As year two of President Trump’s second term begins, the administration’s domestic policies are beginning to creep into the global health landscape in unprecedented ways as the U.S. moves further from multilateralism and foreign aid.

This week, the U.S. Government asked Gavi, the Vaccine Alliance, to phase out vaccines containing the preservative thimerosal as a condition of any future funding, including $300 million that has already been appropriated by Congress. The request promotes unfounded claims connecting thimerosal to autism and other neurodevelopmental disorders by HHS Secretary Robert F. Kennedy, Jr. and other anti-vaccine groups.

On Jan. 27, the Trump administration announced the most significant expansion of the Mexico City Policy (MCP) to date. MCP has historically required, as a condition of U.S. government funding, that foreign organizations certify that they would not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S. funds).” In this revision, MCP will now apply to most recipients of foreign aid (not just foreign NGOs), encompassing significantly more funding – nearly $40 billion – and including a longer list of prohibited services and activities, including DEI and promoting or providing gender-affirming care.

The strongest sign of the Trump administration’s “America First” approach to global health came as the United States’ formally withdrew from the World Health Organization last week. However, states including California are stepping in to fill the void, mirroring the domestic response to fractured federal public health guidance.

– Rachel Bridges, Senior Director

On Tuesday evening, Medicare administrators ‌published a list of 16⁠ branded ‌drugs ‌for the third cycle of the Medicare Drug Price ⁠Negotiation Program, including products reimbursed under ‍Medicare ⁠Part B for the first time. Drugmakers have until the end of February to confirm participation in the program, which would determine maximum fair prices effective in early 2028.

While the previous round of negotiated drugs heavily favored diabetes medicines, treatments for inflammatory conditions and cancer dominate this year’s list. Two drugs that did not make the list – Merck’s Keytruda and Bristol Myers Squibb’s Opdivo – were notably exempt from selection in this cycle due to the expanded orphan drug exemption enacted as part of the One Big Beautiful Bill Act.

In addition to 15 medicines selected for the first time, CMS announced that one previously negotiated drug – Boehringer Ingelheim’s Tradjenta – will be renegotiated.

In a statement, PhRMA highlighted how “seniors have faced higher costs, fewer choices and more barriers to care” since the passage of Medicare negotiation through the Inflation Reduction Act. Analysts have also weighed in, saying that industry impacts should be “manageable” given upcoming losses of exclusivity and the results of past cycles.

– Andrew Wishon, Senior Manager

A deal between Trump and Senate Democrats on Thursday put HHS funding back on track to passage and reduced the risk of a prolonged government shutdown.

The agreement allows the Senate to move forward with funding HHS through the end of September – legislation that was previously stalled due to immigration enforcement issues, not health care-related factors. The close call raised concerns about a potential continuing resolution for HHS that would not include key policies tied to the original bill, such as telehealth extensions.

Under this bill, HHS would receive funding for the remainder of FY26, while DHS operates on a two-week stopgap as Congress hashes out immigration details. There is still a chance of a technical shutdown early Saturday because the U.S. House is currently in recess, but this would most likely last only through the weekend.

Even in that scenario, the impact on health and pharma operations would be minimal. Medicare and Medicaid payments would continue while essential FDA, CDC, NIH and CMS functions would remain operational. Once passed, the HHS funding package will enact key telehealth extensions and other provisions that preserve stability for providers, patients and the industry at large.

– Stephen Tellone and Emily Cohen, CPPA

• No events of note next week

• “My employer quietly changed nearly all of our hospital’s insurance offerings to high-deductible health plans, and I found myself asking my own physician to switch my medication to a drug that is less effective and less safe – but cheaper. I now feared the same bills that kept my patients away.” – Dr. Amy Caggiula, STAT
• “Patient self-pay is no longer a workaround for coverage gaps…It is a core access channel shaped by consumer behavior and structural constraints in the health care system.”  – Laura Jensen, Drug Channels
• “Republican margins in Congress are extremely slim and getting members to coalesce behind one blueprint will be like herding cats. But there is hope given conservatives were able to eke out a tax cut win last summer under similar conditions. To borrow a line from ‘Dumb and Dumber,’ ‘so you’re telling me there’s a chance.’ – Dr. Tom Price, The Hill

• The White House postponed the launch of its direct-to-consumer website, TrumpRx, but did not disclose the reasons behind doing so or when the launch will take place. Endpoints: White House postpones planned TrumpRx launch event.
• The EU and India announced a free trade deal that will eliminate an 11% Indian tariff on EU pharmaceuticals and remove trade duties on machinery and chemicals. Fierce Pharma: EU looks to knock out pharmaceutical export tariffs in sweeping free trade pact with India.
• CMS Administrator Mehmet Oz and other Trump administration officials met with Republicans on the Senate Finance Committee to explore ways to codify most-favored nation drug pricing through legislation. STAT: Oz, other officials meet with key senators to push Trump’s ideas for lower drug prices.
• Twenty brand name drugs saw list price cuts ranging from 9.8% to 91.7% in January, which analysts attribute to pricing pressures from Medicare drug price negotiation. The Wall Street Journal: This Year Drugmakers Cut Prices for Several Widely Used Drugs.
• Novo Nordisk’s chairman warned that falling prices in the obesity market could erode its business if the company does not make moves to protect it. Bloomberg: Novo Must Guard Against Obesity Drug Price War, Chairman Says.
• A law taking effect this May will grant orphan drugs in China seven years of market exclusivity and two years for pediatric indications, making China a more attractive market for global biopharmaceutical companies. BioCentury: China’s orphan drug exclusivity could bolster market, incentivize development.
• Payers have begun to cover Yeztugo, a twice-yearly injectable medicine to prevent HIV, after months of initial reluctance due to pricing. The Hill: ‘Transformative’ HIV PrEP shot slowly overcomes cost hurdles.
• Worries over health care costs superseded those regarding groceries and housing and may impact voters’ choices in the November midterm U.S. elections, according to a KFF poll. The Washington Post: The cost of health care, not food or rent, is now Americans’ top worry.
• Tenpoint Therapeutics received FDA approval for its presbyopia eye drop, Yuvezzi, which the company says will be “priced to parity” with competitor products. Endpoints: Tenpoint wins FDA nod for presbyopia eye drop, secures $235M to bankroll launch.