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December 5, 2025 |
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In 1990, the US Centers for Disease Control and Prevention (CDC) codified five principles under the late Walter Dowdle as its pledge to the American people, including a promise to ground every public-health decision in the highest-quality scientific data and to treat all people with dignity, honesty and respect. But today, as political forces undermine science and erase commitments like World AIDS Day, we are reminded just how fragile those principles have become, and how essential they remain.
This week we track both momentum and mounting threats in the HIV response: powerful World AIDS Day advocacy even as the US refused to recognize it; first recipients of lenacapavir for PrEP in Brazil, Eswatini, South Africa and Zambia; continued CDC turmoil that threatens trust in vaccines and science-based public health; the US’ “New G20” without South Africa; and Kenya signs the first US global health Memo of Understanding (MoU).
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World AIDS Day
Despite the current US administration refusing to recognize December 1 as World AIDS Day (as described here in National Public Radio’s Goats & Soda), global media coverage and action were strong. On South Africa’s eNCA evening newscast, CAPRISA’s Slim Abdool Karim and AVAC’s Mitchell Warren underscored the need for smart, strategic decisions to prevent infections and ensure access to treatment. ABC News featured additional warnings about the devastating impact of US cuts and politics, and CNN highlighted what happens when ideology trumps epidemiology.
For additional reflection, Emily Bass and Ben Plumley offered a powerful—and sobering—conversation via the Shot in the Arm podcast about how political decisions can upend global HIV progress, and how affected countries are increasingly taking control of their responses.
The Journal of the International AIDS Society also published two commentaries for the day. Former CDC leader and longtime HIV advocate and clinician Demetre Daskalakis penned This is not normal: a call for HIV activism, and IAS president Beatriz Grinsztejn and colleagues wrote From Kigali to Rio: advancing an evidence‐based and equitable HIV response.
At ICASA, the Lancet published a six-paper series on Sustainable HIV prevention in Africa, which shares why epidemic control depends on shifting from fragmented, donor-led programs to country-led, integrated systems, using examples of impact from seven African countries.
And in New York City, the #SaveHIVFunding campaign rang the NASDAQ stock market's opening bell in recognition of World AIDS Day and a national week of action, sending a powerful message of unity, resilience, and national resolve to protect the lifesaving HIV programs that millions of people in the US and around the world rely on.
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First Injections of LEN for PrEP
This week people in Brazil, Eswatini, South Africa and Zambia received the first injections via implementation programs outside of the US of lenacapavir for PrEP (LEN). The Global Fund to Fight AIDS, Tuberculosis and Malaria anticipates additional deliveries of LEN in the coming months to both Eswatini and Zambia as well as to Kenya, Lesotho, Mozambique, Nigeria, South Africa, Uganda and Zimbabwe. See AVAC’s updated map of Global Fund and PEPFAR supplies to early introduction countries. Meanwhile, national regulatory agencies in Malawi and Zimbabwe approved LEN for PrEP, bringing the total number of approvals to six. See AVAC’s updated LEN regulatory map.
IMPLICATIONS: These milestones signal a new dawn for HIV prevention—the speed at which LEN is being approved and delivered shows what’s possible when political will, funding, community engagement and innovation align. But this speed must now be matched by scale and equity: to truly change the trajectory of the epidemic, LEN must reach all who need it and be sustained over time. Read more about the events by advocates and partners on LinkedIn here, here and here. Also GBGMC’s Micheal Ighodaro explored the transformative potential of LEN for PrEP if countries commit to access, especially for key populations in Think Global Health.
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Continued Chaos at the US Centers for Disease Control and Prevention (CDC)
A recent New Yorker investigation captures the political interference at the CDC under Health and Human Services (HHS) Secretary, Robert F. Kennedy Jr., which includes changes that are undermining the scientific consensus that vaccines do not cause autism. This week the Advisory Committee on Immunization Practices (ACIP), which was dismissed and replaced with vaccine-skeptical members, meets to consider delaying the hepatitis B vaccine dose at birth, which would be a major departure from decades of proven public-health practice. The Committee meets under a new chairperson, Kirk Milhoan, who has blamed vaccines for causing cardiovascular disease, and began his post just this week. Meanwhile, the CDC issued a warning to clinicians to watch for Marburg virus cases linked to an outbreak in Ethiopia, highlighting emerging global health threats amid institutional instability.
IMPLICATIONS: By dismantling long-standing expert advisory processes and politicizing vaccine guidance, the US is undermining domestic immunization programs and also global confidence in science-driven public health. The potential delay or rollback of routine immunizations threatens to reverse decades of progress, fueling distrust that could spill over into HIV, TB, and other health areas. At such a pivotal moment for HIV prevention, cure research, and vaccine development, destabilizing vaccine policy in the US risks eroding momentum worldwide.
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US Announces a “New G20” Excluding South Africa
Following the closure of the widely hailed G20 summit in South Africa last week where the US was notably absent, this week, the US shared plans for a “New G20” for 2026, which adds new members and excludes South Africa from the summit in Miami next December. In a statement, US Secretary of State, Marco Rubio unfairly and alarmingly called out South Africa’s current government: “Rather than take responsibility for its failings, the radical ANC-led South African government has sought to scapegoat its own citizens and the United States”. In response, South Africa signaled it will take a “commercial break” from G20 participation during the US-led presidency.
IMPLICATIONS: The exclusion of South Africa in the US-led 2026 summit is a warning sign. South Africa has been a leading voice for African and Global South priorities, including equitable access to health, the HIV/AIDS response, and social justice. By sidelining the country with mis- and dis-information, the US risks marginalizing regions already facing unequal burden of disease and limited resources. Key funding, efforts to expand access to medicines and HIV prevention tools may suffer from fractured governance and most vulnerable communities could lose out on representation, accountability, and the collective leverage needed to secure health equity worldwide.
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Kenya Signs MoU Under New US Global Health Strategy For $1.6B
Kenya became the first country to sign the controversial US Health Memos of Understanding (MoU) earning $1.6B in funds disbursed through the next five years in exchange for health care data and specimens for the next 25 years. US Secretary of State Rubio suggested this was the first of many countries (up to 50) to sign the MoUs.
IMPLICATIONS: Kenya’s decision trades long-term access to health data and biological samples for short-term funding raising serious concerns about sovereignty, consent, and accountability. If this agreement becomes the model for dozens more countries, the future of global health cooperation could shift toward transactional arrangements that prioritize US geopolitical interests over community rights and health equity.
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Now streaming on Hulu: HIVUnwrapped: Where Fashion Meets Science — a powerful look at how HIV researchers and fashion designers are teaming up to bring information on HIV to new audiences.
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The Quest For An HIV Cure — Will It Be Discovered in Africa?
Join us for a conversation on the state of HIV cure research in Africa and the opportunities to strengthen and scale Africa-led innovation with leaders from Africa Health Research Institute, KwaZulu-Natal, Root to Rise and moderated by Anna Miti.
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