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AVAC Advocates' Network Logo January 31, 2025
Welcome to Global Health Watch, a weekly newsletter dedicated to 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 aims to provide a clear, concise analysis of the week’s events, supplying advocates with the knowledge to navigate and respond to threats, challenges and opportunities in this critical period of change in global health.

Dear Advocate,

The last week has brought an alarming series of developments affecting global health and human rights. Here's a brief overview of critical changes and their implications:


** Pause on PEPFAR and humanitarian programs ([link removed])
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On Monday, US officials announced a suspension of all PEPFAR programs, threatening access to lifesaving HIV treatment and prevention for millions worldwide and jeopardizing decades of progress in global health. US officials were told to stop providing technical assistance to national ministries of health and PEPFAR’s data and computer systems were taken offline. On Tuesday, Secretary of State, Marco Rubio, a longtime supporter of PEPFAR, approved an “Emergency Humanitarian Waiver”, allowing “life-saving medications” to continue to be delivered. However, official guidance on how to interpret the waiver is lacking and it’s unclear whether providing HIV treatment can resume.

IMPLICATIONS: More than 20 million people living with HIV could lose access to treatment, with widespread job losses expected across multiple countries. Most urgently, the delivery of ARVs funded by PEPFAR has already been disrupted. According to an analysis from amfAR ([link removed]) , 222,333 people start new ARVs daily, meaning that many individuals now face the life-threatening possibility of interrupted treatment. Beyond these immediate impacts, the broader cessation of ARVs for over 20 million people would have catastrophic consequences.

Learn more from amfAR’s Country Analysis ([link removed]) on treatment, testing and other social determinants of health.


** Federal financial freeze ([link removed])
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Also on Monday, the new administration issued (via the Office of Management and Budget, OMB) a freeze on federal financial assistance, which impacts funding for research, healthcare, diversity programs, and energy projects among other efforts. Democrats are arguing that the freeze is unlawful and would harm communities across the US. Some states are pursuing lawsuits. Due to substantial community backlash and legal challenges, the administration rescinded the memo in less than 24 hours. The administration meanwhile asserts the Executive Order is still in effect

IMPLICATIONS: The President’s pause on foreign assistance at the State Department remains in effect. Most international health and humanitarian efforts remain frozen, except for those covered by the waiver for “life-saving medications” referenced above. Even as the status of these federal funding freezes are still being clarified, the administration can be expected to continue to pursue strategies to impound, rescind, and limit access to federal funding for public health research and programs, and use misinformation and rhetoric to justify these actions.

[link removed]
Listen to Mitchell Warren on the Bhekisisa podcast, Weaponising aid: The cruel ways of #Trump2025 ([link removed]) .


** USAID leadership shake-ups ([link removed])
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The new administration has placed career USAID officials on administrative leave, including leaders who run USAID’s Bureau for Global Health, impeding HIV prevention and civil society support worldwide. In addition, many of the agency’s institutional support contractors (ISCs), who comprise more than 50% of the Global Health Bureau, have already been, or are expected to be, let go. Contractors at the State Department Bureau of Global Health Security and Diplomacy (GHSD), including PEPFAR, were also laid-off Wednesday.

IMPLICATIONS: This signals a deliberate effort by the administration to remove anyone seen as disloyal. Reports of loyalty tests for staff ([link removed]) , including inquiries about their “moment of MAGA revelation,” reflect a broad-reaching plan to remove anyone or anything that could scrutinize the administration’s orders. Contractors at USAID and GHSD are essential to the Bureau’s operations, and their expulsion paralyzes the USAID, GHSD and PEPFAR.


** Emerging threat as Uganda confirms new Ebola outbreak ([link removed])
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Uganda’s Ministry of Health confirmed a new outbreak of the Ebola virus in its capital, Kampala. One death has been reported on Wednesday. This is the first outbreak since 2022, when it took four months to contain the spread of the virus.

IMPLICATIONS: The US intent to withdraw from the WHO and the suspension of communication with the US CDC, the country’s lead government agency, makes it impossible for infectious disease control to coordinate with their international counterpart to mitigate this threat.


** National Institutes of Health employees may move to schedule F ([link removed])
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In a publicly shared memo, employees of the National Institutes of Health (NIH) may be reclassified as “schedule F”, which strips them of key worker protections as civil servants. This move could allow the administration to dismiss or vet career employees and scientists based on their perceived loyalty to the administration’s political and ideological positions, including the research they oversee.

IMPLICATIONS: This shift could have a chilling effect on new researchers entering the field, potentially undermining the integrity and independence of scientific research.


** NIH clinical trials and participant travel continues with uncertainty ([link removed])
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Despite NIH restrictions, clinical trials and participant travel to trial sites may still continue, according to an email to staff at the NIH from its Acting Director, Matthew Memoli. Scientists may also discuss ongoing research that was initiated before January 20, given there is no data sharing or public communication outside of those who are part of the research or its funding, leaving the impact on new research uncertain.

IMPLICATIONS: Critical purchases and contracts related to human and animal health, security, and biosafety could proceed, but there are many unanswered questions, especially over the pause in grant reviews and funding decisions.


** Fighting the Global Gag Rule ([link removed])
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One of the early actions of the new administration was the Executive Order to reinstate the Global Gag Rule ([link removed]) . However, the Global Health, Empowerment, and Rights Act, a bill to permanently end the Global Gag Rule, was reintroduced in the House ([link removed]) and Senate ([link removed]) on January 28, making this Act all the more important. AVAC and partners have endorsed the act. Read Congresswoman Lois Frankel’s statement here ([link removed]) and watch this space for further updates.


** Confirmation Hearings for Russell Vought, nominee for Director of Office of Budget and Management ([link removed])
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Russell Vought may be selected to lead the Office of Management and Budget (OMB), an influential office, which plays a key role in developing the annual budget request. In this position, Vought will essentially serve as a key gatekeeper, shaping the Executive Branch's agenda. Confirmation hearings were scheduled for January 30. However, Democratic senators are demanding the vote be delayed ([link removed]) , while debate escalates around federal domestic funding freeze.

IMPLICATIONS: Vought, one of the authors of Project 2025, the conservative blueprint for reshaping the US government, is poised to implement the vision at the highest levels of government. If confirmed, he will have power over foreign assistance, research, and all the programs that save lives in the US and abroad. He will be able to accelerate firings, work stoppages, and withhold federal grants/funds already underway. His leadership represents a direct threat to public health and human rights.

Live in the US? Call your Senator (202) 224-3121 to vote "no" on this confirmation and send a message to Washington that HIV prevention advocates stand firmly against Project 2025 and its writers.


** In Case You Missed It
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AVAC and PrEP4All urged donors at last week’s FCAA Summit ([link removed]) to mobilize emergency funding and unite against these threats. Together, we can protect global health and human rights.
Read the op-ed in POZ Magazine ([link removed])


** What we're reading
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• Researchers are terrified of Trump’s freeze on science. The rest of us should be, too: ([link removed])
Discusses the recent public communications ban of the National Institutes of Health, the CDC and other agencies. This has led to canceled meetings, rescinded grants, travel bans, frozen federal grant reviews and raised alarms about the future of public health and scientific research. — Vox
• Behind the Chaotic Attempt to Freeze Federal Assistance ([link removed]) : Discusses the new administration’s attempt to freeze federal assistance, which led to widespread confusion and concern among federal agencies and aid organizations, highlighting the challenges and potential consequences of such a sudden policy shift. — The New Yorker
• The State of Pandemic Preparedness, the WHO, and the US Withdrawal: ([link removed]) Discusses the withdrawal of the US from the WHO, negotiations on the Pandemic Accord and International Health Regulations, highlighting concerns about the potential impact on global pandemic preparedness. — Brownstone Institute
• Deborah Birx, Who Oversaw PEPFAR, Is Not Surprised at Its Precarious State: ([link removed]) Interviews Deborah Birx, who headed up PEPFAR from 2005 to 2014 and served in the first Trump Administration as an adviser on pandemic procedures. Birx discusses the impact of decisions on the PEPFAR program. — Time
• Trump at Davos ([link removed]) : Reviews the new presidential policies in a world of competing crises, eroding institutions, and increasing geopolitical instability and how these actions are accelerating these challenges. — Project Syndicate
• WHO statement on potential global threat to people living with HIV: ([link removed]) Warns of the impact of the US funding pause on HIV programs, including PEPFAR and calls for immediate exemptions to ensure continued access to lifesaving treatment. — WHO
• UNAIDS statement welcoming the decision by the US Secretary of State to continue life-saving HIV treatment ([link removed]) : UNAIDS welcomed the Secretary of State’s move to approve an Emergency Humanitarian Waiver to allow continued access to HIV treatment for millions globally, despite a broader 90-day pause on foreign assistance. — UNAIDS


** Working in solidarity: Join the effort to track the impact
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Surveys


**
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* Tracking the impact of the PEPFAR Freeze: ([link removed]) The PEPFAR Watch ([link removed]) coalition is running regular surveys throughout the 90-day period

* Impact of USA government administration's directive to pause all foreign aid obligations, ([link removed]) AIDSFonds

* Global AID Freeze Tracker ([link removed]) documents the impact of the foreign aid stop work order


RESOURCES
• [LISTEN] Weaponising aid: The cruel ways of #Trump2025 ([link removed]) , Bhekisisa
• PEPFAR Impact Tracker, ([link removed]) amFAR
• Impact of Stop Work Orders for PEPFAR Programs, ([link removed]) amFAR
• Health for US, ([link removed]) Better World Campaign
• PEPFAR & Global Fund Support for HIV Programs, ([link removed]) courtesy of Brooke Nichols

Stay strong and stay united.

Best,

AVAC
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AVAC Global Advocacy for HIV Prevention
+1 212 796 6423 [email protected] (mailto:[email protected]) www.avac.org ([link removed])
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