and scientific opportunity – and we can’t let the former overtake the latter.

The timeline for generic LEN for PrEP to come to market is expected to be significantly shorter than for CAB for PrEP. Bioequivalence (BE) testing for LEN, which demonstrates a generic product works in the body in the same way as the originator product, is likely to be six months, vs. the 18 months for CAB for PrEP, because of differences in the drug formulation. The rapid granting of voluntary licensing by Gilead also contributes to this shorter timeline. For the latest on LEN, visit here.

AVAC denounces recent proposals and actions by the US administration that signal a clear intention to defund and eliminate lifesaving global health research, development and delivery programs. If passed by Congress, proposed funding rescissions for the current year’s budget would claw back billions of Congressionally appropriated dollars for critical, life-saving programs. In addition, the President’s Fiscal Year 2026 (FY26) budget proposal would further cut funding and entrench a wide range of anti-science and anti-public health policies, many of which undermine the rights of communities vulnerable to HIV. AVAC urgently calls on Congress to step-up in bi-partisan support that aligns the US federal budget with evidence and delivers impact.

“These actions are doing irreparable harm to health research and programs that form the backbone of global efforts to end HIV,” said Mitchell Warren, AVAC’s executive director. “This is not just a budget proposal; this is a shortsighted and reckless policy roadmap that provides further proof that this administration has no regard for science, research, or public health. Every day of unchecked executive overreach unravels decades of progress. Congress must fulfill its duties and intervene to protect policies and programs that have made Americans and the world safer, healthier and more prosperous.”

Released in May as a “skinny” version, the President’s full FY26 budget proposal would dismantle the architecture for global health, including programs and research with historically broad bipartisan Congressional and public support. The FY26 budget proposes slashing PEPFAR by 34% and National Institute of Allergy and Infectious Diseases (NIAID) funding by 36%, for a combined total of over $5.5 billion in cuts – potentially crippling HIV programs and research. The FY26 budget further targets the Global Division of HIV and Tuberculosis (DGHT) at the US Centers for Disease Control and Prevention (CDC) by eliminating it along with other global health programming at the agency. PEPFAR is severely weakened without the partnership of CDC’s global health division and USAID, which bring vast expertise and technical assistance in the implementation of programs at the country-level.

Additionally, the proposed rescissions package would eliminate over $900 million from FY25 global health programs. The rescissions package would cancel not-yet-spent funds, and the administration has not excluded PEPFAR from these further reductions. If passed by Congress, it would codify, or make legal, the unlawful dismantling of USAID, which was initiated through presidential executive overreach and reckless actions by DOGE across federal agencies. Just as important, harmful, ideological rhetoric across FY26 budget documents and the rescissions package attempt to justify targeted cuts to services for the LGBTQI+ community, family planning and reproductive health. Such policies are antithetical to a rights-based public health approach to meeting critical needs among communities who are the most marginalized and vulnerable to HIV and other diseases.

These actions by the administration also come on the heels of last week’s announcement of the elimination of NIH funding for the Consortia on HIV/AIDS Vaccine Development (CHAVD). Founded in 2005, the CHAVD programs – based at Duke University and Scripps Research Institute – have been instrumental to advancing HIV vaccine research and development, contributing to progress toward an HIV vaccine and other scientific innovations.

“A shuttered CHAVD imperils the ongoing quest for an HIV vaccine and sidelines scientific discovery at large, leaving some of the most accomplished scientists in the world without the federal resources needed to continue vital research,” said Stacey Hannah, director of Research Engagement at AVAC. “Americans need to be reminded that vaccines are one of, if not the most cost-effective, impactful health interventions. The CHAVD cuts represent an attack on fundamental science that protects the well-being of all and boosts prosperity in our country and the world.”

These actions are part of a broader anti-science agenda from this administration, which has already taken steps to severely constrain the work of the HIV Prevention Trials Network, the HIV Vaccine Trials Network, the Adolescent Medicine Trials Network for HIV/AIDS Intervention, and the Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections (ACTG).

“In a cruel irony, these combined cuts come just as the field reaches a moment of historic promise in HIV prevention,” said John Meade, senior program manager for Policy Advocacy at AVAC. “Later this month, the US FDA is expected to approve lenacapavir (LEN) as a twice-yearly injectable form of PrEP. This product represents the culmination of decades of investment in all stages of scientific innovation, including basic science and global research infrastructure, especially in South Africa. Without NIH investments over the past two decades, the world would not be on the cusp of approval and introduction of LEN for PrEP.”

AVAC calls on Congress to exercise its power of the purse under the Constitution by rejecting the President’s proposed cuts to global health, research, development and science. Congress must maintain this critical funding, which makes the world safer, healthier, and more prosperous. Congress should also immediately reject the rescissions package in its vote expected next week and do all it can to restore funding for HIV research and programming across the federal government.

The field must urgently make the case for sustained investment. Everyone concerned about the devastating effects of ongoing and threatened cuts should reach out to their Senators and Congresspeople immediately. Call the Capitol switchboard at (202) 224-3121, or reach out to your Senators online and Representatives directly.

Contact: [email protected]

NEW YORK, NY, June 5, 2025 — AVAC denounces recent proposals and actions by the US administration that signal a clear intention to defund and eliminate lifesaving global health research, development and delivery programs. If passed by Congress, proposed funding rescissions for the current year’s budget would claw back billions of Congressionally appropriated dollars for critical, life-saving programs. In addition, the President’s Fiscal Year 2026 (FY26) budget proposal would further cut funding and entrench a wide range of anti-science and anti-public health policies, many of which undermine the rights of communities vulnerable to HIV. AVAC urgently calls on Congress to step-up in bi-partisan support that aligns the US federal budget with evidence and delivers impact.