U.S. State Department and Health Agency Commit to Overhaul Vaccine Safety, Accountability, and Global Health Leadership

The United States aims to advance global health while reflecting American interests, scientific integrity, and accountability to its citizens. Under President Trump’s administration, the U.S. has emphasized that taxpayer funds must support transparent, evidence‑based programs that produce measurable health outcomes.

In the previous year, President Trump instructed Secretary of Health and Human Services Robert F. Kennedy, Jr. and Secretary of State Marco Rubio to meet directly with Gavi, the Vaccine Alliance, to secure concrete reforms before any further U.S. support was considered. The resulting commitments enhance vaccine safety, bolster public health, and align Gavi’s activities with Gold Standard Science and transparency. Accordingly, the United States will promptly release the full $600 million in congressionally appropriated funding for fiscal years 2025 and 2026 to Gavi.

Gavi pledges to transition mercury‑containing vaccines to mercury‑free alternatives and broaden access to newer formulations. In collaboration with its Board and national partners, Gavi will prioritize:

• Transition mercury‑containing meningococcal A vaccines to mercury‑free formulations that protect against additional meningococcal strains;
• Transition mercury‑containing pentavalent DTP‑Hib‑HepB vaccines to mercury‑free hexavalent vaccines that also protect against polio;
• Transition mercury‑containing pneumococcal vaccines to mercury‑free vaccines that protect against additional pneumococcal strains; and
• Transition mercury‑containing hepatitis B vaccines to mercury‑free alternatives.

The Administration considers shifting away from mercury‑containing vaccines—when safer alternatives exist—a pro‑vaccine, pro‑innovation stance. The United States and the European Union eliminated mercury from most childhood vaccines 25 years ago. As of June 2025, the CDC’s Advisory Committee on Immunization Practices no longer recommends any mercury‑containing vaccines. Children in Africa, Asia, and Latin America deserve the same high‑quality, mercury‑free vaccines, and these updates will also broaden protection against additional disease strains.

Implementing these transitions will require manufacturers to increase production capacity, countries to adopt newer formulations, and Gavi’s Board to approve the necessary changes. The United States acknowledges these challenges but welcomes Gavi’s commitment to pursue them through transparent governance and responsible stewardship.

Gavi has already implemented the following reforms requested by the United States:

• Discontinue the promotion and procurement of COVID‑19 vaccines for routine immunization programs.
• Complete extensive operational reforms, including reorganizing and reducing staff in Geneva and establishing a partnership accountability framework that reduces funding for and revises Gavi’s collaboration with other partners, including the World Health Organization.

Gavi has committed to creating an integrated Secretariat to monitor and review advances in vaccine science, including safety. Recognizing the United States’s significant contribution to vaccine access, the United States will resume its seat on the Gavi Board. In this capacity, the United States will hold Gavi accountable for measurable progress and will assess any future U.S. support based on performance, accountability, and implementation of the agreed reforms.

The United States reaffirms that it will not provide federal funding to the World Health Organization via Gavi.

President Trump has stated that U.S. leadership in global health must be grounded in accountability, scientific excellence, and measurable results. The Department of Health and Human Services and the Department of State will continue to ensure that U.S. global health programs and partnerships uphold Gold Standard Science, rigorous independent review, transparency, responsible stewardship of taxpayer resources, and improved health outcomes worldwide.

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