This Issue Brief describes the impacts of the elimination and reduction of funding that supports sexually transmitted infection (STI) research, testing, and prevention programming. This funding is critically important as STI rates continue to increase globally with more than 1 million curable STIs, including chlamydia, gonorrhea, syphilis, and trichomoniasis, acquired every day. Without appropriate testing, treatment, and prevention programs, there is a risk that STI rates will continue to increase leading to more cases of infertility, pelvic inflammatory disease, and cancers. Further, there is the risk that we will lose the ability to monitor, react to, and prevent the rise of antimicrobial resistant gonorrhea, which has become an issue for the majority of treatment options currently available.
Worldwide Prevention, Shared Protection
Why STI Funding Matters
Research Matters – Resources to Protect Research Funding
For more than 30 years, AVAC and partners have worked to protect the infrastructure and funding that drives lifesaving HIV and biomedical research. Today, that mission is more urgent than ever.
Funding from the National Institutes of Health (NIH) fuels innovation, drives the economy, and saves lives. Cuts to this support will make America—and the world—poorer, sicker, and less prepared for future health threats.
Tomorrow (Wednesday, April 30), the US Senate Appropriations Committee will host a hearing on Biomedical Research: Keeping America’s Edge in Innovation at 10:30am ET. Click here to watch the hearing.
And be sure to read the written statement to the Committee from AVAC and The Federal AIDS Policy Partnership (FAPP) Research Working Groups, which provides a strong, urgent appeal to Congress to reject future funding cuts to the NIH and shows the importance and impact investments in biomedical research have had on lives and livelihoods.
Resources for Researchers
In addition, AVAC, TAG and the HIV Medicine Association (HIVMA) co-created a new resource hub, Research Matters, to support researchers advocating for sustained NIH funding. These tools include an Advocacy Toolkit to help move our collective efforts forward. Please share this link with any researchers who have received NIH funding—we will continue to update the hub with resources to support continued advocacy for biomedical research.
Share Your Story
Additionally, AVAC and partners are collecting stories of impact—if you know someone willing to share their story about how NIH cuts are affecting their work, contact John Meade Jr. at [email protected]. This Huffington Post piece by Katie Edwards at the University of Michigan is a terrific example of a researcher sharing the real-world toll on scientists, trial participants, communities, research and public health.
Thank you for standing with us to protect science, health, and progress.
AVAC and FAPP Written Statement: US Senate Hearing on Biomedical Research
AVAC and FAPP submitted written testimony for the US Senate Appropriations Subcommittee’s April 30th hearing, “Biomedical Research: Keeping America’s Edge in Innovation.”
A set of suggested questions for the Senators to consider was also included in hopes of spotlighting key issues around the importance of lifesaving research conducted by the NIH—specifically in the area of HIV—and its critical role in health equity and innovation. We hope that this can be entered into the record for this hearing.
Research Matters Advocacy Toolkit
This toolkit for researchers shares key messages, practical advocacy guides, and resources to help move our collective efforts forward.
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.
Resources
- AVAC v. United States Department of State, AVAC
- AVAC press releases summarizing key decisions in the case, AVAC
- Global Health Watch, AVAC
- All public documents related to the case, Court Listener
- Impact of US Funding Cuts, UNAIDS
- Viewpoint: Testing the Boundaries of Presidential Powers in Health, JAMA
The Role of PEPFAR in HIV Prevention
Protecting Black and Brown Communities Amidst Foreign Aid Cuts
AVAC Senior Program Manager for Policy, John Meade Jr., describes PEPFAR’s historic legacy and strongly argues for its continued importance in the face of attacks by the new US administration. This piece appears in The Broadsheet, the magazine published by the Congressional Black Caucus Health Braintrust.
Impact of PEPFAR’s Stop Work Order on PrEP
The impact of the stop-work order on PrEP is expected to be severe. In a set of slides and on our website, PrEPWatch, we have posted the results of an analysis drawing on key informant interviews with representatives of Ministries of Health and PrEP implementers between 27 January 2025, when stop-work orders were issued by the US government, and the end of February 2025, when the vast majority of USAID-funded projects received official termination notices. Find the latest here.
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.
PEPFAR: A Strategic Necessity for US Leadership and Global Health
The US President’s Emergency Plan for AIDS Relief (PEPFAR) is one of the greatest investments in global health and US diplomacy. With over 20 years of partnership and huge impact, PEPFAR is critical to ending HIV as a public health threat for everybody, everywhere. Champions of global health and evidence-based HIV prevention made clear the potential to end the epidemic or to lose decades of progress in fighting HIV at a March 5th US Congressional briefing, hosted by Congresswoman Robin Kelly, the Congressional Caucus on Black Women and Girls, AVAC and the Global AIDS Policy Partnership (GAPP).
PEPFAR and its lifesaving services have been threatened by the new US administration’s executive order freezing all foreign aid funding. While some PEPFAR programs received waivers to restart some HIV treatment and prevention of mother-to-child transmission (PMTCT) services, many of its activities continue to be suspended indefinitely, including programs for girls, young women, orphans, and vulnerable children. PEPFAR’s authorization expires on March 25.
“The hardest hit are key populations, those already on the margins of society,” said AVAC’s John Meade Jr., Senior Manager for Policy who co-moderated the briefing. “Clinics are shutting down, and communities are losing access to prevention and treatment. Congress must act immediately to restore funds to this extraordinary program. This is not a partisan issue. PEPFAR has enjoyed bipartisan support because it works, because it saves lives. It strengthens economies and reinforces America’s role as a leader in global health.”
Chris Collins, President and CEO of the Friends of the Global Fight Against AIDS, Tuberculosis and Malaria and AVAC co-founder, said that since 2003 when PEPFAR began, it has delivered an unprecedented success in mounting a response against HIV/AIDS, saving 26 million lives and building systems and infrastructure that effectively deliver treatment and prevention.
“People need to understand, we are on a trajectory to end the epidemic with PEPFAR. What it would mean for the United States to continue to lead this global effort would be one of the greatest accomplishments of the century. And it would be an American accomplishment with our partners around the world. There’s a huge prize out there waiting.”
Participants all referenced the UNAIDS goal of ending AIDS as a public health threat by 2030. Angeli Achrekar, Deputy Executive Director of the UNAIDS, described the grave risks of missing this moment: “The end is almost in sight. Yet, if we do not get to the end, we risk serious resurgence. Those gains, that have been made with so much investment and engagement by governments and American taxpayers, will be reversed. We risk backsliding in all this strategic engagement. It’s a reality we all have to face.”
Achrekar said PEPFAR’s fight against HIV/AIDS has led to extensive public and private investment, and among many US businesses, who have strengthened lab and surveillance technology, supply chains, data science, monitoring and evaluation, and healthcare systems at large.
“The result is that countries are not just able to respond to HIV but also to COVID, mpox, Ebola, H1N1 and other threats. That is so important, to stop diseases where they are and prevent them coming to the US,” said Achrekar.
Linda-Gail Bekker, CEO of the Desmond Tutu Health Foundation in South Africa and an AVAC board member, shared the results of a recent modelling study, Potential Clinical and Economic Impacts of Cutbacks in the President’s Emergency Plan for AIDS Relief Program in South Africa: A Modeling Analysis, which found that eliminating PEPFAR would lead to 600,000 additional HIV-related deaths and 565,000 additional HIV infections over 10 years, and increased healthcare expenditures across the population by approximately $1.7 billion. And Bekker decried the additional impact on HIV R&D from US policy under the new administration.
“We are damaging our ability to do ethical clinical research, which I fear because although we have made strides, we have yet to discover an HIV vaccine that is effective, we still have a real quest for a cure, and it takes great effort to stay one step ahead of this virus with treatment and prevention.”
Jirair Ratevosian of the Duke Global Health Institute detailed a 2 to 5 year transition plan for PEPFAR countries to achieve 50% co-financing of their programs, repurpose funding to places where the epidemic is intensifying, and cost-savings through scaled-up prevention of long-acting PrEP for 5 million new users by 2030. Read the recommendations in Reform and Renewal: Five Recommendations for PEPFAR. The prevention target builds on a landmark agreement, announced in December 2024, between PEPFAR, Global Fund, the Children’s Investment Fund Foundation and the Gates Foundation, to provide affordable access to injectable lenacapavir, aiming to reach 2 million people over three years in PEPFAR and Global Fund–supported countries.
“Let’s not forget the amazing opportunity in front of us right now, which is scale-up of long-acting PrEP,” said Ratevosian. “There are two long-acting prevention products right now. If we can get those out to the people most at risk, we can drive down HIV incidence dramatically, in combination with getting treatment to everybody who needs it. That’s the real sustainability in HIV, where countries can take on their own response if we can get these epidemics under control—and that’s do-able if we go to scale with the technology we have.”
In the midst of chaos and confusion, Congress and the new administration need to recognize that ending an epidemic is both the right thing to do and completely possible at this moment in history. Embracing the policies and funding to make it happen makes America and the world stronger, safer, and more prosperous.
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.