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Global Health Watch: Reflecting on 1 Year of Chaos and What’s Next, Congress Pushes Back, the Future of WHO, US Undermines African Authority

This week marks 365 days of disruption and chaos across global health, with many organizations and journalists reflecting on one year after the foreign aid freeze and what the future of global health looks like. This week also saw the US Congress beginning to reassert its role on health funding, ongoing US disengagement from WHO, and new reporting on the hepatitis B vaccine trial in Guinea-Bissau.

We are also watching closely for news of an expanded Global Gag Rule, that is reportedly coming out later today, just as this issue goes to press. It is anticipated that this new gag will include a dramatic expansion beyond abortion and now underscore the US administration’s war on gender, diversity, equity and inclusion. We’ll cover this in next week’s Global Health Watch; the struggle, most definitely, continues.

One Year Later

This week marks one year since the US Presidential Administration issued a deeply cruel executive order freezing foreign assistance. To mark this moment, AVAC’s One Year Later series reflects on the impact of the past 365 days on five key areas of global health and development

One Year Later #5: Rethinking & Rebuilding Global Health

As we wrap up our ‘One Year Later’ series, in this fifth installment, we look to the future and what is built next. Champions of global health must define the architecture of the future, or it will be written by people bent on dismantling it.

One Year Later #4: The Cruel Irony of Lenacapavir for PrEP

In the fourth installment of our ‘One Year Later’ series we focus on lenacapavir and how science is breaking through formidable barriers in understanding HIV and how to prevent it, just as the infrastructure for delivering groundbreaking technology is defunded and destabilized.

EXPrESSIVE Phase 3 Trials Countries of MK-8527

Seventeen countries are hosting sites for the Phase 3 efficacy trials of a monthly PrEP pill, MK-8527, being developed by Merck (also known as MSD outside of the US and Canada). Merck announced the launch of the Phase 3 trials at IAS 2025 in Kigali. MK-8527 was found to be safe and well-tolerated in Phase 2 clinical trials.

Source of Lenacapavir for PrEP Supply to Early Adopter Countries

The Global Fund, with support from CIFF, and PEPFAR have jointly committed to reaching up to two million people with injectable lenacapavir for PrEP over three years. Supply of LEN began arriving in countries in late 2025 with service delivery planned to start in early 2026.

An “Innovation Pile-Up” in Next-Generation LA-PrEP is Possible

The HIV prevention market is headed toward a period of significant opportunity—and possible congestion—as a slate of new products are on track for continued development and potential introduction to the market in 2027 and 2028. Markets and policies must be built to support the products in the market already, so that new options can be rapidly deployed and deliver impact. Otherwise, the field will squander time and money, with epidemic control slipping further out of reach.

Dapivirine Vaginal Ring Regulatory Approval

Regulatory approvals, pending decisions, and appeals as of January 2026.

One Year Later #3: The Undermining of the US Research Enterprise

This third installment of our ‘One Year Later’ series examines this administration’s sustained assault on the research enterprise. What has unfolded is a 365-day cascade of policy, programmatic and, financial actions that threaten US leadership and the scientific ecosystem responsible for lifesaving breakthroughs.

One Year Later