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AVAC Advocates' Network Logo May 23, 2025
Global Health Watch is a weekly newsletter breaking down critical developments in US policies and their impact on global health. Tailored for our partners in the US and around the world, this resource offers a concise analysis of the week’s events, supporting advocates to respond to threats, challenges and opportunities in this critical period of change in global health. 

The US Secretary of State and the Secretary of Health and Human Services appeared before Congress this week defending foreign aid cuts and the dismantling of USAID. Advocates are responding, including the Treatment Action Group (TAG) which issued a stark warning: US agencies are engaging in “unethical, dishonorable, and potentially law-breaking machinations” under new leadership, particularly at the NIH. Meanwhile, the US was absent from the World Health Assembly, where the WHO Pandemic Agreement was ratified and where a high-level dialogue on long-acting HIV prevention took place. All this plus looming Global Fund shortfalls, and new COVID-19 vaccine policy changes in this week’s issue.


** Misinformation and Controversy at Congressional Hearings
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The US Secretary of State Marco Rubio appeared in front of the US Congress this week defending radical cuts to foreign aid and a proposed State Department reorganization that deprioritizes global health programs. In front of the Senate Foreign Relations Committee (of which he was once a member), Rubio was corrected when he wrongly claimed that only 12% of US funding goes to direct services. In fact, 12% is the proportion of funds going directly to local NGOs, with 85% of total funding going towards direct services. He also claimed – without evidence – that 85% of PEPFAR beneficiaries were still receiving services and denied any deaths linked to the US cuts. The Secretary repeated these claims before the House Foreign Affairs Committee and Appropriations State and Related Programs subcommittee and ignorantly characterized voluntary male medical circumcision (VMMC) as wasteful spending. VMMC is proven to reduce transmission of HIV.
([link removed]) Congressional members challenged Secretary Rubio on the legality of the foreign aid freeze and dismantling of USAID and highlighted reported deaths resulting from the cuts. Meanwhile, some Republican Senators, including Senate State, Foreign Operations, and Related Programs (SFOPs) Chair Lindsay Graham, expressed support for foreign assistance amidst calls for transparency and metrics to transition countries off US funding.

Department of Health and Human Services (HHS) Secretary, Robert F. Kennedy Jr. appeared before the Senate this week to defend cuts to public health programs and biomedical research. Similar to his appearance last week ([link removed]) before the Senate Health, Education, Labor and Pensions (HELP) Committee, Kennedy’s remarks were controversial and contradicting.

IMPLICATIONS: These hearings underscore the challenges facing US global health policy and programming amid shifting political priorities and leadership. Advocacy to counter mis- and dis-information, and a vision for this new era of global health financing, are more important than ever. 

READ:
* Senate Democrats Grill Defiant Rubio on Trump Policies ([link removed]) —The New York Times
* Rubio: 'No children are dying on my watch' ([link removed]) —Devex


** An Ethical and Legal Crisis
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In a statement, TAG demands immediate action by the NIH to provide Congressionally appropriated and committed funding to the HIV clinical research networks (ACTG, HPTN, HVTN, IMPAACT).
READ ([link removed])


** World Health Assembly Updates
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The United States was notably missing from the World Health Assembly (WHA) this week, with no official delegation attending. This is a major change from previous years where delegations held leadership and diplomacy roles. In contrast, China sent more than 180 delegates and pledged an additional $500 million ([link removed]) over the next five years to help stabilize the agency following the withdrawal of the United States, reinforcing its growing influence in global health governance.

Meanwhile, the WHA formally voted to adopt the WHO Pandemic Agreement, a legally binding accord that lays the foundation for future pandemic prevention and response, including real-time sharing of vaccines, treatments, and diagnostics. For three years, member states negotiated critical issues, with pressure from civil society to embrace key provisions on equity and intellectual property. Some of those provisions have been addressed, but negotiations on an annex detailing the new Pathogen Access and Benefit Sharing (PABS) ([link removed]) mechanism will continue with the aim of concluding at next year’s WHA. PABS refers to a proposed system where countries share genomic information about novel pathogens and share tools developed to combat those pathogens, regardless of which country discovered the pathogen or developed effective tools—it has been one of the most contested areas of negotiation.
Though the treaty is less ambitious than earlier drafts, nations at the WHA have largely welcomed the agreement as a major achievement.

Many events and discussions were held on the sidelines of the WHA, including Wednesday’s high-level dialogue organized by the Global HIV Prevention Coalition (GPC). The event, A New Era of HIV Prevention: Accelerating Access to Long-Acting Prevention Options ([link removed]) , was co-hosted by UNAIDS, in collaboration with the United Nations Population Fund (UNFPA), United Nations Development Fund, (UNDP), WHO, the Federal Republic of Brazil and Kingdom of the Netherlands. AVAC’s Mitchell Warren, who also co-chairs the GPC, opened the session with urgency and optimism, calling it “one of our greatest opportunities in 44 years of HIV prevention,” even as global solidarity is waning. Dr. Lilian Benjamin Mwakyosi, a past AVAC Fellow and director of DARE in Tanzania issued a powerful reminder that “choice for HIV prevention is not a luxury. It’s a right,” stressing that adolescent girls and young women need accessible, discreet prevention options like long-acting
PrEP. The dialogue underscored the need for political will, financing, and community-centered action to turn scientific breakthroughs like lenacapavir for PrEP into sustained prevention at scale.

READ:
* United States Appears Set to Skip World Health Assembly while China Sends Over 180 Delegates to Geneva ([link removed]) —Health Policy Watch
* For the first time, the U.S. is absent from WHO's annual assembly. What's the impact? ([link removed]) —NPR
* A Pandemic Treaty Without Teeth Will Leave Africa and the World Exposed ([link removed]) —Think Global Health
* Presidents and Prime Ministers Celebrate the Passing of the Pandemic Agreement ([link removed]) —Health Policy Watch


** Global Fund Financial Challenges
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More than 260 civil society advocates joined a conversation organized by the Coalition to build Momentum, Power, Activism, Strategy & Solidarity ([link removed]) (COMPASS) ([link removed]) , Eastern Africa National Networks of AIDS and Health Service Organizations ([link removed]) (EANNASO), CHANGE, and others to explore the financial constraints facing the Global Fund following its Board meeting earlier this month. Advocates learned unmet pledges and declining global health aid will mean that the current Global Fund Grant Cycle 7 will reduce allocations to countries to align with available resources, moving from pledge-based to cash-based allocations. Countries will receive reduced funding envelopes in mid-June 2025, which will trigger a two-week reprioritization process to focus on life-saving services like treatment continuity and community-led monitoring while deferring lower-priority items.

IMPLICATIONS: These changes could jeopardize essential programs, especially those supporting key populations. And they also raise significant questions about the recently launched Global Fund replenishment for the next grant cycle. Civil society must prepare now to advocate for transparent processes, protect vital community interventions and support the Global Fund’s ambition to introduce injectable lenacapavir with speed, scale and equity.


** New US COVID-19 Vaccine Policy
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The US Food and Drug Administration (FDA) outlined in a new blueprint ([link removed]) for COVID-19 vaccines, one that shifts from a recommended annual COVID vaccine for everyone 6 months and older, to adults over 65 and individuals with high-risk conditions, such as compromised immune systems. This shift requires vaccine manufacturers to conduct extensive clinical trials before approving vaccines for healthy individuals aged 6 months to 64 years, potentially delaying access for this group. Rather than proposing the new guidelines through the typical regulatory processes, including opportunities for public comment, this framework was devised and published by the head of the FDA along with the new head of FDA’s Center for Biologics Evaluation and Research (CBER ([link removed]) ).

IMPLICATIONS: This unorthodox process could complicate future vaccine approvals, as well as leave interpretation and coverage decisions up to insurers, which would create major access barriers for many.

READ:
* An Evidence-Based Approach to Covid-19 Vaccination ([link removed]) —New England Journal of Medicine
* FDA will limit Covid vaccines to people over 65 or at high risk of serious illness, leaders say ([link removed]) —STAT


** New Resources: Tracking the Impact of US Cuts to Foreign Aid, USAID, and Research
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As the US administration continues to dismantle foreign aid infrastructure and retreat from its commitments to science and global health, AVAC is tracking the impacts and consequences.

Worldwide Prevention, Shared Protection ([link removed]) outlines the global threat posed by defunding STI research and programming.

Impact of PEPFAR Stop Work Order on PrEP ([link removed]) provides an in-depth look at the stop work orders and contract terminations disrupting HIV prevention access.

HIV Prevention R&D at Risk ([link removed]) highlights how US policy shifts are endangering the future pipeline of HIV prevention tools.
What We're Reading

• The case of the minister and the HIV activists: Are we entering denialism 2.0? ([link removed]) —Bhekisisa
• China to donate $500 million to WHO, stepping into gap left by U.S. ([link removed]) —Washington Post
• Trump Lectures South African President in Televised Oval Office Confrontation ([link removed]) —The New York Times
• Disaster Awaits Us if the NIH Dies ([link removed]) —The Nation
• Lambda Legal Sues National Institutes of Health over Terminating Critical Research Grants Relating to LGBTQI+ Health—Lambda (statement) ([link removed])
• PEPFAR’s Golden Era Is Over. It Urgently Needs a Five-Year Transition Plan ([link removed]) —CSIS
• Exclusive: NIH grant rejections have more than doubled amid Trump chaos ([link removed]) —Nature

RESOURCES
• Politics and Global Health: The Need for a New, Resilient Architecture ([link removed]) —Oxford University
• U.S. Funding Cuts Threaten 39 Research Sites in South Africa Putting Scientific Advancements and Hard Won Progress Against TB and HIV at Risk ([link removed]) —TAG and MSF
• Advocates’ Guide: Understanding the President’s Proposed Fiscal Year 2026 (FY26) Budget and Its Implications for Science, Research and Global Health ([link removed]) —AVAC
• Critical Advocacy: How Civil Society is defending the HIV Response and Global Health ([link removed]) —AVAC
• Research Matters ([link removed]) —AVAC, HIVMA, TAG
• Impact of NIH Grant Terminations ([link removed]) —Association of American Medical Colleges

In solidarity,

AVAC
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AVAC Global Advocacy for HIV Prevention
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