Why we’re watching: If confirmed, Dr. John Nkengasong — who currently runs the Africa CDC — will be the first African to take the helm at the U.S. President's Emergency Plan for AIDS Relief, a program that works primarily in Africa. He succeeds Deborah Birx, a major force who flexed PEPFAR’s muscles with partner countries and emphasized a data-driven approach to funding.

Leadership: Angeli Achrekar, acting U.S. global AIDS coordinator.
$: $5.4 billion in annual U.S. bilateral HIV spending.
HQ: Washington, D.C.
Tidbit: PEPFAR’s 70% local funding target is nearly three times USAID’s four-year goal.
Follow: Michael Igoe, Sara Jerving, and Devex CheckUp.

Analysis: Birx’s departure has left a power vacuum at the world’s largest global health program for a single disease, one likely to be filled by a virologist who has PEPFAR and U.S. CDC experience but who isn’t a Washington political insider. Nkengasong was a surprising choice — we certainly didn’t predict it — and has the opportunity to write a new chapter in PEPFAR’s history at a critical moment. The fight against HIV has been set back by COVID-19, both in terms of interrupted health services for patients and redirected attention of health systems. Nkengasong has a unique perspective, having led efforts against both diseases and worked to increase laboratory and health systems capacity in Africa. At a time when U.S. government agencies are jockeying for influence over the global COVID-19 response and the global health portfolio in general, PEPFAR could evolve under his new leadership. — RK.

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