The US President issued an executive order to overhaul the US childhood vaccination recommendations. The order bypasses the longstanding scientific review process traditionally led by expert advisory bodies including the CDC’s Advisory Council on Immunization Practices (ACIP), which has historically informed this process, before being politicized by the current Administration. The order reduces the number of vaccines recommended for all children; calls for the combined measles, mumps and rubella (MMR) vaccine to be administered as three separate shots; shifts several vaccines—including hepatitis A and B and COVID-19—to "shared clinical decision-making”; and expands exemptions for school immunization requirements. Public health leaders and clinicians immediately condemned the order, warning that it contradicts decades of scientific evidence, creates confusion and raises new barriers for vaccine access. 

IMPLICATIONS: The latest executive order is another divergence from evidence-based public health policymaking and toward politically driven decision-making. Public health experts warn that replacing established scientific review with executive action could erode confidence in childhood immunization, increase vaccine hesitancy and reduce vaccination coverage, leading to more outbreaks of vaccine-preventable diseases. A New York Times article profiles Japan as a “cautionary tale” after the government modified its vaccine schedule for MMR in 1993, making the measles and rubella single shots and the mumps component entirely voluntary. Consequently, coverage of mumps vaccination plummeted, and cases then soared – resulting in deaths among unvaccinated children in Japan. The changes by the federal government also signal how vaccine policy is being developed in the US, raising concerns that scientific expertise is being sidelined in favor of political priorities, and driven by misinformation and skepticism in vaccines. 
 
READ:  

• ‘This is so Wrong’: Experts Condemn Trump’s Vaccination Order—Health Policy Watch 
• Should the M.M.R. Vaccine Be Split Into Three Separate Shots?—New York Times 
• Trump administration order would upend nation’s childhood vaccine schedule—Washington Post  
• Trump’s vaccine plan would require millions of individual shots last used decades ago—Associated Press 

The US Department of State awarded $2 billion in global health and humanitarian assistance to faith-based organizations (FBOs), the largest allocation of foreign aid to these groups in more than 20 years. Under its "America First" Global Health Strategy, the funding, a majority spread over five years, will support faith-based hospitals and clinics in 17 countries and emergency humanitarian response, with major awards going to a consortium of Christian FBOs including World Vision, Samaritan's Purse and Compassion International. Of the $2 billion awarded, approximately $1.4 billion will be for healthcare programming primarily in Africa.  

IMPLICATIONS: News of global health funding is welcome after such sweeping cuts and months of delay, but it marks a major shift in how the US is delivering its foreign aid. The Administration claims the awards reflect a more efficient, results-driven approach and were not based on religious affiliation. However, former USAID officials and global health experts question whether the decisions were guided by evidence. FBOs historically are critical partners in delivering critical care and global health programming in countries that receive US foreign assistance. However, prioritizing a smaller group of FBOs over a broader range of implementing partners, where funding has been frozen or contracts terminated, could reshape HIV prevention and global health programs, and these large FBOs have many of the same administrative and overhead costs as other international NGOs, which were heavily criticized by the Administration in closing down USAID. Concentrating resources in fewer organizations also raises questions about whether diverse, community-led approaches to HIV prevention and health equity will continue to receive the support needed to reach the populations most affected. Moreover, representatives from recipient FBOs contend that the new money does not easily supplant or replace funding lost from the cuts and dismantling of USAID, when many FBOs were adversely affected and forced to reduce programming or shutdown services.  

READ: 

• Trump admin literally puts its faith into a $2B pledge—Devex  
• The new “America First Global Health Strategy” could erode years of progress under PEPFAR—Brookings
• US State Dept Causes Closure of CDC Zimbabwe—To End A Plague... Again 
• Trump administration to give faith-based groups $2B in funding for global health work—NPR  
• US announces nearly $2B in ‘historic’ faith-based partnerships—Devex 

Democratic members of the US Congress continued  oversight of the US Administration's global health policies this week with new inquiries into PEPFAR and the Administration's “America First” Global Health Strategy. California Representative Robert Garcia, the ranking Democratic member of House Oversight and Government Reform Committee, requested in a letter answers from the US Secretary of State following disruptions to PEPFAR and emerging data showing how they have contributed to the deaths of hundreds of thousands of people and the closure of at least 1,700 HIV service sites. Separately, Democratic Senator Raphael Warnock of Georgia led colleagues in a separate inquiry, questioning the Department of State’s reported requirement that African countries grant US officials direct access to sensitive national health data systems as a condition of receiving global health assistance through the bilateral memorandum of understanding (MOUs) agreements that are currently being negotiated with recipient countries. As part of the inquiry, Senate signatories requested a formal briefing from the State Department to answer these questions and provide updates on the data conditionalities present in these agreements. 

IMPLICATIONS: The escalation of these congressional inquiries reflects mounting concern in both chambers of Congress over the Administration's continued restriction and termination of congressionally appropriated global health funding, the lack of transparency surrounding its bilateral Memoranda of Understanding (MOUs), and the need for greater accountability in how the Administration is unilaterally reshaping US global health policy and using foreign assistance as leverage. These latest requests for information also suggest that sustained advocacy by the global health community is beginning to influence policymakers, as new evidence continues to document lives lost and the erosion of global health infrastructure resulting from this accelerated restructuring. While congressional oversight alone will not reverse these policy changes, it demonstrates that coordinated advocacy is elevating global health issues and helping shape the debate around future policy. 

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• Ranking Member Robert Garcia Demands Answers on PEPFAR as Trump Administration Guts Lifesaving HIV/AIDS Programs—House Committee on Oversight and Government Reform 
• Warnock Leads Inquiry into State Department Efforts to Seek Personal Health Data in Exchange for Aid to Developing Nations—Senator Raphael Warnock  

Following the US Senate’s official vote to temporarily block the White House Office of Management and Budget's (OMB) proposal to give political appointees greater authority over federal grant decisions (until December 11), Nature reported this week that the National Institutes of Health (NIH) has begun turning away grant applications for research where the primary purpose is to shape and inform policymaking. This, coupled with the Administration’s attempt to weaken the role of scientific review through the blocked OMB regulation, demonstrates increasing intention to politicize federal research priorities in line with political ideology and not evidence. Internal NIH documents reportedly state that policymakers are no longer considered “mission-relevant stakeholders”, placing dozens of health policy research grants in question. 

IMPLICATIONS: Efforts to reshape the US research enterprise are extending beyond a single OMB proposal to influence what research is funded, who can use it and how scientific evidence informs public policy. While advocacy from the scientific community is gaining traction, the temporary block does not resolve overall concerns about political influence over research funding. And restricting support for policy-focused research would weaken the evidence base that informs decisions on HIV, infectious diseases, pandemic preparedness, and public health, making it more difficult for policymakers to respond to emerging health challenges with rigorous scientific evidence guiding decision-making that is aimed towards saving lives. 

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• White House Attempt to Control Science Grants is Blocked – For Now—Health Policy Watch 
• The White House's new, quiet plan to attack public health—USA Today  
• NIH’s New Ban on Research to Inform Policy Undercuts its Mission—27UNIHTED Substack  
• NIH limits funding for research on the health effects of public policy—Nature