Global Health Funding in the FY 2025 President’s Budget Request

President Biden released his FY 2025 Budget Request on March 11, 2024. Since FY 2024 appropriations have not been finalized yet, comparisons here are made to the FY 2023 enacted level. The budget request includes discretionary funding for U.S. global health programs at the State Department, the U.S. Agency for International Development (USAID), the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH).[i] Highlights include:

  • Total funding would decline: Funding provided to the State Department and USAID through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totals $9.8 billion in FY 2025, a decrease of $733 million below the FY 2023 enacted level.
  • The entire decline is due to a decreased contribution to the Global Fund (but, there are specific technical reasons for the decrease): Funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) totals $1.2 billion, a decrease of more than $800 million compared to FY 2023 ($2 billion). This decrease is due to a funding match requirement that limits the amount the U.S. can contribute, which is a cap of 33% of total contributions from other donors; the FY 2025 Global Fund amount is expected to support the third tranche of U.S. funding as part of its three-year pledge of $4.8 billion toward the Global Fund’s seventh replenishment.
  • Two areas would increase slightly:
    • Maternal and child health (MCH) programs would receive a slight increase, partly due to an increased contribution to Gavi, the Vaccine Alliance, as part of the first year of a four-year pledge towards Gavi’s next replenishment cycle.
    • Family planning and reproductive health (FP/RH)[ii], is the only other area that would receive a slight increase – for both bilateral funding and the U.S. contribution to the United Nations Population Fund (UNFPA).
  • All other areas would remain flat: Funding for bilateral HIV, TB, malaria, nutrition, vulnerable children, neglected tropical diseases, global health security, and the Health Reserve Fund are the same as the FY 2023 amount.
  • Also of note:
    • The FY 2025 request also includes funding for the Global Financing Facility (GFF), provided under MCH funding; the Pandemic Fund, provided under global health security funding; and the Global Health Worker Initiative, provided as its own separate line item.
    • Global health funding at CDC remains flat.

See the table below for additional detail. See other budget summaries and the KFF budget tracker for details on historical annual appropriations for global health programs.

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[i] Total funding for global health is not currently available as some funding provided through USAID, NIH, and DoD is not yet available.

[ii] Funding through the Economic Support Fund (ESF) account for FP/RH was specified by the White House Office of Management and Budget (OMB) during a conference call on the international affairs budget, per PAI.

 

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