Breakthroughs Blog: WHO

2025 has been a whirlwind year for global health. In the United States, we've seen the integration of the US Agency for International Development (USAID) into the Department of State, transformation at the Department of Health and Human Services (HHS), and a complicated and prolonged budget process. Globally, we've seen setbacks and progress in HIV and malaria, an evolution at the World Health Organization (WHO), a multilateral win with the Pandemic Agreement adoption, and African partners stepping up to boost autonomy.As the year draws to a close, GHTC is reflecting on the innovations, policy shifts, and pivotal moments that defined 2025 and what they signal for the years to come.US global health leadership in transitionOn day one of his second term, President Donald Trump initiated an effort to realign US foreign assistance programs with the goal of making America safer, stronger, and more prosperous. This effort started with an overhaul of USAID, triggering a series of layoffs, stop-work orders that turned into award terminations, and withdrawals from multilateral partnerships, culminating in the agency’s official integration into the State Department on July 1.While this suspension and termination of USAID programs disrupted critical research projects and health services worldwide earlier this year, in September, the State Department unveiled the America First Global Health Strategy, which outlines a plan to reshape the US government’s global health programming, presenting opportunities for global health research and development (R&D).The new strategy centers multiyear bilateral agreements with countries while reducing ties with nongovernmental organizations and narrowing health focal areas. While critical questions remain on implementation—including on whether the agency still retains needed expertise and how it will coordinate with interagency technical partners like the US Centers for Disease Control and Prevention (CDC)—the strategy’s focus on integrating aid more directly into national health systems is a step forward in improving sustainability and self-reliance. The strategy also raises the exciting possibility that funds could be used to support “innovative, breakthrough technologies.”  Building on USAID’s successes and shortcomings in that space, the department has a clear opportunity to establish a centralized R&D fund—in complement to bilateral agreements—to invest in innovative tools that could leapfrog global health progress. Through collaboration with global health stakeholders and interagency partners, State could reshape US global health programs to continue to save lives; foster funding beyond US government resources, including through partner nations; and promote shared security and prosperity.Overhaul of US scientific and public health infrastructureThe United States has long been a leader in global health R&D and science more broadly, with American researchers, universities, companies, and patients benefiting. In 2025, sweeping changes at HHS reshaped America’s public health and research infrastructure. These far-reaching reforms aimed to advance administration priorities of promoting “gold standard science,” improving efficiency, transparency, and oversight and realigning investments to match administration objectives. At the National Institutes of Health (NIH) and CDC, these changes have included significant staff departures, among them seasoned leaders, and the appointment of many officials who were previously critics of these agencies. It has also included new policies to overhaul oversight of foreign awards and cap indirect costs, changes to longstanding vaccine guidance, and the terminations of numerous awards, including a wind-down of mRNA vaccine development activities. The speed and scale of these changes have raised concerns across the biomedical research and public health communities. While thoughtful reforms could yield benefits, experts warn that current actions risk driving US scientists abroad, disrupting promising clinical trials, weakening the pipeline of new tools, eroding trust in public health guidance, and weakening the structures that have sustained US scientific leadership. US budget swings and shutdowns2025 began with a race to fund the government, with President Trump signing the fiscal year 2025 budget into law in mid-March. While the budget maintained global health R&D-relevant funding lines at prior levels, it funded a government that now looked significantly different after sweeping layoffs and restructuring. Months later, the administration issued its budget request, proposing significant cuts and a restructuring of global health and research programs, reflecting far-reaching changes it had already begun to enact.In June, the administration proposed a request to rescind billions in funding for foreign aid. Though Senators stepped in to remove cuts to global programs for HIV/AIDS and several other health areas, the package ultimately became law, cancelling $500 million in previously appropriated global health funds and raising the possibility that this administration will continue to use rescissions as a tool to withdraw funding.  By late summer, Senate and House appropriators advanced interim funding bills that included higher-than-expected funding for global health and medical research, maintaining funding proposed for elimination by the administration. But then stalled negotiations triggered the longest-ever government shutdown, during which the administration implemented unprecedented furloughs and layoffs that affected critical staff at public health and health research agencies.While the shutdown ended on November 12, pushing the funding fight until January, and most associated layoffs were reversed, uncertainty about future funding for global health R&D persists, especially with a deeply divided Congress and the potential of further recissions.A year of setbacks and breakthroughs in HIV and malaria effortsGlobal HIV/AIDS and malaria efforts faced major setbacks in 2025 as declining US and international donor support has threatened decades of hard-fought progress. Funding cuts could lead to millions of additional HIV and malaria cases in the coming years and has already stalled promising research advancing new HIV and malaria tools.Amid these challenges, the June approval by the US Food and Drug Administration of lenacapavir, a twice-yearly injectable drug for HIV prevention, marked a major milestone and a reminder of the incredible progress possible through strong support for research. Developed by Gilead and supported by NIH-backed research, the drug offers an alternative to daily pills or bi-monthly injections, making prevention more accessible and easier to maintain. Global partners are stepping up to expand access, and Phase 3 trials of a once-yearly version are planned.In November, Medicines for Malaria Venture and Novartis shared Phase 3 trial results for GanLum, a new drug found to be highly effective at treating malaria, including drug-resistant cases, and capable of blocking disease transmission. Pending approval, it could help counter rising resistance to current treatments.Other notable R&D advances in 2025 also targeted the growing threat of antimicrobial resistance, including a Phase 3 trial for a novel antibiotic targeting a dangerous antibiotic-resistant pathogen, support for what could be the first-ever vaccine for Escherichia coli, and efforts to harness artificial intelligence to transform antibiotic discovery. These breakthroughs underscore the importance of sustained R&D investment and the efforts to ensure new tools reach those who need them.WHO restructures amid budget shortfallFacing a severe budget crisis and pressure from member states to reprioritize programs, WHO launched a sweeping overhaul in 2025, cutting staff, slashing its budget, and reorganizing core functions. At its February Executive Board meeting, member states approved a $1.1 billion budget reduction, leaving a remaining $1.7 billion shortfall for 2026 and 2027, despite a recent increase to membership dues and appeals for voluntary contributions.In late April, WHO announced a plan to halve its senior leadership team and consolidate departments. Infectious disease and climate and health programs remain relatively well-resourced, and merging several disease-specific initiatives into a new division could strengthen certain programs. However, neglected tropical diseases and health emergency preparedness and response programs face sharp cuts, while reductions in regional and in-house expert posts may weaken global lab and surveillance networks and delay critical guidance, raising concerns about WHO’s outbreak response capacity.One core R&D function spared from the worst cuts was WHO’s prequalification (PQ) program, which evaluates medical products to support regulatory approval and rollout in countries with less advanced regulatory authorities. The program has marked some important achievements this year, launching a new portal to improve transparency for developers, introducing a new streamlined review and guidance process for TB diagnostics, and prequalifying lenacapavir for HIV prevention through a compressed process completed in just 36 days. As WHO and the broader United Nations system grapple with financial strain and diminished donor support, questions remain about the capacity to deliver on their mandate. A major outbreak could test the limits of this leaner system.Pandemic Agreement provides hope in challenging year for multilateralismAt the World Health Assembly in May, delegates adopted the Pandemic Agreement, a milestone win for global health after three years of complex negotiations. However, consensus on a pathogen and access-benefit sharing system was not reached, requiring member states to return to the negotiating table to finalize an annex for adoption at next year’s assembly. Persistent disputes over the voluntary or legally binding nature of participation signal tough negotiations ahead.While the Pandemic Agreement is a huge win, pushback from key countries and declining pandemic preparedness investments raise concerns about global readiness. Annex negotiations and the 2026 United Nations High-Level Meeting on Pandemic Prevention, Preparedness, and Response will further test international unity on this crucial topic.Meanwhile, 2026 brought notable R&D advances to strengthen our defenses against pandemic threats. The Coalition for Epidemic Preparedness Innovations launched the first-ever adjuvant library of 25 immune-boosting substances to improve vaccine effectiveness and awarded $17.3 million for Phase 2 trials of a promising Nipah vaccine, among the first candidates targeting the priority virus to reach this critical stage. IAVI’s vaccine candidate for Lassa virus, another virus with pandemic potential, was also found to be safe and effective in a first-in-human Phase 1 trial, marking further R&D progress against concerning disease threats.Partners step up to fill gaps and boost autonomyAmid steep foreign aid funding losses, African nations are accelerating efforts to boost manufacturing and laboratory capacity on the continent and reduce reliance on external partners. At October’s Conference on Public Health in Africa in Durban, South Africa, thousands of participants endorsed The Durban Promise, a roadmap for Africa’s health sovereignty, urging action on manufacturing, financing, workforce and capacity development, and regulatory strengthening, a signal of growing continental unity.This momentum was echoed by the Accra Reset, led by Ghanaian President John Mahama, to forge further progress toward greater sovereignty and more equitable global cooperation. At the continental level, the Africa Centres for Disease Control and Prevention launched a new biomanufacturing fellowship to help meet the goal of producing 60 percent of Africa’s vaccine dose needs locally by 2040.South Africa held the G20 presidency this year, culminating in the first G20 summit held on African soil and a declaration focused on priorities for Africa and the Global South. The summit was punctuated by the absence of the United States, underscoring the imperative for greater African autonomy as international aid declines and health threats rise. With the United States assuming the G20 presidency next year, its priorities will be closely watched. Looking ahead to 2026If 2025 has taught us anything, it’s that global health is unpredictable and constantly evolving, so we won’t speculate on exactly what 2026 may bring. But a truth remains clear: global health R&D is a strong investment that pays off—saving lives, strengthening economies, and fueling scientific progress. As the United States redefines its approach and role in the broader global health ecosystem, it remains to be seen how it, and others, will step up to ensure that promising technologies in the pipeline are advanced to improve lives around the world.For other fascinating global health news delivered to your inbox weekly and to stay abreast of developments in 2026 and beyond, sign up now to receive GHTC’s R&D News Roundup newsletter.

This fall, the global health community gathered against a backdrop of change. Shifts in global funding, visible pullbacks from multilateralism, and an evolving global development architecture are reshaping how actors engage and advocate on the world stage.For the Global Health Technologies Coalition (GHTC)—and for many others—this moment has prompted reflection on how we show up in global forums and what it means to engage meaningfully amid transition. Following a busy season of high-level gatherings, we’ve taken time to reflect on what these moments revealed—both in the lead-up and in the conversations that followed—and how they are shaping our thinking about GHTC’s role and path forward in these spaces. Reconnecting at UNGA80 In the run-up to this year’s 80th United Nations General Assembly (UNGA80), there was an unusual air of hesitation across the global health community. Typically, mid-August brings a flurry of coordination calls and side event planning, but this year, the energy felt uncertain. For GHTC, our initial hesitation to participate stemmed from UNGA’s focus on noncommunicable diseases (NCDs), an area outside our traditional advocacy repertoire. However, we also had questions about which of our partners would be in New York City this year and what our role could or should be in the tumultuous year we have all had. Yet, as it goes, we and other organizations confirmed our plans to attend UNGA, and soon, the familiar rhythm of civil society’s presence in New York began to take shape.  In New York, GHTC and the Global Health Council (GHC), with STUF United Fund, cohosted an event on innovation, security, and equity in a changing global landscape, which brought together policymakers, funders, and implementers to examine how global health can stay resilient amid geopolitical uncertainty. The discussion was lively and focused on the technical aspects of innovation, security, and equity, but afterwards participants commented not on those technical matters, but on our authentic and pragmatic approach and tone with which we addressed these topics. Audience members remarked that the discussion was one of the most genuine moments of the week. For GHTC, moderating this dialogue reinforced the need for global health advocates to bridge communities and connect innovators, funders, and policymakers around a shared vision for equitable access. It also reminded us that the credibility of civil society depends on showing up authentically, especially in moments of uncertainty or disagreement.  One striking development at UNGA this year came during the High-Level Meeting on NCDs, where the United States laid out objections to the political declaration and voted against it, taking consensus for the resolution off the table. While this move was not unexpected given the US government’s posture toward multilateralism this year, it was still a sobering moment. Secretary of Health and Human Services Robert F. Kennedy has made NCD prevention a national priority under his leadership at the department, yet his sharp criticism of the declaration underscored the United States’ continued reluctance to advance these goals through global cooperation. Women’s health as a catalyst for R&D transformation  As the global health community’s focus shifted from New York to Berlin, Germany for the World Health Summit (WHS), many of the same themes carried forward—innovation, equity, and the importance of collaboration amid shifting global priorities. After UNGA80, we saw how essential it was for civil society's voices to remain present and aligned in global conversations, and we viewed WHS as an opportunity to do just that. For us, a standout moment in Berlin was our participation in the Gates Foundation’s Women’s Health Innovation Equity Forum—a convening of global leaders, innovators, and funders dedicated to advancing accountability and progress in women’s health research and development (R&D).  What stood out the most at this forum was the shared understanding that women’s health R&D can be a testing ground for how we build a more equitable and collaborative innovation system overall. Conversations at the forum went beyond individual products or technologies to look at the broader ecosystem: how research can better reflect women’s lived experiences, how artificial intelligence and digital tools can be designed to avoid bias, and how we can create inclusive pathways from discovery to delivery. The call was not just to innovate for women but to innovate with women, by centering their voices, co-designing solutions that fit their realities, and ensuring that they are represented as leaders, scientists, and decision-makers throughout the R&D process. These ideas align with GHTC’s work to strengthen the global health innovation ecosystem. Our goal is to help make equitable, inclusive, and well-resourced innovation systems the rule, rather than the exception.  Reimagining the global health architectureOver the past several months, we've participated in a number of conversations, meetings, and working sessions aimed at reimagining how the global health architecture can be rebuilt stronger and more resiliently in the years ahead. One gathering, hosted by the Wellcome Trust just after WHS, brought a new focus and sense of shared purpose to this discussion, convening partners from across North America and Europe to explore the future of global health amid ongoing change and reform. This initial session focused on North American and European partners, with additional regional discussions planned to ensure perspectives from low- and middle-income countries and other stakeholders are fully represented as the series continues. The gathering brought together an extraordinary mix of leaders—funders, policymakers, researchers, and advocates—who are committed to reimagining how the global health ecosystem advances innovation and equity. Our discussions explored how the next generation of global health architecture could deliver faster, more inclusive, and stronger regional capabilities for research and manufacturing and more sustainable financing that bridges discovery and delivery. It was both humbling and energizing to be part of such a thoughtful, solutions-oriented dialogue at a moment when the global community is being called to reexamine what collective action really looks like.  For GHTC, these reflections really brought home why our coalition’s work matters. The conversations highlighted how innovation, access, and financing are all part of the same continuum, which is exactly what GHTC has been advocating for as we work to strengthen R&D systems, regulatory pathways, and product access. What struck us the most was the shared understanding that reforming global health innovation is not only a technical or financial issue but also a matter of trust, shared power, and accountability. We left the meeting encouraged and inspired, knowing that voices like ours, grounded in evidence, partnership, and advocacy, have an important role to play in shaping a more connected, inclusive, and resilient global health ecosystem. In Berlin, we also had the chance to join our partners, including the Medicines for Malaria Venture (MMV), Impact Global Health, and others, at events highlighting innovation and equitable access on the margins of the WHS. Finally, to close out our continued engagement with the civil society arm of the G20, we supported our partners—including the South African Health Technologies Advocacy Coalition, Resilience Action Network Africa, MMV, Better Health Solutions, and others—in hosting a side event on science, research, and innovation on the sidelines of the G20 Social Summit. This event highlighted the value of meaningful partnerships and global collaboration, reinforcing the importance of civil society's voices in shaping health innovation and research agendas worldwide. Looking aheadAs this season of global convenings draws to a close, GHTC is taking stock. We are reexamining our multilateral priorities and exploring how to continue showing up—strategically, collaboratively, and boldly—in spaces that are themselves evolving. We extend deep thanks to our partners—GHC, MMV, Impact Global Health, the South African Health Technologies Advocacy Coalition, Resilience Action Network Africa, Better Health Solutions, and many others—for the coordination and collaboration that made this season so meaningful. Even during a period of change, these gatherings reaffirmed that innovation, solidarity, and shared purpose remain at the heart of progress in global health. 

The World Health Organization's (WHO's) TB Vaccine Accelerator Council recently published a new report calling for action to ensure equitable access to future tuberculosis (TB) vaccines currently in the pipeline. While the only licensed vaccine for TB is 100 years old and has limited effectiveness in adolescents and adults, as of September, there are 16 candidate vaccines in clinical development, six of which are in Phase 3 trials. WHO estimates that a vaccine for adolescents and adults that is at least 50 percent effective could avert up to 76 million TB cases and 8.5 million deaths over 25 years. However, as the report claims, global demand could far exceed supply in the initial years after a vaccine is approved because there is no designated funding for such a rollout in low- and middle-income countries most affected by TB, which are already facing significant funding shortfalls. In anticipation of these potential bottlenecks and barriers to access, the report identifies six solutions to encourage countries with a high burden of TB, manufacturers, and other funders and stakeholders to start preparing now for the rollout to ensure future vaccines can reach people who need them faster. In a Phase 1 randomized controlled trial, an experimental intranasal vaccine against multiple H5N1 avian flu strains generated a broad immune response, demonstrating the potential of such a vaccine to play a major role in preparing for outbreaks of emerging viruses with evolving strains, as H5N1 continues its worrying spread. The University of Maryland research team tested the vaccine against a placebo in 40 adults between 18 and 45, finding that the vaccine was safe, well-tolerated, and stimulated immunity at various doses. One group received a vaccine dose combined with an adjuvant, an ingredient used to trigger a stronger immune response, and their immune systems were better able to neutralize infected cells for longer, suggesting that the use of an adjuvant could be a promising approach that might allow for lower doses, which could stretch limited vaccine supplies in the event of an outbreak. Last week, IAVI published new findings from the first-in-human Phase 1 clinical trial of its Lassa virus vaccine candidate, which show that one dose of the vaccine triggers robust and long-lasting immunity and is safe. There are no vaccines or treatments currently licensed against the dangerous illness, which causes thousands of deaths in endemic West Africa and has been designated as a priority pathogen with pandemic potential. The trial enrolled 114 volunteers in Liberia and the United States. The candidate, now undergoing a Phase 2a trial in West Africa, is currently the most advanced Lassa fever vaccine candidate in the pipeline and uses the same platform as Merck’s single-dose Ebolavirus vaccine, which is approved in more than a dozen countries. 

A team of chemists from the University of Warwick and Monash University has identified a promising, potent new antibiotic that seems to be much more effective than existing drugs against deadly superbugs like MRSA and shows no signs of resistance so far, encouraging news as the global threat of antimicrobial resistance continues to grow and the pipeline of new antibiotics continues to fall short. The molecule had been overlooked for decades as an intermediate chemical in the natural process to produce another known antibiotic, methylenomycin A, which was discovered 50 years ago, and despite having been synthesized multiple times, the synthetic intermediates have seemingly not been tested before for antimicrobial activity. The new antibiotic is much more potent than methylenomycin A itself—100 times more active against a range of serious bacteria. It could not only be a powerful new tool against rising drug resistance, but this work could also pave the way for new approaches to antibiotic discovery. A team of researchers has developed an antivenom using antibodies from a llama and an alpaca that can neutralize venom from some of the world’s most venomous snakes. Snakebites are a neglected public health issue that kill around 20,000 people in sub-Saharan Africa yearly. Current antivenom treatments are usually specific to a single snake species, and it can be difficult to identify which of the many types of venomous snakes is behind a bite, making timely, effective treatment difficult to achieve. The researchers exposed an alpaca and a llama to venoms from 18 of the most dangerous snake species in sub-Saharan Africa, isolated the antibodies that the animals produced against the venom, and then combined some of those antibodies in a single cocktail. In mice, the treatment protected against toxins from 17 African snake species and reduced skin damage. Many scientists previously thought that developing a broad-spectrum antivenom would require too many antibodies to be practical because some venom can contain up to 100 toxins, but this study shows that a combination of just a handful of antibodies can neutralize the venom of many snake species, paving the way for the development of similar broad-spectrum antivenoms for other areas where snakebites are a common public health challenge. Last week, Cepheid announced that its Xpert MTB/XDR test for tuberculosis (TB) drug resistance has been prequalified by the World Health Organization (WHO), enabling procurement through international agencies and greater access in areas with a high TB burden. The test is designed to detect resistance to multiple first- and second-line TB drugs from patient samples. It also delivers results quickly, within 90 minutes, allowing health care providers to make quicker, more reliable treatment decisions and have a better understanding of drug resistance, especially in regions with a high TB burden where timing and accuracy are critically important.