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AVAC Advocates' Network Logo July 31, 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. 

Scientists and advocates gathered in Rio for the 26th International AIDS Conference (AIDS 2026) this week to discuss the future of the HIV response, just as former NIAID Director Anthony Fauci appeared before a hostile Senate Committee on Homeland Security & Governmental Affairs, reminding us that the greatest barriers to ending HIV are increasingly political, not scientific. In addition, this week’s issue covers the US Administration's use of vaccine funding as leverage in negotiations with Gavi and a new policy restricting gain-of-function research.


** Former NIAID Director, Anthony Fauci Testifies Before US Congress
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Former NIAID Director Anthony Fauci appeared before the US Senate Committee on Homeland Security & Governmental Affairs after being subpoenaed to testify as part of its ongoing investigation into the US response to the COVID-19 pandemic. Questions from Republican Senators were especially hostile, and in response, Fauci answered with the same response to every one of them: “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution.” Senator Rand Paul who chairs the Committee said it would vote next week on whether to hold Fauci in contempt of Congress, insinuating that he is not entitled to Fifth Amendment protection.

In advance, more than 150 scientists, physicians and public health advocates signed an open letter ([link removed]) condemning the "ongoing vilification and harassment" of scientists noting the Administration and its allies are “waging a war on individual scientists, through public harassment, arrests, criminal indictment, and ongoing threats of prosecution” and urging lawmakers to end it. AVAC also issued its own statement of support ([link removed]) for Fauci, calling for the Committee “to cease its erroneous investigations and harassment of renowned scientists and public servants such as Dr. Fauci, whose career, track-record, and devotion to public health research and development has changed the very course of the HIV epidemic at home and abroad.”

IMPLICATIONS: The hearing is part of the ongoing assault on evidence-based research, scientists and scientific institutions, which have been the foundation of decades of public health progress. It follows the White House Office of Management and Budget's (OMB) proposed regulation to give political appointees greater authority over federal grant decisions, which could dramatically reshape how federal dollars are spent and who decides, replacing evidence-based decision-making with political priorities. The consequences are weakening public trust, discouraging scientific leadership and leaving the US less able to prepare for the next pandemic or public health emergency.

READ:
* Fauci Invokes Fifth Amendment Nearly 100 Times in Bitter Senate Hearing ([link removed]) —New York Times
* Fauci to Testify About COVID Pandemic: What His Diaries Reveal ([link removed]) —Newsweek
* The Unmaking of Anthony Fauci ([link removed]) —The Atlantic
* 5 takeaways on Fauci’s hostile Senate hearing, GOP contempt threats ([link removed]) —The Hill
* Stop 'Harassment' of Fauci, Scientists Urge Politicians ([link removed]) —MedPage Today
* Fauci invokes Fifth Amendment in declining to answer questions before Senate panel ([link removed]) —STAT


** New US Policy Restricts Gain-of-Function Research
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The US Administration issued a new Policy for Stopping High-Risk Life Sciences Research ([link removed]) , which prohibits federally-supported "dangerous gain-of-function" research “strengthens oversight of other high-risk life sciences research, and restricts funding for research conducted in countries that lack appropriate safety, security, and oversight standards.” The policy goes into effect in November.

IMPLICATIONS: The policy is another example of political interference in the scientific enterprise and is seemingly being used as fuel to secure support for the Administration’s claims around Fauci and the origins of the COVID-19 pandemic. Scientists warn that broadly restricting this work could hamper efforts to predict viral evolution, develop vaccines, and prepare for future outbreaks.

READ:
* New U.S. rules on risky pathogen research draw mixed reviews ([link removed]) —Science
* Joint Statement on the United States Government Policy for Stopping High-Risk Life Sciences Research ([link removed]) —US Department of State
* Trump’s NIH Ends Funding, Support for Gain-of-Function Research ([link removed]) —Bloomberg Law
* Feds shut down ‘dangerous’ gain-of-function research, tighten oversight of foreign collaboration ([link removed]) —CIDRAP


** Gavi Finally Receives its Congressionally-Appropriated Funding
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The US Department of State will release the full $600 million in US funding appropriated by Congress for Gavi, the Vaccine Alliance, noting that ([link removed]) “discussions resulted in significant commitments that strengthen vaccine safety, improve public health, and better align Gavi’s work with the principles of Gold Standard Science and transparency.” The funding, which was set to expire September 30 was being withheld by Health and Human Services Secretary, Robert F. Kennedy Jr., who criticized Gavi's use of vaccines containing thimerosal, a preservative, which extensive reviews by the World Health Organization and other scientific bodies have found to be safe in the small amounts used in multidose vaccines. Gavi had already begun transitioning to newer vaccine formulations
that do not contain thimerosal.

IMPLICATIONS: This is another example of the growing influence of politics or political ideology over global health policy and evidence-based decision-making. Although Congress appropriated the funding, the Administration delayed the release of funding as leverage to extract commitments from Gavi, including accelerating the transition away from thimerosal-containing vaccines, ending support for routine COVID-19 vaccination programs, reducing support for the World Health Organization, and creating a new mechanism to review vaccine science and safety. The delay underscored the vulnerability of global immunization programs to shifting domestic politics. Together with the evidence of disruptions to PEPFAR-supported programs following the US foreign-aid freeze presented at AIDS 2026 (see below), these developments highlight how political decisions are increasingly shaping not only the financing of global health programs, but also who can access lifesaving interventions and how scientific
evidence is translated into policy and practice.

READ:
* US finally moves to release $600 million to Gavi ([link removed]) —Devex
* U.S. Department of State and U.S. Department of Health and Human Services on Strengthening Vaccine Safety, Accountability, and American Leadership in Global Health ([link removed]) —US Department of State
* Collins says State Department will reinstate funding for global humanitarian vaccine alliance ([link removed]) —The Hill
* Trump administration to dispense $600M for vaccines RFK Jr. held up ([link removed]) —Politico
* State Department agrees to reinstate vaccine funding for Gavi ([link removed]) —CIDRAP


** International AIDS Conference Wraps Up
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The International AIDS Conference is wrapping up as this issue goes to publication. The meeting underscored an important reality: the barriers to ending HIV are no longer primarily scientific—they are political. Across plenaries and satellite sessions, researchers, advocates and policymakers returned to the same question: will the world deliver lifesaving innovations with speed, scale and equity, or allow them to remain the privilege of a few? New data presented in Rio offered an early warning about the consequences of political choices: analyses found that disruptions linked to the US foreign aid freeze contributed to declines in PEPFAR-supported HIV treatment in 2025 ([link removed]) , including reductions in pediatric treatment coverage and the closure of HIV service sites across multiple countries. At the same time, researchers presented modeling data suggesting that the investigational monthly oral PrEP pill alimatravir (MK-8527) could
potentially be manufactured for as little as $3 per person per year if produced at sufficient scale. During an AVAC satellite session, Executive Director Mitchell Warren reflected ([link removed]) that, "16 years since we first learned that PrEP was safe and effective as a daily oral tablet, we have successfully squandered our opportunities," arguing that the challenge is no longer discovering what works, but building the systems and political commitment needed to ensure these tools reach the people who need them most.

IMPLICATIONS: The discussion and debate ([link removed]) makes clear that the future of the HIV response will be determined by political choices around the world. As new data on treatment, prevention, cure and delivery innovations were shared, governments are slashing foreign assistance, dismantling public health infrastructure, attacking scientist and scientific institutions and retreating from the global partnerships that made this progress possible. Without sustained investment, equitable licensing agreements, and leaders willing (and able) to defend evidence-based policymaking, the world risks repeating one of the central failures of the HIV response: allowing lifesaving innovations to arrive years—or decades—after they are needed most.

READ:
* A rocky rollout A powerful new prevention drug could help end the HIV epidemic—but supply is falling far short ([link removed]) —Science
* Why is Latin America still waiting for long-acting HIV prevention ([link removed]) ?—Devex
* Activists and leaders at global HIV meeting decry price of prevention drug ([link removed]) —Science
* Global AIDS conference kicks off in Rio ([link removed]) —Bay Area Reporter
* Special edition: Access takes center stage at International AIDS Conference ([link removed]) —Devex
* Promise of monthly oral pill sparks renewed interest in post-exposure prophylaxis (PEP) ([link removed]) –AIDSMap
* AIDS 2026: Some pieces falling into place for monthly HIV prevention pill, but key data not yet in ([link removed]) —Spotlight (SA)
* Will African Countries That Rejected Trump’s Health Deals Be Forced Back to the Negotiating Table? ([link removed]) —Health Times
* We analysed SA’s first LEN roll-out data. Here’s what we found ([link removed]) —Bhekisisa
* Mitchell Warren on the fallout from PEPFAR cuts ([link removed]) —Managed Healthcare Executive
* Nearly 200,000 lenacapavir shots given across Africa, but supply issues pose challenges ([link removed]) –AIDSMap
* New HIV Frontier: The Fight to Access Long-Acting Prevention Drugs ([link removed]) —Health Policy Watch
* 15 things the State Department said about the future of PEPFAR and global healt ([link removed]) h— Lights, Camera, Equity! Substack
* The US State Department Redraws the Map of Africa at the AIDS2026 Conference ([link removed]) —To End A Plague...Again Substack


** AVAC’s AIDS 2026 Highlights
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See AVAC’s reports on what’s interesting and important coming out of AIDS 2026.
* Science, Systems, and Communities: Turning Progress into Impact ([link removed]) , July 30
* Innovation Without Access is Injustice: AIDS 2026 Opens in Rio ([link removed]) , July 28

What We're Reading

• Adjusting to a Post-PEPFAR World ([link removed]) —Health Policy Watch
• Cuts to anti-AIDS foreign aid take a toll in Africa ([link removed]) —Washington Post
• Donor Government Funding for HIV in Low- and Middle-Income Countries in 2025 ([link removed]) —KFF —Save HIV Funding
• Without US aid, Africa must rethink how it funds leaders ([link removed]) —Devex
• African Union Pushes For Greater Domestic Spending On Health Amid Reports Of Huge Disruptions To HIV And TB Services ([link removed]) —Health Policy Watch
• How Trump’s “America First” Administration Could Shut U.S. Scientists Out of the Next Nobel-Worthy Discovery ([link removed]) —ProPublica
• New Unitaid Head Gets High Marks – but Can He Save the Organization? ([link removed]) —Health Policy Watch
• White House offers its science blueprint: More AI, less life sciences ([link removed]) —STAT
• Leadership Shakeup at CDC's Ebola Response Team ([link removed]) —MedPage Today
• Trump's CDC Director Nominee Moves Closer to Confirmation ([link removed]) —MedPage Today
• Key Senate panel backs Trump’s picks for CDC, pandemic preparedness ([link removed]) —STAT
• Phase 3 Trial of Weekly Oral Islatravir–Lenacapavir for HIV-1 Treatment ([link removed]) —NEJM
• Lenacapavir: A blueprint for innovation, regulation, and access ([link removed]) —Global Health Technologies Coalition
• People with HIV are living longer but have fewer years of good health. New guidelines aim to change that ([link removed]) —Spotlight (SA)
• Towards Elimination of Sexually Transmitted Infections: Research Developments and Vaccine Uptake ([link removed]) —JIAS

In solidarity,
AVAC
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AVAC Global Advocacy for HIV Prevention
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