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AVAC Advocates' Network Logo January 2, 2026
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 Lancet journal ended the year with a provocative editorial – 2025: an annus horribilis for health in the USA ([link removed](25)02588-7/fulltext) . But sadly, it was not just in the US; it has been a year of chaos and disruption globally. This 49th issue of Global Health Watch looks back—like many news stories this week—across 2025 to highlight the most consequential decisions, disruptions, and debates that defined the year and will continue to shape what comes next.


** The Foreign Aid Freeze and the Legal Fight to Restore it
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On the first day in office, the new US Administration issued a sweeping foreign aid freeze ([link removed]) that halted life-saving global health and HIV programs, severed active grants, research underway and cost millions of people their lives and livelihoods. In less than a month, AVAC responded suing ([link removed]) the President, the State Department and the US Agency for International Development (USAID). The Global Health Council also led a similar lawsuit challenging the freeze as unlawful and harmful. Together, the two cases argued for months in various courts that the foreign aid freeze not only jeopardized health as a human right but also bypassed congressional authority and undermined trust in US leadership. Ultimately, the cases unlocked millions of dollars of development assistance for work done in January and February, but millions more dollars expired at
the end of the fiscal year in September. The cases are ongoing and as important as ever, both to restore foreign assistance and to re-assert that it is Congress (and not the President) who has the power of the purse.

READ:
* The Monthslong Legal Battle to Save Foreign Aid ([link removed]) —New York Times
* AVAC v. United States Department of State ([link removed]) —AVAC
* “Lift the Freeze”: HIV/AIDS Advocates in Fight over Trump Foreign Aid Cuts ([link removed]) —Democracy Now
* The Supreme Court’s Major Cases During the 2025-2026 Term ([link removed]) —Washington Post
* Supreme Court has expanded presidential powers under Trump. How far will it go? ([link removed]) —Washington Post


** Research Under Assault
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Science faced underfunding and systematic destabilization in 2025. In just one month under the new US Administration, the National Institutes of Health (NIH) abruptly canceled approximately 1,800 research grants. By April, mass layoffs ([link removed]) and forced reassignments across Health and Human Services (HHS) agencies, including the Centers for Disease Control and Prevention (CDC), NIH, and US Food and Drug Administration (FDA), further crippled each agency’s capacity and expertise. A proposal to drastically cut the overall NIH budget and consolidate its 27 institutes ([link removed]) was soon introduced along with the fiscal year 2026 budget, which proposed an $18 billion cut from the NIH and $1.5B cut in HIV prevention ([link removed]) . Around the same time, the NIH signaled
a major shift away from investments in basic science and clinical research, undermining the discovery pipeline that fuels future breakthroughs. Then, in November, HHS ordered the CDC to phase out all “non-essential” nonhuman primate research ([link removed]) , threatening foundational preclinical studies, including those that have been pivotal to HIV PrEP and PEP, amongst many other health priorities. These actions were compounded by a pause or effective ban on some international research collaborations, a proposed cap on indirect cost rates ([link removed]) that support core university infrastructure, and changes to the scientific review processes ([link removed]) , together weakening the systems that sustain rigorous, independent research.

READ:
* The Trump Administration’s Most Paralyzing Blow to Science ([link removed]) —The Atlantic
* HIV Prevention R&D at Risk: Tracking the Impact of US Funding Cuts ([link removed]) —AVAC
* Trump has blown a massive hole in global health funding—and no one can fill it ([link removed]) —Science
* Trump administration agrees to reconsider frozen and denied NIH grant submissions related to DEI ([link removed]) —STAT
* Presidential HIV council warns proposed cuts could reverse decades of progress ([link removed]) —CNN
* Nearly 2,000 top researchers call on Trump administration to halt ‘assault’ on science ([link removed]) —STAT


** The Cruel Irony of the Best Shot at HIV Prevention
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Despite all the chaos, 2025 offered remarkable milestones in HIV prevention science, and a stark illustration of the contradictions shaping global health. Injectable lenacapavir for PrEP (LEN), the six-month injectable, which provides nearly complete protection against HIV infection, moved with unprecedented speed ([link removed]) from regulatory approvals and guidelines to real-world introduction. South Africa and Zambia authorized LEN within months of US and EU regulatory approvals; the World Health Organization (WHO) rapidly issued guidance ([link removed]) and prequalification ([link removed]) ; and initial LEN delivery began in Brazil, Eswatini, South Africa, and Zambia, setting the stage for expanded access in 2026. At the same time, efficacy trials began of the next promising PrEP option, the monthly oral candidate
MK-8527 ([link removed]) , reinforcing what’s possible when innovation, evidence, and advocacy align.

Yet, all this scientific momentum occurred alongside the deepest assault on global health and the systems that make it possible. The cruel irony of this moment is that as the science breaks barriers, the infrastructure meant to support discovery, evaluation, and equitable delivery is being weakened, threatening the very gains the field has fought decades to achieve. As AVAC has emphasized, the greatest opportunity in HIV prevention lies in speed, scale, and equity ([link removed]) .

READ:
* In under a year, Trump administration has threatened decades of progress in global fight against HIV/AIDS ([link removed]) —Prism
* A ‘Breakthrough’ Drug to Prevent HIV, an ‘Unprecedented’ Rollout ([link removed]) —NPR
* When Politics Trumps Science: Why the US isn’t giving South Africa LEN ([link removed]) —Bhekisisa
* ‘Best of Times, Worst of Times for HIV Prevention’ ([link removed]) —Managed Healthcare Executive
* Cruel Ironies ([link removed]) —AVAC


** Attack on Vaccine Science
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Actions in the last 11 months have eroded evidence-based policy, disrupted institutional capacities, and deepened mistrust and uncertainty in vaccine science. In May, NIH’s National Institute of Allergy and Infectious Diseases (NIAID) announced that funding for the Consortia for HIV/AIDS Vaccine Development (CHAVD) ([link removed]) would end after the current grant cycle in June 2026 — eliminating $67 million annually and about 10% of global HIV vaccine research funding. Then, $500 million in Biomedical Advanced Research Development Authority (BARDA) grants for research and development of the mRNA vaccine platform ([link removed]) were soon cancelled, and members of the CDC’s Advisory Committee on Immunization Practices (ACIP) were replaced ([link removed]) . The US also stopped supporting Gavi,
the vaccine alliance ([link removed]) , and language on the CDC website ([link removed]) was replaced with anti-science and anti-vaccine sentiment. As AVAC said in an August statement ([link removed]) , “These actions dangerously sow vaccine disinformation and mistrust, which has proliferated since the COVID-19 pandemic. Dangerous ideology results in dangerous policymaking, putting many lives at stake and complicating efforts to both discover and implement clinical and cost-effective interventions to make America and the world healthier, safer, and more prosperous.”

READ:
* We Don’t Seem to Be Making America Healthy Again ([link removed]) —New York Times
* This Is the Damage Kennedy Has Done in Less Than a Year ([link removed]) —New York Times
* Experts Question Denmark’s Vaccine Program as a Model for the U.S. ([link removed]) —New York Times
* The U.S. vaccine schedule is a jet engine. Denmark’s is a toy plane ([link removed]) .—Washington Post


** Changing Global Health Architecture
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As rising nationalism, geopolitical tensions, and funding retrenchment intensify, the architecture of global health and how countries engage in it and with one another is being fundamentally reshaped. Longstanding multilateral systems are giving way to a more fragmented, country-to-country model under the US America First Global Health Strategy ([link removed]) . The strategy prioritizes bilateral health Memorandums of Understanding (MoUs) with individual countries in exchange for funding support, data sharing, and pathogen access, signaling a major recalibration away from traditional multilateral institutions and frameworks. Meanwhile, the US stepped back from longstanding global health platforms including an unprecedented absence at the World Health Assembly ([link removed]) , withdrawal from the WHO
([link removed]) , and diminishing support for joint initiatives like Gavi, the vaccine alliance ([link removed]) . Civil society and advocates are actively debating what this means for shared goals and equity in global health, even as institutions like WHO and UNAIDS ([link removed]) explore how to adapt in a rapidly evolving landscape.

READ:
* ‘America First’ in Global Health: Oxymoron or opportunity? ([link removed]) —Devex
* 4 more African nations secure $2.3bn US health funding under America First strategy ([link removed]) —Business Insider Africa
* Writing in Real Time: How 2025 Rewired Global Health—and My Work Alongside It ([link removed]) —Lights, Camera, Equity! Substack
* UNAIDS board launches new process for transition amid sunset calls ([link removed]) —Devex

What We're Reading

• In a tumultuous year, US health policy has been dramatically reshaped under RFK Jr. ([link removed]) —Associated Press
• Podcast: Unmasking Global Health: Reflections on 2025 ([link removed]) —Global Health Unfiltered
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How Cameroon Fought to Save Its Malaria Program After the U.S. Cut Critical Funding ([link removed]) —New York Times
• Evaluating the impact of two decades of USAID interventions and projecting the effects of defunding on mortality up to 2030: a retrospective impact evaluation and forecasting analysis ([link removed](25)01186-9/fulltext) —The Lancet
• Podcast: Global Health | The rollercoaster continues in 2026 ([link removed]) —Pandemia (German language)
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AVAC Global Advocacy for HIV Prevention
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