The Trump Administration’s Foreign Aid Review: Status of U.S. Support for CEPI

Background on the U.S. and CEPI

• The Coalition for Epidemic Preparedness Innovations (CEPI) aims to accelerate the development of vaccines and other technologies to prepare for and respond to epidemic and pandemic threats. Pooling and leveraging contributions from more than 30 governments, philanthropic foundations, and private sector partners, CEPI invests to drive research and development into vaccine and therapeutic candidates against high-threat pathogens. It also works to strengthen global laboratory and vaccine manufacturer networks and regulatory environments and to research and support vaccine safety. A core focus is its “100 Days Mission”, an effort to reduce the time it takes to develop vaccines and other countermeasures during outbreaks with pandemic potential.
• Since its founding in 2017, CEPI contributed to the first licensed vaccine for Chikungunya; is supporting the development of vaccines for Lassa fever, MERS, Nipah virus and Rift Valley fever, all of them currently in clinical trials; and aided in the development of seven COVID-19 vaccines that were licensed for use.
• The U.S. government made its first financial contribution to CEPI in 2020 and has thus far invested $217 million in the organization. In January of this year, CEPI and the U.S. International Development Finance Corporation (DFC) announced an MOU to collaborate on aligning vaccine investments, among other activities. In May, CEPI and the U.S. Department of Defense signed a new agreement to enable collaboration on projects to expand protection against disease outbreaks, including a project to advance a therapeutic product against Nipah virus that. CEPI has also collaborated with the U.S. Biomedical Advanced Research and Development Agency (BARDA) on emergency response and vaccine development for filoviruses, particularly Ebola Zaire, Ebola Sudan, and Marburg. The FDA is a member of CEPI’s Joint Coordination Group and the overall relationship between CEPI and the U.S. government had been managed by USAID, which has held the U.S. government seat on the CEPI Investors Council.
• CEPI reports that it has contributed significantly to the U.S. economy through its funding of U.S.-based vaccine developers and that this funding far exceeds the amount of funding it has received from the U.S. government.
• CEPI replenishes funding every five years. For the last replenishment round, held in 2022, the U.S. pledged $150 million over five years, which has been exceeded. The U.S. accounts for approximately 6% of total contributions received by CEPI to date.

Current Status of U.S. Support for CEPI

• Funding: In FY 2024, Congress approved up to $100 million in funding to be allocated to CEPI. The FY 2025 Continuing Resolution that passed in March carried forward language from the prior year again stating that up to $100 million could be provided to the organization. CEPI has not yet received its FY24 funds, and it is not yet known if or how much funding will be provided for FY25.
• Foreign aid review/freeze: The foreign aid review’s stop-work order initially froze all U.S. bilateral programming but was not applied to CEPI or other multilateral institutions. The administration subsequently announced that it canceled 86% of all USAID awards. KFF analysis finds that of 770 global health awards identified, 80% are listed as terminated, including the CEPI contract. CEPI reports that it has not received a termination notice.
• International organizations review. A second executive order, calling for a 180-day review of U.S. participation in all international intergovernmental organizations, is currently underway. Per the order, the purpose of the review is to determine which are “contrary to the interests of the United States and whether such organizations, conventions, or treaties can be reformed.”
• Reorganization: The administration notified Congress on March 28, 2025 of its intent to permanently dissolve USAID and that any remaining USAID operations would be absorbed by the State Department, including remaining global health activities which would be integrated into its Bureau of Global Health Security and Diplomacy (GHSD). On May 29, 2025, the State Department further notified Congress of its proposed reorganization plan.

What to Watch

• Results of foreign aid and international organization reviews: The administration could soon release results of its 90-day foreign aid review (which has already been extended by 30 days), and the outcome of the review of international organizations is expected later this year. It is unknown whether there will be any recommendations related to U.S. support for or engagement with CEPI, and how or if Congress will respond to any such recommendations.
• Reorganization. While the administration has notified Congress that it intends to retain and integrate certain USAID activities into the State Department’s GHSD, no additional information is available on what this would mean for the relationship with CEPI.
• Funding/Budget Request: The administration’s FY 2026 budget request includes significant reductions in funding for global health, and does not include funding for CEPI. The administration also submitted its first rescission package to Congress, including proposed rescissions of more than $1 billion in prior year funds for global health (little information on specific funding lines to be eliminated has been provided). Final appropriation amounts and rescission decisions are determined by Congress.