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AVAC Advocates' Network Logo March 7, 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. 

This week's issue covers challenges confronting the US National Institutes of Health under the new administration, the uncertain future of PEPFAR, continued legal battles over the foreign aid freeze and urgent efforts in Africa to secure sustainable health funding amid drastic aid cuts. Read on for more.


** AVAC vs. Department of State
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On Wednesday, in response to the US government’s request, the Supreme Court ruled ([link removed]) that the administration must release up to $2 billion in frozen foreign aid funding for work completed before February 13. This overturned a temporary stay granted by the Chief Justice last week. This was a small victory along the way. And on Thursday, the case was back in the District Court for a four-hour hearing where the judge ordered from the bench that the government must pay AVAC, the Global Health Council and other plaintiffs the outstanding balances they are owed by Monday evening.

IMPLICATIONS: Thursday’s ruling is a "concrete step" forward, said the judge overseeing the case, but it does not rule on or indicate the fate of the $2 billion in payments owed to other aid organizations. Even if some contracts are eventually reinstated, the State Department has already cancelled 90% of USAID’s work and tens of billions of dollars in Congressionally approved spending, so it is unlikely implementing partners and programs receive the funding they need to continue this critical work.

FOLLOW ALONG: You can follow along with progress on the case at, [link removed].

READ: Trump administration ordered to pay select USAID partners by Monday ([link removed]) —Devex


** Threats to US-funded Research
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At a March 5 congressional hearing ([link removed]) on threats to US-funded research, representatives debated strategies to counter security threats while investing in the US scientific enterprise. Republican committee members focused on restricting international students and researchers from US institutions, whereas Democrats focused on the threats from within. Specifically, administration and Congressional attacks on federal agencies, which jeopardize US leadership in discovery and innovation, and cuts to “indirect costs”, which are essential for maintaining research infrastructure and administrative overhead. “The money has to come from somewhere. The result [of these cuts] will be less research, driving many out of business. The impacts are potentially huge,” said MIT’s Maria Zuber who gave testimony at the hearing.

In a related and unprecedented move, the NIH on Wednesday initiated mass terminations of active research grants that no longer align with its new “agency priorities.” Internal documents reveal ([link removed]) that NIH staff are required to review projects for ties to diversity, equity, and inclusion—especially those involving transgender issues, or research in China—and to classify them into categories for easier cancellation decisions.

And further, the NIH announced that it will centralize peer review of all grant and cooperative agreements, and research and development contracts within its Center for Scientific Review ([link removed]) .

IMPLICATIONS: Forcing federal grants and programs to adhere to partisan ideology is anti-science and anti-evidence. Subjecting funding decisions to political tests will undermine essential research and jeopardize long-term research and future discovery. Further excising key populations from research ultimately limits the benefits and interventions that result from publicly funded biomedical research for those most vulnerable to HIV and other diseases.

READ: Exclusive: NIH to terminate hundreds of active research grants ([link removed]) —Nature


** The Future of the NIH: Jay Bhattacharya’s Confirmation Hearing
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At his confirmation hearing ([link removed]) to become NIH Director, nominee Jay Bhattacharya faced tough questioning on future NIH priorities, and how he would balance scientific integrity and political pressures. When questioned about the proposed indirect cost rate cuts and their ramifications, Bhattacharya defended the policy, saying it would enhance research efficiency while sustaining vital infrastructure. Bhattacharya pledged to focus the NIH on chronic diseases, rebuilding public trust in science through transparency and debate, and undergoing structural changes to support innovative research.

IMPLICATIONS: Despite concerns over Bhattacharya’s vaccine skepticism, AIDS denialism and racist views of immunology, his confirmation appears likely with a full Senate vote imminent. If confirmed, Bhattacharya would serve under Health and Human Services (HHS) Secretary Robert F Kennedy Jr. (RFK Jr.), who controls funding, administration and how science is communicated via the US CDC, NIH, FDA and other important health agencies. As the potential lead for NIH, Bhattacharya will be tasked with carrying out elements of RFK Jr.’s agenda of ‘Making America Healthy Again’. RFK Jr. was confirmed ([link removed]) in February despite concerns over his vaccine skepticism, AIDS denialism, and racist views of immunology.

READ: Trumps’s pick to head NIH avoids major controversy at Senate hearing ([link removed]) —Science


** Undermining NIH Public Engagement
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HHS Secretary Kennedy issued a policy statement ([link removed]) rolling back a 1971 policy that requires public comment on rules related to grants, loans, public property and benefits. This policy shift veils the decision-making process and could enable controversial changes to be imposed without public discussion or debate.

IMPLICATIONS: This new directive will inalterably transform how NIH operates and significantly restrict the research community’s ability to engage in policymaking. It guts a critical mechanism established nearly 50 years ago for public and expert scrutiny of policy and stifles collaboration between scientists and government that has long driven scientific innovation and progress in public health. Moreover, this move further limits community engagement in NIH processes and research, losing valuable perspectives and insights that are necessary to enrich the impact of publicly funded biomedical research.

READ:
* RFK Jr. kills policy on public comment for health regulations ([link removed]) —Axios
* RFK Jr.'s Limits on Rule Comments Have Risk for Medicaid, Grants ([link removed]) —Bloomberg Law


** PEPFAR in Jeopardy
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Advocates continue to fight for the PEPFAR program. On Wednesday, AVAC, the Global AIDS Policy Partnership (GAPP) and The U.S. Congressional Caucus on Black Women & Girls Co-Chairs Representatives, Robin Kelly (D-IL), Yvette Clarke (D-NY), and Bonnie Watson Coleman (D-NJ) hosted, the congressional briefing, The State of PEPFAR. The briefing featured a broad panel with AVAC’s Senior Policy Manager John Meade, Jr. serving as co-moderator. Panelists included Friends of the Global Fight’s Chris Collins, Desmond Tutu HIV Center Director and AVAC Board member Linda Gail Bekker, Angeli Achrekar of UNAIDS and Jirair Ratevosian of the Duke Global Health Institute. They offered insightful analysis on how recent administrative decisions threaten global progress in HIV.

“The hardest hit are key populations—Black gay men, sex workers, transgender people, people who inject drugs and Adolescent girls and young women—those already on the margins of society. Their clinics are shutting down, their communities are losing access to PrEP and HIV treatment,” noted AVAC’s John Meade, Jr. “Congress must act immediately to restore and protect funding for PEPFAR and global HIV programs. This is not a partisan issue—PEPFAR has enjoyed strong bipartisan support for over two decades because it works. It has saved lives, strengthened economies, and reaffirmed America’s role as a leader in global health.”

READ:
* Trump says 'male circumcision in Mozambique' is a 'scam.' What's the program about? ([link removed]) —NPR
* FROZEN OUT: Impact Of the PEPFAR Funding Freeze on Programs for Key Populations ([link removed]) —GBGMC


** Africa and Sustainable Health Funding
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The foreign aid freeze, dismantling of USAID and many other US actions under the new administration are accelerating discussions on how African governments will tackle the immense challenges ahead. At this week’s Africa Health Agenda International Conference ([link removed]) (AHAIC) in Kigali, African leaders, advocates, and delegates confronted the funding crisis head-on, exploring urgent, innovative financing models to ensure the long-term sustainability of essential health programs. While some see this moment as an opportunity to build capacity and reduce dependence on external aid, others warn that without significant domestic reforms, the sudden loss of aid will intensify poverty, strain resources, and further impede development across the continent.

READ: Why some Africans see opportunity in foreign-aid cuts ([link removed]) —the Economist


** PxWire Special Edition
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The new edition dives into the assault on global health and its devastating impact on HIV prevention—from crippling existing PrEP delivery to threatening the rollout of LEN for PrEP and paralyzing R&D.
Read PxWire ([link removed])


** What we're reading
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• WATCH: “Lift the Freeze”: HIV/AIDS Advocates Win Supreme Court Victory in Fight over Trump Foreign Aid Cuts ([link removed]) —Democracy Now
• Funding freeze on US foreign aid is 'over,' Trump administration claims ([link removed]) —Devex
• Defunded Aid Programs Are Asked by Trump Administration to Prove Their Value, on a Scale of 1 to 5 ([link removed]) —the New York Times
• The Global Fund will roll out the twice-yearly anti-HIV jab — with or without PEPFAR ([link removed]) —Bhekisisa
• WATCH: Trump USAID cuts make impact in South Africa ([link removed]) —UK Channel 4
• KFF Health Tracking Poll February 2025: The Public’s Views on Global Health and USAID ([link removed]) —KFF
• US suspends aid to South Africa after Trump order ([link removed]) —the Guardian
• As Ebola Spreads in Uganda, Trump Aid Freeze Hinders Effort to Contain It, U.S. Officials Fear ([link removed]) —the New York Times

RESOURCES
• PEPFAR Watch ([link removed])
• Project 2025 Tracker ([link removed])
• Litigation Tracker ([link removed]) —Just Security 
• Impact of the Executive Order on COMPASS Tanzania Partners and Overall National HIV Response ([link removed]) —COMPASS
• Federal Government Outlays ([link removed]) —DataETC


**
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** Donate today to help fund our efforts. Every contribution helps us keep the pressure on!
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In solidarity,

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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