Update: On February 3, 2026, the President signed the “Consolidated Appropriations Act, 2026” which includes funding provided in the FY 2026 National Security, Department of State and Related Programs (NSRP) appropriations bill and accompanying explanatory statement detailed below. This resource was originally published on January 14, 2026.
On January 11, 2026, the Appropriations Committee released the FY 2026 National Security, Department of State and Related Programs (NSRP) (formerly State, Foreign Operations, and Related Programs [SFOPs]) appropriations bill and accompanying explanatory statement. The bill and explanatory statement include funding for U.S. global health programs at the State Department. Funding for global health programs at the State Department through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totals $9.4 billion, which is a decrease of $615 million (-6%) compared to the FY25 level ($10 billion). All program areas either decreased or remained flat as follows:
- Decreased: Funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), bilateral HIV, tuberculosis (TB), global health security, neglected tropical diseases (NTDs), and vulnerable children declined; while the Global Fund accounted for the largest decrease (-$400 million or -24%), this funding supports the administration’s pledge of $4.6 billion for the eighth replenishment and serves as the first installment of that pledge. In addition, the explanatory statement accompanying the bill states that there are also “sufficient unobligated balances” from prior Acts “to fulfill the United States pledge for the seventh replenishment.”
- Remained Flat: Funding for malaria, maternal and child health (MCH), nutrition, and family planning and reproductive health (FP/RH) remained flat.
In addition, the bill included provisions that either impact or provide direction on global health funding including:
- Program Area Amounts: Funding for many of the global health program areas is specified in the explanatory statement (rather than the bill). Unlike prior years, this bill specifically states that funding “shall be made available at not less than the amounts specifically designated in the respective tables included in the explanatory statement” ensuring that the administration is required to provide the amounts for the areas specified. The bill also prohibits the administration from deviating from the global health amounts in the bill and explanatory statement.
- Funding Availability Timeframe: PEPFAR funding (bilateral HIV and the contribution to the Global Fund) is available for five years. Funding for most other program areas is provided for two years, with the exception of funding for Gavi, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations (CEPI), which is provided for one year.
- Reports/Briefings: The bill requires the administration to provide updates (via reports or briefings) on numerous global health areas including (but not limited to) the PEPFAR Transition Strategy, Market Access Strategy, bilateral health agreements, multilateral health engagement, the development of an Innovation Fund, and the status of available funding (i.e. apportionment, allocations, obligations, and disbursements).
- Additional Requirements: The bill requires coordination with the Centers for Disease Control and Prevention (CDC) on global health activities and establishes the Prevention, Treatment, and Response Initiative, which supports “research, development, and delivery of vaccines and other prevention technologies”.
See the table below for additional detail on global health funding. See other budget summaries (including the summary on FY 2026 Labor, Health and Human Services, Education, and Related Agencies (Labor HHS) global health funding) and the KFF budget tracker for details on historical annual appropriations for global health programs.
KFF Analysis of Global Health Funding in the FY 2026 Conference Appropriations Bill & Explanatory Statement
<details><summary>Click to expand table notes</summary>i - Funding for FY25 was provided in a full-year Continuing Resolution (CR), which maintained FY24 levels. All FY25 amounts and associated notes are based on those specified in relevant FY24 appropriations bills.
<br>ii - The FY24 final bill text for "State, Foreign Operations, and Related Programs" (SFOPs) states that up to $200 million of the funds appropriated by this Act through various accounts "may be made available to combat such infectious disease of public health emergency."
<br>iii - These funding amounts do not take into account the $500 million in rescinded funding under the Global Health Programs account in the “Rescissions Act of 2025”’ (P.L. 119-28).
<br>iv - The FY26 House bill states that up to $200 million of the funds appropriated by this Act through various accounts “may be made available to combat such infectious disease of public health emergency.”
<br>v - The FY26 conference bill states that up to $200 million of the funds appropriated by this Act through various accounts may be made available “to respond to a Public Health Emergency of International Concern.”
<br>vi - Unless otherwise specified, funding amounts listed under the "National Security, Department of State and Related Programs - Global Health" heading are provided through the Global Health Programs (GHP) account.
<br>vii - The FY26 explanatory statement accompanying the FY26 conference bill includes $45 million for microbicides and $10 million for the Prevention, Treatment, and Response Initiative (Section 7058(e)).
<br>viii - <u>FY24/25 Final:</u> The explanatory statement accompanying the FY24 final bill states that this funding is “for the second installment of the seventh replenishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which is a reduction compared to the prior fiscal year as a result of other donor contributions.” <u>FY26 Request:</u> The FY26 request does not include a specific funding amount for the Global Fund, but states that funding can be provided through either the GHP account or the newly created “America First Opportunity Fund” (A1OF) and that the amount provided cannot exceed 20% of total contributions during the 8th Replenishment for a total of $2.4 billion over the three year period. <u>FY26 Conference:</u> The explanatory statement accompanying the FY26 conference bill states that the agreement supports the $4.6 billion U.S. pledge to the eighth replenishment and that the $1.25 billion provided in the agreement is for the first installment of the replenishment. The explanatory statement also states that the “funds shall be contributed to the Global Fund on a quarterly basis to the fullest extent practicable” and that “sufficient unobligated balances [that] exist[ed] from prior Acts to fully fund the first installment of the eighth replenishment and to fulfill the United States pledge for the seventh replenishment” are to be provided in a “timely manner.”
<br>ix - The explanatory statement accompanying the FY26 conference bill includes $14.4 million for the Global TB Drug Facility.
<br>x - The explanatory statement accompanying the FY26 conference bill includes $2 million for maternal and neonatal tetanus.
<br>xi - The FY26 conference bill states that funding for Gavi, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) is available for one year, whereas historically these amounts were provided for a two-year period.
<br>xii - <u>FY26 Request:</u> The FY26 request eliminated the International Organizations & Programs (IO&P) account. In prior fiscal years, funding for UNICEF and UNFPA was provided through the IO&P account. <u>FY26 House:</u> The FY26 House explanatory report accompanying the bill states that a contribution to UNICEF may be made using funding provided to the newly established National Security Investment Programs account. <u>FY26 Conference:</u> The explanatory statement accompanying the FY26 conference bill states that “the agreement includes $339,000,000 for International Organizations and Programs. Funds under this heading should be programmed consistent with the practice of prior years.” The agreement includes funds for UNICEF “consistent with prior year levels.”
<br>xiii - The explanatory statement accompanying the FY26 conference bill includes $3 million for iodine deficiency disorder and $33 million for micronutrients (of which $22.5 million is for Vitamin A).
<br>xiv - <u>FY24/25 Final:</u> The FY24 final bill states that "not less than $575,000,000 should be made available for family planning/reproductive health." <u>FY26 House:</u> The FY26 House bill states that “of the funds appropriated by this Act, not more than $461,000,000 may be made available for family planning/reproductive health,” but does not indicate the accounts that may be used for this funding." <u>FY26 Conference:</u> The FY26 conference bill states that “not less than $575,000,000 should be made available for family planning/reproductive health.”
<br>xv - Other funding for bilateral family planning/reproductive health has historically been provided through the Economic Support Fund (ESF), which was eliminated in the FY26 conference bill, and has been incorporated in the National Security Investment Program (NSIP).
<br>xvi - The explanatory statement accompanying the House FY26 NSRP appropriations bill does not provide specific funding amounts for FPRH or GHS under the GHP account. After the funding amounts specified for all other areas (e.g., HIV, TB, MCH, etc.) are removed, $864.71 million remains under the GHP account, which is funding that could be used for FPRH and GHS (or other areas as determined by the Administration).
<br>xvii - The FY24 final and FY26 conference bills state that if this funding is not provided to UNFPA it “shall be transferred to the ‘Global Health Programs’ account and shall be made available for family planning, maternal, and reproductive health activities.”
<br>xviii - The explanatory statement accompanying the FY26 conference bill includes $4.275 million for blind children.
<br>xix - <u>FY24/25 Final:</u> The explanatory statement accompanying the FY24 final appropriations bill states that the agreement includes “up to $100,000,000 for a contribution to the Coalition for Epidemic Preparedness Innovations (CEPI).” <u>FY26 House:</u> The report accompanying the House FY26 bill states that the “Committee supports funding for the Coalition for Epidemic Preparedness Innovations, at levels consistent with prior fiscal years.” <u>FY26 Conference:</u> The explanatory statement accompanying the FY26 conference bill states that the agreement includes funds for a U.S. contribution to the Coalition for Epidemic Preparedness Innovations (CEPI) “consistent with the fiscal year 2024 level.”
<br>xx - <u>FY24/25 Final:</u> The FY24 final bill states that “up to $70,000,000 of the funds made available under the heading ‘Global Health Programs’ may be made available for the Emergency Reserve Fund” without specifying whether this funding would come from GHS amounts or potentially other areas. <u>FY26 Request:</u> The FY26 Request states that funding from the GHP account may be provided to the “Emergency Reserve Fund” without specifying an amount. <u>FY26 House:</u> The FY26 House bill states that “up to $50,000,000 of the funds made available under the heading ‘Global Health Programs’ may be made available for the Emergency Reserve Fund” without specifying whether this funding would come from GHS amounts or potentially other areas. <u>FY26 Conference:</u> The FY26 conference bill states that “up to $20,000,000 of the funds made available under the heading ‘Global Health Programs’ may be made available for the Emergency Reserve Fund.”
<br>xxi - <u>FY24/25 Final:</u> The explanatory statement accompanying the FY24 final bill states that the agreement “includes funding for a contribution to the Pandemic Fund.” <u>FY26 Conference:</u> The explanatory statement accompanying the FY26 conference bill states that the agreement includes funds for a U.S. contribution to the Pandemic Fund “consistent with the fiscal year 2024 level.”
<br>xxii - The explanatory statement accompanying the FY24 final bill states that “of the funds made available for ‘Other Public Health Threats’ … the agreement includes up to $6,000,000 for the Health Reserve Fund.”
<br>xxiii - The explanatory statement accompanying the FY24 final bill states that “of the funds made available for ‘Other Public Health Threats’… the agreement includes not less than $10,000,000 to support the global health workforce.”
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