So far, four Africa countries have signed bilateral health MoUs with the US under the “America First Global Health Strategy”: Kenya, Liberia, Rwanda and Uganda. These agreements provide 5 to 10 years of funding and health support in exchange for co-financing, health data, pathogen-specimens, and national health system data, marking a major shift in how global health cooperation is structured under US leadership. Kenya’s agreement, which was the first and largest to date, promises about US $1.6–1.7 billion over five years and a commitment from Kenya to raise domestic health spending. Civil society groups across Africa and globally are sounding alarms about the process noting that agreements have been negotiated and signed without public consultation, parliamentary oversight, or community input. Thursday, Kenya’s High Court issued a conservatory order, temporarily blocking any transfer or sharing of sensitive health data until a full hearing in early 2026. The Court is reviewing two major petitions: one on data protection and digital rights, and another on whether the MoU bypassed constitutional requirements for parliamentary approval. 

IMPLICATIONS: These MoUs begin to reconstruct US-led global health investments, moving away from multilateral frameworks and programs informed by community and civil society input toward bilateral, government-to-government agreements. This raises critical questions about sovereignty, transparency, and equity with health data and biological samples being treated as bargaining chips, and unclear protections for privacy, benefit-sharing, or local ownership. The Kenya High Court’s ruling underscores the seriousness of these concerns. African nations with larger economies, such as Kenya, may be better positioned to push back against problematic provisions, but many other countries may not have the same leverage.  

READ:  

• The US signs first bilateral health deal with Kenya for $1.6 billion—Devex  
• African and Global Civil Society Call on African Heads of State and Government to Demand Fair Terms in U.S. Health Agreements—Public Citizen, RANA  
• Kenya Court Halts $1.6 Billion Health Deal as US Courts Uganda—Bloomberg  
• Rapid US health deals spark concerns over lack of public consultation—Devex   
• Lessons from America's Health Agreements with Kenya and Rwanda—To End A Plague Again Substack  
• The Kenya–US Health Framework: Progress, Pitfalls, and What to Watch—KLEIN Kenya  
• US Delays Zambia Health Agreement as Signing Becomes Contingent on Mining Deal—To End A Plague Again Substack 

A wave of new reports and commentary are showing the far-reaching impacts of recent US policy decisions on science and global health. STAT released American Science, Shattered, a multipart investigation detailing how actions taken under the US Administration have disrupted research labs, upended scientific careers, and fractured an eight-decade partnership between universities and the federal government.  

In case you missed it, scientists, researchers, and advocates participated in the Save AIDS Research Marathon sharing firsthand accounts of what decades of federally supported HIV research have delivered — and what stands to be lost. Their stories highlight how foundational US investments have driven breakthroughs in the treatment and prevention of HIV and other diseases that have saved tens of millions of lives, and how recent project terminations and budget cuts are already reverberating across the research landscape. 

Last Friday the Advisory Committee on Immunization Practices (ACIP), which was dismissed and replaced with vaccine-skeptical members, voted (contentiously) to change longstanding US hepatitis B vaccine policy. Instead of universally recommending that all newborns receive a hepatitis B vaccine at birth, without any new data or evidence, the committee now advises that a birth dose be given only to infants born to mothers who test positive for the virus or whose infection status is unknown. The panel recommended that mothers who test negative for hepatitis B delay vaccination for two months and use antibody testing to determine whether to administer a third dose, further decreasing the likelihood that infants will receive full immunization against a leading cause of liver cancer.  

IMPLICATIONS: This decision reflects broader disruptions at the US Centers for Disease Control and Prevention (CDC) that are eroding evidence-based vaccine policy in the US and raising alarm among global health advocates. Leading physician groups and public health experts issued a warning that the policy change could result in unnecessary illness and death, arguing that it departs from the robust scientific evidence that underpinned the universal birth-dose strategy. At a time when confidence in vaccine programs remains essential to strategies for the control of infectious disease, this decision brings uncertainty into routine vaccine recommendations and risks further eroding trust in public health institutions. 

READ:  

• CDC advisers vote to overturn decades-long policy on hepatitis B vaccine for infants—NPR  
• Doctor groups form united front against RFK Jr’s efforts to limit vaccine access—CIDRAP  

AVAC and partners released the 2025 update of The People’s Research Agenda (PRA), a people-centered framework to drive equitable and accelerated HIV prevention research and development (R&D) and product introduction. The PRA tracks the science, highlights where investments align—or fail to align—with community priorities and identifies critical gaps that must be addressed for the pipeline of HIV prevention to meet the needs of diverse populations. This year’s update includes an expanded online dashboard for tracking, translating, and advocating for HIV prevention R&D. 

CONTEXT: The past ten months have wreaked havoc on biomedical research, and the path forward now demands sharper priorities, smarter investments, and a deliberately balanced portfolio that reflects what is both needed and achievable to drive real epidemic impact. Every funding decision carries greater weight in determining whether communities will have meaningful choices in prevention. Sustaining progress requires protecting the full continuum of research: investing in basic science and early-phase discovery, supporting late-stage trials and product development, and ensuring community engagement and implementation science remain central to translating advances into access. Ultimately, the goal is a pipeline that delivers viable, effective, people-centered prevention options to those who need them most.   

READ:  

• Peoples Research Agenda: 2025 Update—AVAC