The U.S. Global Health Budget: Analysis of the Fiscal Year 2017 Budget Request
The international affairs budget is comprised of base funding, which supports enduring programs, and funding for Overseas Contingency Operations (OCO), which has been defined by the Administration as “extraordinary, but temporary” funding supporting efforts in Iraq, Afghanistan, and Pakistan (see Congressional Research Service, State, Foreign Operations, and Related Programs: FY2015 Budget and Appropriations, December 8, 2014). The global health funding from USAID and the State Department detailed in this analysis is part of base funding in the international affairs budget. In the FY17 request, the total international affairs budget (base and OCO) was $54.1 billion, a decrease of approximately $433.6 million from the FY16 enacted level. Base funding was $39.3 billion in the FY17 request, a decrease of $433.4 million from the FY16 enacted level, while OCO funding totaled $14.9 billion in the FY17 request, a $0.2 million decrease from the FY16 enacted level.
The Assistance for Europe, Eurasia and Central Asia (AEECA) account was eliminated in FY13. Funding provided through this account was incorporated into other accounts (e.g. GHP and ESF). The FY16 Omnibus reconstituted the Assistance for Europe, Eurasia, and Central Asia (AEECA) account, which had historically provided additional funding for TB, however, AEECA funding for TB programs in FY16 is not yet known. The FY17 request eliminates the AEECA account.
The FY17 request included $137.6 million in TB funding provided through bilateral HIV programs (GHP account) at the State Department (see U.S. Department of State, Congressional Budget Justification, Foreign Operations, Appendix 2, February 26, 2016). TB funding provided through bilateral HIV programs (GHP account) at the State Department is not known for prior years.
FY16 Omnibus (P.L. 114-113) bill states that, of the funding appropriated for bilateral assistance, "not less than $575,000,000 should be made available for family planning/reproductive health" ($524 million through the GHP account and $51 million through other accounts such as ESF and/or AEECA).
U.S. funding for UNFPA is provided through the International Organizations and Programs (IO&P) account at the State Department.
U.S. funding for UNICEF is provided through the International Organizations and Programs (IO&P) account at the State Department.
WASH is considered a cross-cutting issue that receives funding from multiple accounts through both direct appropriations and as part of funding provided to other program areas (e.g. HIV and MCH). Since the FY16 Omnibus bill did not specify the accounts and program areas used to reach the $400 million in WASH funding, this amount was not included in overall global health funding totals in order to prevent double-counting of funding.