Introducing Global Health Watch! Tracking US actions and their impact

The last week has been intense and sobering. As strategic and dedicated advocates, we already know the profound impact elections have on our work and our world. Recent developments in the United States underscore the challenges ahead, especially with the new administration’s alignment with the Project 2025 agenda—a playbook designed to reshape US federal agencies and policies drastically. 

There are already Executive Orders—which are directives issued by the President of the United States—that have significant implications for our collective work, in the US and around the world. This is, we fear, just the beginning. Administrative actions, such as pausing foreign assistance, including the lifesaving PEPFAR program; halting diversity, equity and inclusion (DEI) initiatives; curtailing public communications; and “scrubbing” agency websites represent a systematic effort to control narratives and stifle dissent. And many of the Executive Orders from this past week are aimed at changing who is in control of information.  

Some of the new political and policy shifts that we are tracking and what they mean for the programs and systems that matter most to HIV prevention efforts, include:  

AVAC will continue to track these developments, analyze their implications, and convene and coordinate with partners to strategize responses. Beginning this week, we will share a weekly synthesis and insights report, Global Health Watch to help navigate this challenging terrain and ensure our advocacy for an evidence- and rights-based, equitable response to the HIV epidemic continues.  

In addition, AVAC and PrEP4All published a new commentary in POZ magazine asking philanthropic funders gathered at this week’s Funders Concerned About AIDS (FCAA) Summit to adapt to these urgent threats. AVAC urges donor partners and advocates to support one another, and join together in an emergency effort, with immediate funding. As a united front, we can and must defend global health and human rights at this crucial time when collective action by donors, multilaterals, advocates and impacted communities is imperative.   

Stay strong, stay safe, and stay sane. It’s a long road ahead, but with our partnerships, we must persevere. 

Avac Event

Introducing the Dual Prevention Pill: Lessons Learned and What’s Next for Regulatory, Research, and Rollout

This webinar has been cancelled because funding was pulled by the new US administration. Follow critical developments in US policies and their impact on global health via our new newsletter. Learn more here.

Join the IMPT and guest speakers from AVAC and Population Council for a discussion on the dual prevention pill (DPP)—a single pill that combines oral pre-exposure prophylaxis (PrEP) and oral contraception (OC) to prevent HIV and pregnancy. If approved, the DPP will be the first multi-purpose prevention technology (MPT) to be marketed since condoms.

The discussion will include real-time learnings to inform the broader MPT field on the DPP’s regulatory approval process, acceptability study results in South Africa and Zimbabwe, implementation updates, and lessons learned. 

There will be a Q&A session following the presentations.

Much Accomplished, Much to Do

2024–2025 Fellows Progress Update

As we enter a new year, we also enter the midway point of the AVAC 2024-2025 Fellowship program, which runs 18 months. Fellows and their projects are taking giant strides in new areas of advocacy, and realizing strategic wins toward epidemic-bending goals, with much more to come! For more than a decade, Fellows have tackled critical issues for the field, focusing on U=U and new technologies, including long-acting PrEP, the Dual Prevention Pill (DPP) and the dapivirine ring (DVR). 2024-2025 fellows have added new areas of focus including on Pandemic Prevention, Preparedness and Response (PPPR); anal health; and HIV prevention in prisons. 

Here are some of their accomplishments of the 2024–2025 Fellows Program

Ezra Meme (Uganda) is AVAC’s first Fellow to advance a Pandemic Prevention, Preparedness and Response (PPPR) agenda. He contributed to the development of the Uganda National Action Plan for Health and Security to bolster public health emergency centers throughout the country. While the billions committed in Ugandan shillings still need to be secured, Ezra will continue to monitor and advocate for this unprecedented public health project. He also successfully advocated for the government’s launch of the Antimicrobial National Action plan. And, he’s been closely monitoring Mpox, advocating for a digital mapping tool to track its control efforts. 

Bahati Thomas Haule (Tanzania) is laser focused on scaling up and normalizing U=U and the accompanying need for timely viral load testing and results. She’s gotten buy-in from PEPFAR and UNAIDS to support a substantial U=U media campaign and she’s collaborating with the Elizabeth Glaser Pediatric AIDS Foundation to spread knowledge of their model U=U program for “nationwide utilization.” She’s also in dialogue with Global Fund to support increased lab capacity and provider training. Bahati presented to the UK Parliament on the need to support LEN for PrEP and for World AIDS Day, she published an opinion piece in the Swahili newspaper Mwananchi, advocating for ARV-based prevention. 

Mokone Rantsoelaba (Lesotho) is AVAC’s first Fellow to advocate for HIV services in prison. After visiting nearly all his country’s correctional facilities, he released an assessment of HIV services for the incarcerated in Lesotho. His work was so well received that he was asked to integrate many of his recommendations into Lesotho’s Correctional Services Healthcare Policy, including the training of providers and fast-tracking all new prevention methods for scale-up in prisons. Mokone initiated and continues to convene the Southern African Development Community (SADC) regional correctional institutions along with the United Nations Office on Drugs and Crime (UNODC) to share best practices. Mokone has also been invited as a guest columnist for one of Lesotho’s top publications.   

Sammy Anyula Gorigo (Kenya) is AVAC’s first Fellow to spotlight anal health. Specifically, Sammy’s been promoting HPV vaccines, screening and treatment for all men, particularly gay and bisexual men and other MSM. Thus far, he integrated HPV screening as a standard of practice into Nairobi County Health Management. He updated two separate guidelines to include anal health care for men—Kenya’s Standard Operating Manual for Prevention and Management of STIs and the National Guidelines for HIV and STI Programming with Key and Vulnerable Populations. He’s been invited to PEPFAR’s COP planning and writing process to develop an anal package of care. Lastly, for World AIDS Day, he published an opinion piece landing in The Nation, The Star and The Standard.  

Rhoda Msiska (Zambia) is ensuring a swift introduction of the DPP. She’s earned a leading advocacy role, engaging the Ministry of Health to fast-track and de-medicalize PrEP and ensuring DPP inclusion in the national PrEP implementation plan. She’s working with the MoH to set aside DPP funding through the Global Fund and taking to the radio airwaves to create demand. Importantly, Rhoda has secured a first meeting with ZAMRA, Zambia’s regulatory body, to encourage moving forward with civil society support. And, at R4P Conference in Lima Peru in October, Rhoda spoke on a panel addressing strategies for the delivery of the DPP.   

Elina Mwasinga (Malawi) is dually focused on HIV prevention for pregnant women and lactating mothers and HIV cure research. Thus far, she’s secured commitment from the National AIDS Commission to integrate cure into Malawi’s Technical Working Group on Research to coordinate activities and ensure a robust cure research portfolio. Likewise, Elina secured integrated PrEP-family planning services with specified inclusion of pregnant and lactating mothers, as reflected in the MOH’s EMTCT Accountability Roadmap. And, she presented on the use of broadly neutralizing antibodies (bNAbs) to prevent vertical transmission during a WHO consultation and on advocacy as a panelist speaker at the 2024 International AIDS Conference. 

Pamela Fuzile (South Africa) is focused on boosting youth engagement in prevention and supporting young champions. She’s establishing a national level youth platform for new technologies in nine provinces where members can influence decisions in the HIV and PrEP technical working groups at SANAC. A key objective is youth advocacy for the inclusion of injectable PrEP and the dapivirine ring in all public health facilities responsive to the needs of young people.

Congrats to all the Fellows on their impressive work thus far. We’ll report on their total accomplishments in late 2025.

AVAC’s Most Downloaded Resources of 2024

From the implementation of DoxyPEP to the game-changing trial results of lenacapavir for PrEP, 2024 has been a landmark year for advancements in HIV and STI prevention. AVAC’s most downloaded resources capture these pivotal milestones, offering essential insights and tools to power your advocacy. Dive into the highlights and stay informed about the strategies shaping the future of HIV prevention.

AVAC’s Top 10

This episode of PxPulse looks at why and how the decisions that shape global health must be made by those facing the greatest risks. As the world evaluates the pandemic response and debates on decolonizing global health gain momentum, equity in global health has never been more urgent.

This graphic shows currently available options for HIV prevention, newly approved and recommended treatment, and those in development.

This plan provides a broad view of all the moving parts and identifies actions and actors responsible for ensuring time is not wasted and opportunity not squandered.

This PxPulse podcast episode 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 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.

This report examines disbursements by the U.S. NIH and the Bill & Melinda Gates Foundation and is one of few reports to track funding trends in vaccine and diagnostics R&D, and pipeline investments for some of the most common STIs.

Led by AVAC alongside a network of partners, the People’s Research Agenda puts forward recommendations to diversify and strengthen the HIV prevention pipeline, enhance investment and financial support for HIV prevention research and development, and guide an advocacy strategy that truly addresses the needs of communities across the prevention pipeline.

This roadmap aims to build on existing progress while accelerating the pace of HIV prevention. With anticipated regulatory approvals and production scaling, this plan targets over 2.5 million LEN users in low- and middle-income countries by 2027. It focuses on structural barriers and integration of generics into national programs.

Good Participatory Practice Guidelines  have been shaping and improving clinical research since 2007. They provide a global reference guide for ethical and effective stakeholder engagement, helping ensure the priorities of trial participants and their communities are centered in clinical trials and broader research agendas.

DoxyPEP is a post-exposure prophylaxis used to prevent the acquisition of some bacterial STIs after sex. This advocates’ guide addresses questions regarding who will benefit most from DoxyPEP and how to implement this strategy broadly to ensure equitable access.

In 2024, Gilead Sciences released findings from the PURPOSE 1 and PURPOSE 2 trials testing lenacapavir (LEN) as HIV prevention. This advocates’ primer provides background on the product and trials; a summary of the early findings of PURPOSE 1 & 2; key questions and next steps.

Avac Event

Conference on Retroviruses and Opportunistic Infections 2025

The 32nd annual  Conference on Retroviruses and Opportunistic Infections (CROI) that took place from March 9–12 in San Francisco, CA convened researchers, advocates and others under drastically altered circumstances, as the new US Administration’s assault on global health and research devastates the HIV response. Foreign aid programs are frozen, US agencies championing science and global health are being dismantled, and US leadership around the world is receding at a critical moment.

Read our summaries:

View our Community Breakfast Clubs

The CROI Community Liaisons, AVAC and the  European AIDS Treatment Group organized a series of daily  Community Breakfast Clubs which were open to all. These live webinars featured researchers and advocates exploring some of the most consequential science and discussions from CROI.

Topics included:

  • Breaking New Ground: The latest advances in HIV cure
  • The End of AIDS — Near and Far? (40 Years of HIV)
  • Still Here! Living with HIV Long-Term
View the recordings

Avac Event

African Workshop on HIV & Women 2025

The inaugural edition of the African Workshop on HIV & Women will take place in hybrid format on 27 – 28 February 2025 in Nairobi, Kenya.

The time zone that will be used for this meeting is East Africa Time (EAT). If you need to convert the times to your timezone, this website might be of interest to you: www.WorldTimeBuddy.com.

This exciting new initiative is a regional workshop paired to the annual “International Workshop on HIV & Women”. It is an outstanding opportunity for both local and international healthcare providers, researchers, government, industry, and community representatives to discuss and further increase their knowledge on the issues related to HIV and women living in Africa.

The primary purpose of this workshop is to support changes that will provide a better quality of life for women living with HIV and reduce HIV transmissions in the region.

The format of the workshop enables attendees to learn from renowned HIV experts, discuss challenges, gaps, and opportunities for further learning and research. The debates and roundtables are an especially important vehicle to discuss issues and challenge dogma.

The workshop also provides a forum for early-career investigators to present their research and to personally meet with experts they view as mentors and inspiration for their work.

The meeting organizers hope this workshop will catalyze forming a community, where attendees continue to participate yearly and form valuable relationships and partnerships that lead to collaborative projects and positive changes.

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.

Listen

Resources

Oral PrEP Prices in LMICs

This chart tracks pricing for oral PrEP as tenofovir disoproxil and emtricitabine (TDF/FTC) as compared to generic pricing in low- and middle-income countries (LMICs) since 2005.

Avac Event

I Am More Than HIV Prevention – Results from the HPTN 091 Study with Transgender Women

HPTN 091, the I Am study, evaluated the impact of a multicomponent HIV prevention strategy to increase the uptake and adherence of pre-exposure prophylaxis (PrEP) among transgender women. The strategy included HIV prevention services, gender-affirming hormone therapy, and peer health navigation.

This webinar featured Dr. Tonia Poteat, study co-investigator, who will review the study findings and discuss implications.

Speakers:

  • Tonia Poteat, Ph.D., Duke University School of Nursing, Division of Healthcare in Adult Populations

This webinar featured Portuguese and Spanish translation thanks to HPTN.

Video Recording and English Audio / Spanish Audio / Portuguese Audio / Slides / Resources

Introducing the Gears of Lenacapavir Rollout and The People’s Research Agenda

This World AIDS Day, the HIV/AIDS response stands at a crossroads, with injectable lenacapavir set to transform HIV prevention. But as the new UNAIDS report highlights, it also comes at the same time as restrictive policies, economic instability, and geopolitical challenges threaten to frustrate access and rollback so much of the progress that has been achieved over the past two decades. 

AVAC’s 2025 advocacy agenda prioritizes collaboration and strategies for equitable and accelerated product introduction that maximize the public health potential of new prevention options and simultaneously sustains investment in critical research and development. AVAC’s newest publication, The Gears of Lenacapavir for PrEP Rollout, provides a clear pathway for the speed, scale and equity needed to translate exciting science into public health impact, while our recent The People’s Research Agenda (PRA) meets this high-stakes moment for HIV prevention with a clear, concise and collaboratively developed set of priorities for how prevention research should be conducted and what products should be developed in the future. 

Despite the challenges, 2025 holds immense potential for ensuring the equitable rollout of new options and the accelerated development of a pipeline of additional options, the combination of which can help move the field closer to ending HIV/AIDS.  

For the latest information on injectable lenacapavir for PrEP, be sure to join us for our webinar Tuesday, December 3. And read more below about both the Gears of LEN for PrEP Rollout and The People’s Research Agenda. 

The Gears of Lenacapavir for PrEP Rollout: Driving Speed, Scale, and Equity

Lenacapavir’s rollout is not just about making a new drug available as quickly as possible; it is about ensuring that it reaches the people who need it most, as swiftly and equitably as possible. Gilead has announced its readiness to manufacture up to 10 million doses for 2026, but this potential hinges on coordinated action by governments, donors, and civil society. The roadmap outlines the essential gears driving this effort, from robust demand generation and procurement strategies to equitable distribution and community-driven implementation. Crucially, the roadmap emphasizes lessons learned from previous PrEP interventions: that availability alone is not enough. With global HIV targets still unmet and disparities persisting, this effort demands decisive action and long-term planning.

Download the infographic

The People’s Research Agenda: A Community-Driven Vision

The People’s Research Agenda (PRA) brings the voices of affected communities to the forefront of HIV prevention research and product development. With limited resources, the stakes for decisions about which products to develop and eventually deliver become even higher for funders, communities, policy makers and governments. The PRA offers a bold vision for aligning scientific innovation with community needs. By amplifying the perspectives of those most affected by the epidemic, the PRA is a tool for driving accountability among funders, developers, and policymakers. As a living, adaptable framework, it ensures that evolving needs and challenges in the prevention landscape remain at the center of decision-making.

A Call to Action

The rollout of lenacapavir and the implementation of the PRA come at a critical moment in the global HIV/AIDS response. Achieving their full potential will require sustained collaboration, strategic investments, and unwavering commitment to equity. Together, we can transform this pivotal moment into lasting progress.