The Senate Committee on Appropriations approved the FY 2025 State, Foreign Operations, and Related Programs (SFOPs) appropriations bill, accompanying report, and amendments on July 25, 2024. The SFOPs bill includes funding for U.S. global health programs at the State Department and the U.S. Agency for International Development (USAID). The SFOPs bill includes funding for U.S. global health programs at the State Department and the U.S. Agency for International Development (USAID). Funding for these programs, through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totaled $9.7 billion, a decrease of $886 million (-8%) below the FY 2024 enacted level. All of the decrease is due to reduced funding in the bill for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), though the accompanying report notes that the decline is “a result of the statutory cap on U.S. contributions related to other donor funds.” Funding for maternal and child health, UNICEF, nutrition, family planning and reproductive health (FP/RH), global health security, the Health Reserve Fund, and Global Health Worker Initiative increased compared to FY 2024 enacted levels; all other global health areas remained flat. The bill also included an extension of PEPFAR from March 25, 2025 to September 30, 2026. See the table below for additional detail on FY 2025 Senate levels compared to the FY 2024 Omnibus as well as the FY 2025 President’s Request and FY 2025 House levels. See other budget summaries and the KFF budget tracker for details on historical annual appropriations for global health programs.
KFF Analysis of Global Health Funding in the FY25 Senate State, Foreign Operations, and Related Programs (SFOPs) Appropriations Bill
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i - Unless otherwise specified, funding amounts listed under the "State, Foreign Operations, and Related Programs (SFOPs) - Global Health" heading are provided through the Global Health Programs (GHP) account.<br>
ii - Some HIV, tuberculosis, MCH, nutrition, and global health security funding is provided under the ESF or AEECA accounts, which is not earmarked by Congress in the annual appropriations bills and is determined at the agency level.<br>
iii - The FY25 International Affairs Budget CBJ states that the Global Fund request is “expected to support a third tranche towards the Seventh Replenishment, with the three-year U.S. contribution totaling $4.8 billion to match $1 for every $2 contributed by other donors.” The FY25 House report states that this funding is “for the third installment of the seventh replenishment of the Global Fund.” The explanatory statement accompanying the FY25 Senate bill states that this funding is “for the third 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 level as a result of the statutory cap on U.S. contributions related to other donor funds.”<br>
iv - The FY25 International Affairs Budget CBJ states that the Gavi request “will be included as the first year of a four-year pledge towards Gavi’s next strategic cycle.” The explanatory statement accompanying the FY25 Senate bill states that this amount is for a contribution to Gavi “as a first installment of a five-year U.S. pledge of not less than $1,580,000,000 to support Gavi’s sixth strategy period.”<br>
v - The FY25 House bill eliminates funding for the International Organizations and Programs (IO&P) account, which has historically been the source of contributions to United Nations entities such as UNICEF. It is possible that funding for UNICEF may be provided through another account.<br>
vi - The FY24 final bill states that "not less than $575,000,000 should be made available for family planning/reproductive health." The explanatory statement accompanying the House FY25 SFOPs 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 at USAID, which is funding that could be used for FPRH and GHS (or other areas as determined by the Administration). Since the House FY25 bill text states that “of the funds appropriated by this Act, not more than $461,000,000 may be made available for family planning/reproductive health” without specifying an account, it is possible the Administration could fund all or a portion of this amount through the GHP account with the remainder directed to GHS (or other areas as determined by the Administration). The FY25 Senate bill states that “not less than $600,000,000 should be made available for family planning/reproductive health.”<br>
vii - The FY24 final and FY25 Senate 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>
viii - The explanatory statement accompanying the FY24 final bill states that the agreement "includes funding for a contribution to the Pandemic Fund."<br>
ix - The explanatory statement accompanying the FY24 final bill states that the agreement includes “up to $100,000,000 for a contribution to the Coalition for Epidemic Preparedness Innovations (CEPI).” The FY25 request specified that $100 million was for multilateral initiatives “such as” CEPI. The explanatory statement accompanying the FY25 House states that the Committee supports CEPI funding “at not less than the fiscal year 2024 enacted level,” which is $100 million. The explanatory statement accompanying the FY25 Senate bill states that the Committee “recommends funding for a U.S. contribution to the Coalition for Epidemic Preparedness Innovations” but does not specify an amount.<br>
x - 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. The FY25 Request includes funding for the Emergency Reserve Fund under Global Health Security. The FY25 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. The FY25 Senate 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.<br>
xi - 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.” The explanatory statement accompanying the FY25 Senate bill states that “up to $10,000,000 of the funds made available for ‘Other Public Health Threats’ … be made available for the Health Reserve Fund.”<br>
xii - 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.” The explanatory statement accompanying the FY25 Senate bill states that “not less than $20,000,000 of the funds made available for ‘Other Public Health Threats’ … be made available to support the global health workforce, which are in addition to funds made available from other program lines in the table for such purpose.”<br>
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