Presented by Clinton Global Initiative
After months of speculation about whether the U.S. would pull the plug on the U.S. President's Emergency Plan for AIDS Relief, the Trump administration made a rare positive announcement on foreign aid. Through PEPFAR, the U.S. plans to deliver lenacapavir — a twice-yearly injectable proven highly effective in preventing HIV — to 2 million people in high-burden countries.
But as soon as the announcement was made, a barrage of questions and criticisms emerged. Asia Russell, the executive director of international advocacy group Health GAP, told me the administration is missing a zero in its announcement, arguing that reaching only 2 million people — particularly if limited to pregnant and breastfeeding women — would barely dent the HIV epidemic.
Even before the news, there were already serious concerns about access.
In an in-depth report, Devex contributor Paul Adepoju describes the euphoria at IAS 2025 in July when researchers unveiled lenacapavir’s promise. With near-total protection across multiple populations, it was hailed as the next best thing to a vaccine. In trial sites, participants showed a strong preference for the injectable over daily oral pills.
But researchers and renowned experts in the field cautioned about a potentially slow rollout, warning it could mirror cabotegravir, the bimonthly prevention jab hampered by licensing barriers, patent disputes, and pricing battles.
Then there’s the cost and logistical demands of administering the injections.
On top of individuals needing to travel to a clinic, “You need a nurse, HIV testing, diagnostics at the point of delivery, and a supply chain that never fails. That is not simple,” said Glenda Gray, one of the most established experts on HIV. She worries about sustaining that infrastructure long term and ensuring people who most need the drug feel safe from stigma at clinics.
Affordability also remains a major hurdle. In the U.S., lenacapavir costs thousands of dollars — which would be outrageously expensive in places such as South Africa. Gilead has pledged to supply it at no profit to the 120 countries covered by its voluntary licensing agreements, but has yet to disclose what that price will actually be.
Read: Can health systems keep pace with HIV prevention’s breakthrough?
ICYMI: US announces support for HIV prevention game-changer with mixed reactions
HIV prevention innovations are not the only ones facing access hurdles because of cost. In many countries, nearly half of pregnant women never receive an ultrasound, putting them and their babies at risk.
A new artificial intelligence-enabled ultrasound scanner called BabyChecker is currently being trialed in several countries across sub-Saharan Africa and Latin America to help determine if pregnant women are dealing with a high-risk pregnancy.
The pilot shows promise, Devex contributor Sophie Edwards reports. In Kisumu County in Kenya, health workers have already scanned more than 700 women and identified 57 high-risk and 159 mild-risk cases. This means they were able to detect complications such as babies in breech position early and were able to refer mothers to hospitals so they can be assured of a safe delivery.
The full BabyChecker kit, which includes the handheld device, a smartphone, and a subscription to the AI, plus unlimited scans for a year, costs around $5,000. That’s significantly cheaper than traditional mid-range ultrasound machines that cost between $25,000 and $45,000. But users still find it expensive.
Delft Imaging, the Dutch social enterprise behind the innovation, agrees that the cost needs to come down. But right now, funders are shouldering the burden.
Read: Could AI ultrasounds be the 'great equalizer' for maternal health?
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87%
—That’s how much the world’s top 20 corporate donors — led by five pharmaceutical giants — increased their giving between 2019 and 2023, according to a new report by The Bridgespan Group, a nonprofit that advises philanthropic organizations.
Johnson & Johnson, Eli Lilly and Company, AstraZeneca, and Amgen Inc. account for the top four largest corporate givers. Their average annual philanthropic giving was within the range of $2 billion to just over $3 billion. Gilead Sciences Inc. was also in the top 20 with an average annual giving of $340 million. Much of their corporate giving involved medicine and vaccine donations.
Read: Corporate philanthropy surges, led by pharma giants
Measles is making a nightmare comeback — including in the U.S., where more than 1,400 cases have already been reported in 2025.
That should be a warning sign: the U.S. public health system isn’t working as it should.
“Measles is often seen as a litmus test for the strength of a country’s public health system. Its resurgence typically signals gaps in vaccination coverage, health equity, and trust in medical infrastructure,” Jonny Barty, CEO at Acasus, a consulting company working on health and education-related solutions, writes in an opinion piece for Devex.
Still, he remains hopeful. With stronger routine immunization and better tools to find under- and unimmunized children, outbreaks can be stopped.
“The good news is that we know what’s required, the measles vaccine works, and reaching every community is possible,” he writes.
Opinion: Measles is surging and it’s a warning we can’t ignore
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Clinton Health Access Initiative
United States
For the first time, more children are obese than underweight. UNICEF estimates that 1 in 10 children aged 5 to 19 are affected, a trend researchers link to diets dominated by ultra-processed foods. [BBC]
The Global Fund is shifting its resources to the very poorest countries to manage cuts in foreign aid, according to Executive Director Peter Sands. [The Independent]
The Greater Bay Area International Clinical Trial Institute, University of Hong Kong’s medical school, and GlaxoSmithKline will launch a study to examine the potential of the shingles vaccine to prevent cardiovascular diseases and dementia. [South China Morning Post]