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The U.S. Global Health Budget: Analysis of Appropriations for Fiscal Year 2016

Table 1: Comparison of Global Health Funding to International Affairs Budget, FY 2012 – FY 2016 (i)
  FY12
(millions)
FY13
(millions)
FY14
(millions)
FY15 Omnibus (millions) FY16 Omnibus (millions)
Global Healthii $9,792 $9,571 $10,150 $10,159 $10,219

of which International Affairs

$8,793 $8,607 $9,019 $9,028 $9,076
International Affairsiii $54,368 $51,906 $50,885 $50,886 $54,560

of which Base (Enduring)

$43,165 $41,084 $44,365 $41,628 $39,665

of which Overseas Contingency Operations (OCO)

$11,203 $10,822 $6,520 $9,258 $14,895
Global Health share of International Affairs Budget (Base Funding) 20% 21% 20% 22% 23%
NOTES:
i – FY12 through FY14 are final funding amounts. FY15 and FY16 are preliminary estimates.
ii – Some global health funding (e.g. NIH funding for international HIV research) that is not earmarked by Congress in the appropriations bills and is determined at the agency level is not yet known for FY15 and FY16; for comparison purposes, any unknown global health funding amount is assumed to remain at the prior year level.
iii – International Affairs is Function 150 Account only and includes both Base (Enduring) and Overseas Contingency Operations (OCO) funding. OCO has historically included some funding for global health programs, but this amount is not yet known for the FY15 or FY16. The majority of U.S. global health funding is provided as part of Base (Enduring) funding.
Table 2: U.S. Funding for Global Health Programs, FY 2015 – FY 2016 (i)
Department / Agency / Area
FY15 Omnibus
(millions)
FY16 Omnibus
(millions)
Difference
(millions, %)
USAID – Global Health Programs (GHP)
HIV/AIDS $330.0 $330.0 $0
(0%)
Tuberculosis $236.0 $236.0 $0
(0%)
Malaria $669.5 $674.0 $4.5
(0.7%)
Neglected Tropical Diseases (NTDS) $100.0 $100.0 $0
(0%)
Global Health Security $72.5 $72.5 $0
(0%)
Maternal & Child Health (MCH) $715.0 $750.0 $35
(4.9%)
of which GAVI $200.0 $235.0 $35
(17.5%)
of which Polio $51.5 $51.5 $0
(0%)
Nutrition $115.0 $125.0 $10
(8.7%)
Vulnerable Children $22.0 $22.0 $0
(0%)
Family Planning & Reproductive Health (FP/RH)ii $524.0 $524.0 $0
(0%)
Total USAID: $2,784.0 $2,833.5 $49.5
(1.8%)
State – Global Health Programs (GHP)
HIV/AIDS Bilateral $4,320.0 $4,320.0 $0
(0%)
of which UNAIDS $45.0 $45.0 $0
(0%)
Global Fund $1,350.0 $1,350.0 $0
(0%)
Total State: $5,670.0 $5,670.0 $0
(0%)
Total GHP – State & USAID
Total USAID & State GHP: $8,454.0 $8,503.5 $49.5
(0.6%)
State & Foreign Operations – Other Accounts
Family Planning & Reproductive Health (FP/RH)ii $51.1 $51.1 $0
(0%)
HIV $0.2 Not Yet Known
Maternal & Child Health (MCH) $117.6 Not Yet Known
Polio $7.5 $7.5 $0
(0%)
Nutrition $21.2 Not Yet Known
Other Public Health Threats $31.6 Not Yet Known
Tuberculosis $6.3 Not Yet Known
State & Foreign Operations – International Organizations & Programs (IO&P)
United Nations Children’s Fund (UNICEF) $132.0 $132.5 $0.5
(0.4%)
United Nations Population Fund (UNFPA) $35.0 $32.5 $-2.5
(-7.1%)
State & Foreign Operations – Contributions to International Organizations (CIO)
World Health Organization (WHO $113.7 Not Yet Known
Pan American Health Organization (PAHO) $65.7 Not Yet Known
National Institutes of Health (NIH)
HIV Research $451.2 Not Yet Known
Malaria Research $169.3 Not Yet Known
Fogarty International Center (FIC) $67.8 $70.4 $2.7
(3.9%)
Centers for Disease Control and Prevention (CDC)
Global HIV/AIDS $128.4 $128.4 $0
(0%)
Global Immunization $208.6 $219.0 $10.4
(5%)
Polio Eradication $158.8 $169.0 $10.2
(6.4%)
Other Global/Measles $49.8 $50.0 $0.2
(0.3%)
Parasitic Disease and Malaria $24.4 $24.5 $0.1
(0.5%)
Global Public Health Protection $55.1 $55.2 $0.1
(0.1%)
Global Disease Detection & Emergency Response $45.4 $45.4 $0
(0.1%)
Global Public Health Capacity Development $9.8 $9.8 $0
(0.4%)
Total CDC: $416.5 $427.1 $10.6
(2.5%)
Department of Defense (DoD)
HIV/AIDS $8.0 $8.0 $0
(0%)
Malaria $17.5 Not Yet Known
Total Global Health Funding
Total Global Health Funding:i $10,158.6 $10,219.4 $60.7
(0.6%)
NOTES:
i – FY15 and FY16 are preliminary estimates. Some global health funding amounts (e.g. NIH funding for international HIV research) are not earmarked by Congress in the Omnibus bill and are determined at the agency level; for comparison purposes, any unknown global health funding amount is assumed to remain at the prior year level.
ii – Both the FY15 Omnibus (P.L. 113-235) and the FY16 Omnibus (P.L. 114-113) state that, of the funding appropriated for bilateral assistance, “not less than $575,000,000 should be made available for family planning/reproductive health.” In recent years, final FP/RH funding amounts have been greater than the amount specified in the annual appropriations bills. For instance, according to data on ForeignAssistance.gov, final FY15 funding for FP/RH totaled $621 million (includes both bilateral funding and the U.S. contribution to UNFPA).
Table 3: Other Related Non-Global Health Funding, FY 2015 – FY 2016
Department / Agency / Area
FY15 Omnibus
(millions)
FY16 Omnibus
(millions)
Difference
(millions, %)
Development Assistance (DA) $2,507.0 $2,781.0 $274
(10.9%)
Economic Support Fund (ESF) $4,746.8 $4,319.0 $-427.8
(-9%)
of which Overseas Contingency Operations (OCO) $2,114.3 $2,422.7 $308.4
(14.6%)
Assistance for Europe, Eurasia and Central Asia (AEECA) $929.7
of which Overseas Contingency Operations (OCO) $438.6
Feed the Future (FtF) Initiativei $1,000.6 $1,000.6 $0
(0%)
Global Agriculture and Food Security Program (GAFSP)ii $43.0
McGovern-Dole International Food for Education and Child Nutrition Program $191.6 $201.6 $10
(5.2%)
Food for Peace (FFP-Title II)iii $1,466.0 $1,716.0 $250
(17.1%)
Millennium Challenge Corporation (MCC) $899.5 $901.0 $1.5
(0.2%)
NOTES:
i – The bill states that, of the funds appropriated for bilateral assistance, “not less than $1,000,600,000 should be made available for food security and agricultural development programs.”
ii – The FY15 Omnibus bill states that, of the funding appropriated for bilateral assistance programs, a portion “may be made available as a contribution to the Global Agriculture and Food Security Program if such contribution will not cause the United States to exceed 33 percent of the total amount of funds contributed to such program.”
iii – According to the Explanatory Statement, the Omnibus bill provides $1,466 million for Food for Peace Title II Grants and “an additional one-time increase of $250,000,000 . . . [for] ongoing food assistance requirements as a result of growing conflicts throughout the world . . . [and] to respond to areas suffering from natural disasters.”
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