As the comment period to oppose the White House Office of Management and Budget’s (OMB) proposal to give political appointees greater authority over federal research grants closes next Monday, the Global Fund avoided new ideological restrictions on US funding even as it prepares for a new Executive Director. And new articles and analyses of US bilateral health agreements under the “America First Global Health Strategy” suggest the Administration’s vision for global health is shifting from supporting epidemic control to managing country transitions.

The Latest on the White House OMB’s Proposal Politicizing Federal Grants

The last day to submit comments opposing the OMB’s proposal to give political appointees greater authority over federal research grant decisions is Monday, July 13. The proposal has drawn major and widespread opposition from scientists, advocates, universities, associations, former government officials, the biotechnology industry and members of Congress, all calling out the weakening of a long-standing scientific peer-review process and injection of political considerations into federal funding. The proposal has already drawn more than 93,000 public comments and submissions opposing the rule. See AVAC’s submission. The US Administration aims to finalize the rule by October 1.

IMPLICATIONS: These rules, if adopted, would mandate that federally-funded science align with a politically motivated “America First” agenda aimed at dismantling decades of transformative global collaboration. These rules have the potential to dramatically reshape how federal dollars are spent and who decides, replacing evidence-based decision-making with political priorities. Notably, the published proposed rule specifically and falsely references PEPFAR as justification for increased political scrutiny of federal grants, linking HIV and global health programs to a broader debate over federal spending, oversight and executive authority. For the HIV field, these changes could affect the entire research-to-rollout continuum and global partnerships, at a time when scientific collaboration is necessary to achieving 2030 HIV targets and advancing global health equity.

TAKE ACTION: The proposed rule is still open for public comment through July 13. Click here to comment or see  AVAC’s Action Alert for more instructions. Submitted comments could slow implementation of any changes to the process because the OMB must reply to them all. The outpouring of comments could also persuade Congress, which has repeatedly rejected the Administration’s previous proposals to gut research funding, to use its power to stop these changes. Comments also put into the public record that are not adequately addressed, could be raised again in lawsuits to stop the changes.

READ:

• Collins calls on OMB to rescind parts of controversial proposed grant rule—The Hill  
• Defend Science Research dashboard 
• Research!America Resources on OMB proposed rule 
• A Proposed Rule Would Politicize Medical Research. Scientists Are Not Happy.—New York Times
• The New Trump OMB Rule: Organizations And The Public Raise Concerns—Forbes  
• Trump’s federal grant overhaul plan draws strong pushback—Axios 
• Trump administration pursues more durable changes to science policy after setbacks in court—STAT  

Global Fund Gains Stability Amid Leadership Transition

The US government will continue funding the Global Fund without imposing its expanded global gag rule or other ideological funding conditions to US contributions. This will allow US funding to continue without restrictions related to abortion, diversity, equity and inclusion policies. At its Board meeting this week, the Global Fund also confirmed that its search for a new Executive Director will proceed as planned despite reports that the confidential nomination process might be restarted following media leaks. The Board is expected to appoint its next Executive Director in October.

IMPLICATIONS: While the decision not to impose the expanded global gag rule removes one immediate challenge, the Fund still faces significant financial uncertainty. Its next Executive Director will inherit an organization facing the major challenges of constrained resources, evolving donor expectations and increasing pressure to sustain impact in a changing global health landscape.  

READ: 

• Scoop: Global Fund, US agree on path around expanded gag rule—Devex  
• Despite Frictions, Global Fund Asserts Confidentiality Rules and Schedule—Health Policy Watch  

The New Model for US Global Health Partnerships 

PEPFAR and US bilateral health agreements continue to evolve. This week, Think Global Health expanded its tracker of the US Administration’s bilateral health agreements, showing that 31 countries have now signed five-year agreements that increasingly shift financing and implementation responsibilities to national governments through co-investment and country ownership models. Andrew Green focuses on one country, South Sudan, in a Devex piece that looks at the country’s new three-year, $166 million MoU with the US, noting that while it preserves support for HIV and disease surveillance, funding may be insufficient to offset recent aid reductions and the country may struggle to meet its own financial commitments. 

In a separate analysis, Jirair Ratevosian broke down what five reports from the US Department of State to Congress reveal about the Administration’s vision for global health. He writes, “Read together, these excerpts are overwhelmingly about the mechanics of transition: MOUs, implementation plans, co-investment, funding adjustments, corrective actions, benchmarks, workforce transfer, and reductions in US assistance. There is much less discussion of incidence, viral suppression, advanced disease management, prevention gaps, community systems, or epidemic control… It suggests they are no longer the organizing principle.”  

IMPLICATIONS: These pieces reflect a move toward implementation of the new global health agreements. As implementation continues, we’ll be watching whether the financing assumptions, implementation systems and country commitments that are the foundation of these agreements are sufficient enough to sustain HIV and broader health gains. As Ratevosian notes, “Every Administration has its own priorities. But organizing principles matter because they determine what leaders measure, what they reward, and ultimately what they protect. When transition becomes the primary frame, there is a risk that epidemic control becomes something assumed rather than something actively managed.” 

In a separate analysis, Jirair Ratevosian broke down what five reports from the US Department of State to Congress reveal about the Administration’s vision for global health. He writes, “Read together, these excerpts are overwhelmingly about the mechanics of transition: MOUs, implementation plans, co-investment, funding adjustments, corrective actions, benchmarks, workforce transfer, and reductions in US assistance. There is much less discussion of incidence, viral suppression, advanced disease management, prevention gaps, community systems, or epidemic control… It suggests they are no longer the organizing principle.”

READ: 

• Tracking the “America First” Bilateral Health Agreements—Think Global Health 
• Will the US funding deal rescue South Sudan’s health system?—Devex  
• What Five Reports to Congress Reveal About the Future of Global Health—Lights. Camera. Equity! Substack

What We’re Reading

• The USA at 250: science in the new gilded age—The Lancet
• Africa’s vaccine sovereignty goal is set for its biggest hurdle—Semafor 
• From Spider-Man to Mandela, the many influences in Professor Salim Abdool Karim’s remarkable scientific career—Spotlight 
• Experimental Ebola Trials Begins in Congo as Death Toll Tops 500—Bloomberg
• The HIV prevention approach needs reprioritization, not acceleration—Devex  
• RFK Jr. plans to create list of injuries caused by Covid-19 vaccines—STAT  
• Don’t abolish the NIH. Fix it.—Monica Bertagnolli LinkedIn 
• Africa Asserts Itself as WHO Pandemic Agreement Talks Resume—Health Policy Watch  
• Lab-Leak Payback Has Begun—The Atlantic 
• Faith groups urge White House to release funding for HIV/AIDS prevention—The Hill  
• I fear a new HIV and Aids epidemic is coming – and the world won’t care, UN official warns—The Independent 
• SAMRC and Ospedale San Raffaele Launch Phase I Trial of Long-Acting HIV Prevention Antibody—SAMRC
• Advancing the inclusion of pregnant and lactating populations in HIV PrEP research: ethical, regulatory, and surveillance recommendations from a multisectoral working group—Frontiers in Reproductive Health 

The AIDS 2026 conference is fast approaching. To help advocates stay informed and engaged, AVAC has curated a collection of its Advocates’ Guides covering the science, policy, implementation and advocacy conversations shaping the future of the HIV/AIDS response. Developed with partners across the field, these guides help translate complex science and policy to help inform advocacy before, during and after the conference.

For those presenting at AIDS 2026, please check out AVAC’s slide deck containing the latest infographics on the research & development pipelines, the delivery of new prevention options and the impact of US funding cuts on foreign assistance and on research and science. We will be continuously updating it, so be sure to check back for updates as the conference approaches.

The introduction of injectable lenacapavir for HIV PrEP (LEN) is underway–in some places at least. To ensure communities remain at the center of LEN rollout, this new Advocates’ Checklist for Lenacapavir for PrEP Introduction is an immediate, actionable blueprint. And read more in this blog by the co-chairs of the Civil Society Caucus of the Coalition to Accelerate Access to Long-Acting PrEP and AVAC staff.

Planning For MK-8527

Expanding prevention choice means investing in a diverse pipeline of HIV prevention options. MK-8527 is an investigational antiretroviral (ARV) once-monthly oral PrEP pill that is currently in Phase III clinical trials. If proven safe and effective, it could offer another important PrEP option. This resource provides advocates with an overview of the MK-8527, the science behind it and the latest on its clinical development.  

Podcast: The Future of PrEP

AVAC’s Executive Director Mitchell Warren joined ITPC’s Make Medicines Affordable podcast to discuss the future of PrEP. While Lenacapavir is a transformative option for HIV prevention, Warren shares what it will take to ensure it reaches the people who need it most.

Download the Latest Infographics from AVAC

Presenting at AIDS 2026?

These graphics are updated regularly, so be sure to check back.  

Additional Resources

• People’s Research Agenda: This people-centered framework guides equitable and accelerated HIV prevention research, development and product introduction. It tracks scientific progress, assesses whether investments align with community-defined priorities, and identifies critical gaps in the prevention pipeline needed to meet the diverse needs and preferences of all populations 
• HIV Prevention Product Overview: The graphic provides an overview of PrEP products currently available and in late-stage clinical trials. 
• Lenacapavir Resource Hub: Your one-stop resource for all things lenacapavir, this page brings together the latest news, advocacy resources, scientific updates, implementation tools and infographics to help advocates stay informed and ensure LEN rolls out with speed, scale and equity. 

P.S. On Tuesday, July 14 AVAC and partners will share the impact stories of ten years of the Coalition to Accelerate and Support Prevention Research (CASPR). We hope you’ll join us.