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Presented by MSD for Mothers | Is Kenya missing young women and girls with its lenacapavir rollout, and where to look for a global health job.
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So much for unity in getting the global HIV response back on track. Though a new political declaration on HIV/AIDS was adopted with the support of 149 United Nations member states on Tuesday, the United States and seven other countries voted against it during a high-level meeting in New York.
Adopted every five years since 2001, this was the first time the declaration was not approved by consensus, speaking to the politicization of some elements of the document. That includes support for sexual and reproductive rights, which the Trump administration has targeted since taking office, and for services for men who have sex with men and other marginalized — but also frequently criminalized — communities. “We were prepared for the worst, even for the situation where we might not have a political declaration,” Javier Hourcade Bellocq, a civil society leader and a board member of The Global Fund to Fight AIDS, Tuberculosis and Malaria, tells me.  This year’s declaration recognizes that efforts to end AIDS as a public health threat by 2030, which was codified in the 2016 political declaration, are at risk of being completely derailed. Annual new HIV infections were supposed to have dropped to 370,000 last year. Instead, there were 1.3 million, according to UNAIDS. Those infections occurred as the U.S. and other major donors cut back on global HIV funding, creating what UNAIDS has called a “perilous moment” for the response. As a result, HIV testing programs actually fell by 22% between 2024 and 2025 in the countries hardest hit by the virus, according to new UNAIDS statistics. And prevention services are rapidly disappearing. That has some worried that this year’s numbers could be even worse. But the effort to recover progress ran up against politics and a fear that global interest in the HIV response is waning. Though Washington was involved in the negotiations up to the high-level meeting, according to UNAIDS officials, the Trump administration ultimately did not get on board with the final draft. In rejecting the political declaration, Deputy U.S. Representative to the U.N. Tammy Bruce said the document strayed too far from the targets for ending AIDS “by including divisive topics,” according to Health Policy Watch. Russia, Israel, Burkina Faso, Burundi, North Korea, Niger, and Saudi Arabia also voted against the declaration, while 14 other countries abstained. The European Union registered its frustration that this year’s document seemed to be watered down in response to the politicization of the process. On behalf of the EU, Cyprus said the “human rights-based approach” has been weakened in the 2026 version compared to the 2021 declaration. Cyprus also disassociated the EU from calls for greater sharing of intellectual property — a fraught topic as negotiations around the pathogen access and benefit sharing annex continue. Civil society groups had also raised concerns in the lead-up to the high-level meeting that the document did not make more explicit how member states would make up the funding shortfall. And observers said they were disappointed by the poor turnout from member state representatives for many of the discussions during the high-level meeting. “The absence was very loud,” Hourcade Bellocq says. Still, civil society ultimately voiced support for the declaration. “In today’s political context, this political declaration is a major win,” Florence Anam, co-executive director of the Global Network of People Living with HIV, said in a statement. But will it be enough? Background reading: Can the new UN political declaration get the HIV response back on track? |
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A Message From MSD for Mothers
From access to quality: Rethinking maternal health systems Global maternal deaths are declining, but quality care gaps persist. From efforts focused on strengthening standards of care to deploying digital tools to help reshape maternal health systems, Maternity Matters examines how private sector engagement is contributing to safer, quality care. |
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Never enough
And even when there’s good news in the HIV sector, it still seems to be clouded by challenges.
Lenacapavir has the potential to help overcome some of the obstacles that are slowing efforts to end AIDS by 2030. The long-acting injectable form of preexposure prophylaxis, or PrEP, is the closest thing we have to a vaccine — and demand is sky-high. But activists have warned that the rollout is not happening on the scale that it needs to if lenacapavir is going to truly be transformational. And now, in the places where it is rolling out, there are warning signs that some communities are being left behind. That includes adolescent girls and young women between 15 and 24 years old in Kenya, where the rollout has been happening for three months, Devex contributor Anthony Langat reports. Though they are most at risk of acquiring HIV, they are not specifically being encouraged to access lenacapavir, and no effort is being made to overcome the stigma or fragmented health services they will face if they still attempt to do so. Oral PrEP was rolled out through the existing HIV system and struggled with retention and adherence, particularly among adolescent girls and young women. “Unless community-based delivery infrastructure reaches those girls before they give up, Lenacapavir follows the same trajectory,” Serah Malaba, co-CEO of Tiko — an NGO working to improve healthcare access for women and girls, tells Anthony. Read: Is Kenya’s lenacapavir rollout missing young women and girls? |
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Lung cancer has an 80% cure rate when caught early, yet screening remains low in medically underserved areas. Moghanaki explains how public-private partnerships are being used to scale equitable, lifesaving early detection. |
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Free falling
 It’s not just the global HIV funding that is in a nosedive. Overall, official development assistance, or ODA, has fallen for the third year in a row, and health is the sector hardest hit, according to the latest data published by the Organisation for Economic Co-operation and Development. With overall ODA projected to fall to $152 billion in 2026 — a decline of about 6.9% from last year — health ODA is likely going to plummet anywhere from 29% to 46% from 2024 to 2026. That’s somewhere between $5 and $8 billion. (The lack of clarity is because the United States hasn’t made clear exactly how much of its ODA is going to health.) While funding may be falling, that doesn’t mean all of the jobs in the health sector are disappearing. As part of our Careers coverage at Devex, we crunched the numbers to find out which U.N. agencies and other development organizations were still hiring in the global health sector. At the top of the list was UNICEF, which posted 556 health-related jobs in 2025. Unsurprisingly, the World Health Organization was just behind. Want to see the full list? Sign up to become a Devex Career Account member. Read: Health ODA faces steepest cuts in 2026, OECD says Plus: The top global development employers in health 
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Moving forward
The response to the ongoing Ebola outbreak in the Democratic Republic of Congo continues to scale up. The latest? WHO expects to start clinical trials next week on two candidate therapeutics — the monoclonal antibody MBP134 and antiviral remdesivir — and evaluate whether they are safe and effective in treating patients with the Bundibugyo species of the Ebola virus, alone and in combination. The U.S. and Gilead Sciences donated doses of the drugs for the trials. WHO’s Dr. Vasee Moorthy, who oversees research and development during outbreaks, says the agency is looking to enroll around 1,000 people for the trial with plans to expand it across multiple facilities over time. The trials will take place in the middle of a fast-moving outbreak. Just five weeks after WHO declared it a public health emergency of international concern, there have been more than 1,100 confirmed cases and over 290 deaths. Almost 80 health workers have been infected to date. The response also faces continued challenges, including contact tracing, which is made more difficult by the lack of incentive. During the 2018–2020 Ebola outbreak in Ituri, DRC, vaccines were offered to encourage contacts to come forward for monitoring. But in this case, there are no vaccines. “Most of them are daily laborers,” says WHO Director-General Tedros Adhanom Ghebreyesus. “There is the economic fear. So they don’t want to come forward because, for one, they don’t get vaccines, or second, if there is quarantine applied, isolation applied, then they can’t have even their daily bread.” ICYMI: Why Ebola responders have ‘a few things’ working in their favor 
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Jenny Lei Ravelo contributed to this edition of Devex CheckUp. It was edited by Rumbi Chakamba, copy edited by Sheri-kae McLeod, and produced by Mariane Samson. For any news tips, please get in touch: [email protected].
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