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AVAC Advocates' Network Logo April 10, 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. 

Proposed US budget cuts, HIV supply chain disruptions, evolving Global Fund commitments, and a renewed attempt to undermine US vaccine policies highlight a landscape under rapid shifts this week.


** Proposed US 2027 Budget Signals Major Cuts and Restructuring of Global Health Programs
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The US President released his Fiscal Year 2027 budget request ([link removed]) , proposing cuts in and restructuring of global health funding—approximately 46%—under a consolidated Global Health Programs account aligned with the America First Global Health Strategy. The proposal eliminates funding for key HIV prevention and health services, including voluntary medical male circumcision (VMMC), LGBTQ-focused programming and broader reproductive health services. It also removes disease-specific budget lines that have historically enabled Congressional oversight of HIV, TB and malaria investments. Notably, the request preserves the match for the US contribution to the Global Fund but does not specify an amount, or include funding for Gavi, the Vaccine Alliance. The proposal also includes language changing PEPFAR’s funding duration from 5 years to 3 years and codifies the Promotion of Human Flourishing rules (also known as the expanded Global Gag
Rules). The budget also includes a proposed 12% cut to the NIH budget—last year, the President proposed a 40% cut to the NIH, which Congress rejected outright.

IMPLICATIONS: The US Congress ultimately determines final appropriations, as per the US Constitution. Congress has historically rejected cuts of this level, but the proposal signals a clear determination of the US President to deprioritize science, research and global health programs—and the first 15 months of this Administration has also shown its rejection of Congress’s power of the purse.

READ:
* Global Health Funding in the FY 2027 President’s Budget Request ([link removed]) —KFF
* Save HIV Funding Campaign Responds to Trump FY27 Budget, Urges Congress to Protect People Living with & Vulnerable to HIV by Rejecting Cuts & Providing Funds to Meet Urgent Health Care Needs— ([link removed]) Save HIV Funding
* White House proposes 12% cut to federal health agencies in 2027 budget request ([link removed]) —STAT
* Slasher sequel: Trump again proposes major cuts to U.S. science spending ([link removed]) —Science
* Trump’s Foreign Aid Overhaul Sent Millions More Dollars to Big U.S.-Based Contractors ([link removed]) —New York Times


** Abrupt Shutdown of US Global Health Supply Chain Raises Risks for HIV, TB and Malaria Programs
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The US Department of State abruptly announced plans to terminate, by May 30, 2026, the Global Health Supply Chain–Procurement and Supply Management (GHSC-PSM) mechanism, which has been implemented by a consortia led by Chemonics and which is responsible for end-to-end procurement and delivery of HIV, TB and malaria commodities. In March, State Department Senior Official Jeremy Lewin, decided to extend Chemonics’ contract until 2027. This reversal of that decision comes without a clear transition plan, posing significant risk of medication stockouts and disruption in getting diagnostics and medications to communities. There has been some discussion of a future shift toward the wambo.org platform used by the Global Fund, which primarily serves as a pooled procurement mechanism, and hasn’t historically provided logistics support, such as warehouses and last-mile distribution. Two hundred and fifty civil society organizations signed on to a letter to the US Secretary of State
([link removed]) calling for immediate reversal of this decision and retaining the earlier decision made by Lewin.

IMPLICATIONS: Without proper planning and capacity, an abrupt transition from GHSC-PSM to wambo.org or other platforms risks severe disruptions to HIV, TB and malaria care. Advocates stress that any transition must be deliberate, transparent and centered on continuity of care, with sufficient time to vet new partners to avoid the waste, fraud and abuse that can plague procurement processes. The priority now is not just opposing the timeline, but identifying and securing the components of a responsive, resilient supply system and ensuring that any new mechanism can meet those standards before critical systems are dismantled.

READ:
* US Upends Global Supply Program for Malaria and HIV Amid Warnings ([link removed]) —Reuters
* Exclusive: Country Deadlines for Emergency Closeout of US Global Health Supply Chain ([link removed]) —To End a Plague…Again Substack
* Sudden Termination of US Global Health Supply Chain Program Will Cost Lives ([link removed]) —Health GAP
* When the Supply Chain Is the System ([link removed]) —Alain Casseus Substack
* The Global Fund veteran building Africa CDC's pooled procurement platform ([link removed]) —Devex


** Global Fund Commitments Update
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In a delayed announcement, the European Commission finally pledged €700 million to Global Fund to Fight AIDS, Tuberculosis and Malaria at this week’s G7 One Health Summit—a slight reduction from their previous pledge in the last three-year cycle. As reported previously ([link removed]) , the Global Fund Board approved $10.78 billion in country allocations for the 2027–2029 cycle and set aside $260 million in catalytic funding to accelerate access to innovations, including scale-up of LEN, new molecular tuberculosis diagnostics and improved malaria vector-control tools.

IMPLICATIONS: This pledge reflects commitment, but also broad-based reductions in contributions from large country donors such as the UK and France and uncertainty across global health budgets. Together, these developments reinforce the Global Fund’s importance and value, but the question is not only which multilateral organizations will be appropriately funded, but whether future global health partnerships can preserve the collective action needed to comprehensively address HIV, tuberculosis, malaria and emerging health threats, and what forms those partnerships will take. 

READ:
* Commission announces new global health commitments at One Health Summit ([link removed]) —European Commission
* Flurry of Pledges at G7 One Health Summit ([link removed]) —Health Policy Watch
* Drastic UK Aid Cuts Hit Fragile African Health Systems ([link removed]) —Health Policy Watch
* How UK aid spending fell sharply in 2025 ([link removed]) —Devex


** New ACIP Charter Reopens Path for Changes to US Vaccine Policy
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The US Administration issued a new charter for the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), which reopens a potential path for Health and Human Services Secretary (HHS) Robert F. Kennedy Jr. to push through devastating changes to national vaccine policy. The charter alters the structure and mandate of the ACIP, broadening criteria for individuals to be eligible, including those focused on vaccine injury and safety concerns, and potentially allowing for the reappointment of members whose qualifications had been challenged in court. Last month, a US federal judge blocked RFK Jr.’s attempt to overhaul pediatric vaccine policy and restructure the ACIP.

IMPLICATIONS: These changes—alongside ongoing petitions to make routine vaccines optional under “shared clinical decision-making”—could further destabilize US vaccine guidance and contribute to growing confusion about immunization standards and trust in public health. As Global Health Watch highlighted last month ([link removed]) , “dangerous ideology results in dangerous policymaking, putting many lives at stake and complicating efforts to both discover and implement clinical and cost-effective interventions.”

READ:
* With New Charter, Kennedy Redesigns Vaccine Committee and May Sidestep Court Ruling ([link removed]) —New York Times
* RFK Jr. Has Stopped Talking About Vaccines. A Memo Shows Why ([link removed]) —Bloomberg


** Tracking the America First Global Health Agreements
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A new report from amfAR digs into the first US global health MoUs, raising concerns about transparency, metrics and accountability.

Track it all:
* amfAR ([link removed]) report
* KFF MoU tracker ([link removed])

What We're Reading

• The foreign aid blame game ([link removed]) —Devex
• US CDC Delays Publishing Report Showing COVID Vaccine Benefits Wapo Reports ([link removed]) —Reuters
•

Top C.D.C. Official Delays Report on Covid Shot’s Effectiveness ([link removed]) —New York Times
• Trump administration drops court fight to cap NIH payments for research overhead costs ([link removed]) —STAT
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‘No more than a drop in the ocean’: this drug could end new HIV infections in Eswatini – why isn’t there enough? ([link removed]) —The Guardian
• Is there enough of this game-changing HIV prevention drug? ([link removed]) —HealthBeat
• Lenacapavir and the Access Impasse: Understanding Why Gilead Said No to MSF ([link removed]) —Health Quotient Newsletter
• Civil Society Calls for Greater Engagement in Rollout of HIV Prevention Drug Lenacapavir As Global Tensions Grow ([link removed]) —Health Journalist Network (Uganda)
• Integration Without Loss both at Local and Global Levels: Lessons from the MSF–Gilead Lenacapavir Case ([link removed]) —The Global Advocacy Data Hub
• Our LEN is here. Now for quality checks in Ireland ([link removed]) —Bhekisisa
• Subscription pricing could expand access to HIV prevention breakthrough while controlling costs ([link removed]) —STAT
• Merck’s experimental HIV prevention pill could be made for less than $5 a year, researchers say ([link removed]) —STAT
• Monthly Islatravir Shows Comparable Safety for HIV PrEP, Lowers Lymphocyte Counts ([link removed]) —Infectious Disease Society
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Rebalancing power in infectious disease modelling: Toward inclusive and contextual approaches ([link removed]) —PLOS Global Public Health
• The Pasteur Institute of Iran illustrates important truths about global public health ([link removed]) —STAT
• Pharma fallout from Iran war won't end with ceasefire ([link removed]) —Axios
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