Matthew Kavanagh

No One Is Defying Trump Like Brazil’s President

When Brazilian's kicked out Bolsinaro they got Lula.
Jealous.
www.nytimes.com/2025/07/30/w...

Important implications for @who.int and others. Under the new pandemic agreement there are opportunities to do so. Time for action and planning is now, not when the next pandemic hits and the power dynamics play out in exactly this way again /fin

... and secrecy was among the most powerful tools that concentrated power. Again, cooperation between states can address this.

Why? Because the international system gave power in negotiations to the major pharmaceutical companies who held monopolies over the production of these medicines. They had the leverage they needed to extract these concessions in the middle of a crisis.
There are alternatives...

...we also show that significant new policy shifts were made via these contracts on indemnification, intellectual property, and more. All without consultation or transparency.

... South African negotiators objected, labeled these unacceptable, but they ultimately remained in the contracts.

Among the most striking provisions in the vaccine contracts were those that required South Africa to make large, non-refundable, and up-font payments without committing the companies to delivery dates or volumes. These are *not* standard or good procurement practice...

...to explain why South Africa's access to vaccines was so much poorer than other countries. Look👇 it's only when vaccination in US and EU started dropping that enough doses were finally available for South Africa to scale up. Why?

We analyzed the unredacted contracts and negotiation drafts secured by @hji-sa.bsky.social via litigation and looked at provisions in COVID-19 vax contracts agreed by South Africa as an example of the kinds of policy made via contract around the world...

Law and power in pandemic negotiations: Policymaking via contract in South Africa’s dealings with COVID-19 vaccine companies COVID-19 vaccine distribution was marked by deeply unequal access for Africa, Asia, and Latin America. This article analyzes negotiations between government and pharmaceutical companies, through th...

Can voluntary deals ensure equitable vaccine access in a pandemic? Our new research w @hji-sa.bsky.social
on South Africa’s COVID-19 negotiations shows no. Major policy made via private contract. Implications for global governance... 🧵
doi.org/10.1080/1744...
@abinader.bsky.social

The lessons New York still has not learned from the Covid vaccine rollout With Covid vaccines, New York state chose a “let 'er rip” public health policy rather than more stringent enforcement of guidelines on distribution criteria.

powerful new piece from @nschwalbe.bsky.social @statnews.com
"Given the oversized role that Cuomo played in New York during the Covid-19 response, this election presents a long-overdue opportunity to acknowledge failures & get to much-needed work to address them
www.statnews.com/2025/07/28/n...

Daring to dream of long-acting HIV prevention A piece of ancient wisdom states that a healthy person has a thousand dreams, a sick person only one. Thanks to advances in HIV care, many people living with HIV can live healthy lives and no longer s...

...these are just some of our findings. Check out the full article and the accompanying excellent editorial.
www.thelancet.com/journals/lan...

7. change policy to reach all: A reason for low uptake of PrEP is policy. eligibility historically used to restrict access, not because it was good public health but b/c supplies were limited/expensive. We analyzed 112 countries over 8 years and showed policy remains a problem, that can change

3. overcome patent barriers: 5 major patent applications are pending in India. Argentina already rejected at least 1 finding lack of inventive step. Applying a high-quality patent standard is appropriate given the implications of monopoly control over global generic supply.

2. break the cycle of mediocrity low uptake for prevention technologies create self-fulfilling prophecies: low programmatic ambition and low demand projections maintain high prices, restricting availability and restricting access. We could instead set ambition high to create positive cycle...

1. bring the future price forward: negotiated agreement securing lenacapavir at approximately $25 per person per year, near price parity with oral PrEP, for a 2-year period across all LMICs is possible!...

Lessons for long-acting lenacapavir: catalysing equitable PrEP access in low-income and middle-income countries Despite substantial advances in biomedical HIV prevention, including long-acting injectable pre-exposure prophylaxis (PrEP) options such as cabotegravir, barriers to widespread adoption and scale-up p...

Our piece in @thelancet.com sets out a 10-point framework for catalysing equitable access to lenacapavir, built on difficult lessons of HIV treatment and PrEP scale-up and the realities of reduced global funding. Led by @sharonannlynch.bsky.social they include.. 🧵
www.thelancet.com/journals/lan...

Trump’s tariff hike against Brazil boosts Lula and isolates Bolsonaro The Brazilian president prioritizes negotiations in the trade dispute, but announces that if the White House carries out the threat, he will respond with reciprocal levies

Making my day
english.elpais.com/economy-and-...

Authored by @sharonannlynch.bsky.social, @matthewkavanagh.bsky.social, ‪‪@linda-gailb.bsky.social‬, ‪@rmcohen72.bsky.social‬, Yogan Pillay, Yvette Raphael, & Agrata Sharma the 10-point framework to accelerate access, even at a time of drastic funding cuts & threats to the gains of the past 25 years.

Lessons for long-acting lenacapavir: catalysing equitable PrEP access in low-income and middle-income countries Despite substantial advances in biomedical HIV prevention, including long-acting injectable pre-exposure prophylaxis (PrEP) options such as cabotegravir, barriers to widespread adoption and scale-up p...

Newly approved long-acting lenacapavir has the potential to transform the HIV epidemic, but only if barriers to access are addressed. A new piece in The Lancet HIV explores this.
www.thelancet.com/journals/lan...

Measles cases surge to record high since disease was declared eliminated in the US | CNN There have been more measles cases in the US this year than any other since the disease was declared eliminated a quarter-century ago.

Measles is just a leading indicator. We’re going to find far wider damage to our health over time from this current political moment
www.cnn.com/2025/07/05/h...

O'Neill's Jeff Crowley, @matthewkavanagh.bsky.social , and Dr. Charles Holmes respond to the recent FDA approval of lenacapavir and what it means for the fight to end the HIV epidemic.
oneill.law.georgetown.edu/press/oneill...

Brilliant

WHO says mpox is still an int’l public health emergency.

Africa has roughly 400x fewer MVA-BN doses per case than the U.S.

Meanwhile, Bavarian Nordic is keeping the vaccine price sky high.

This isn't a scarcity crisis - it's a Big Pharma greed-inspired affordability crisis.

Can Mamdani Persuade New York to Elect Its Youngest Mayor in a Century? Zohran Mamdani has won over young, left-leaning New Yorkers with his energy and progressive ideas. But is he capable of running the largest city in the country?

Still kinda blown away to see Mamdani’s son as a front runner for mayor of NYC. Gives me hope that federalism can save US democracy

www.nytimes.com/2025/06/10/n...

Global Council on Inequality, AIDS and Pandemics Creating a policy environment where inequalities can be addressed so that the world can end AIDS and better prepare for and respond to pandemics.

"… inequality creates the conditions through which outbreaks turn into pandemics, and pandemics last for years.”
Last month, O'Neill's @matthewkavanagh.bsky.social moderated a session on Ending Inequalities in Pandemic Responses at #WHA78.
www.inequalitycouncil.org/leveraging-t...

In a world of rising nationalism, outside the US & European bubble remember this remains contested. South Africa is working hard to advance a vision of internationalism based, not in holding on to some past neoliberal order, but on building a different south-inclusive order.
👋from G20 health mtgs

Low blow Carlson

The Global Health Politics Podcast Hosted by Joseph Harris, the Global Health Politics podcast features intimate, one-of-a-kind conversations with leading scholars, practitioners, policymakers, and activists working on critical issues ...

Great new conversation with @jlynch13.bsky.social out now! Come listen to her talk about her new books & the #politicaleconomy of #health! @profbambra.bsky.social @cambridgeup.bsky.social @policypress.bsky.social @matthewkavanagh.bsky.social #globalhealth globalhealthpoliticspodcast.buzzsprout.com