White House Releases FY18 Budget Request

The White House released its FY 2018 budget request to Congress on May 23, 2017, which includes significant cuts to global health funding. It seeks to shift the U.S. approach to development, stating that, the request “prioritizes and focuses foreign assistance in regions and on programs that advance U.S. national security by helping countries of strategic importance meet near- and long-term political, economic, development, and security needs.”  It further states that “While the United States will continue significant funding for global health programs, even while refocusing foreign assistance, other stakeholders must do more to contribute their fair share to global health initiatives.”

Key highlights are as follows (see table for additional detail):

  • Funding provided to the State Department and USAID (through the Global Health Programs account), which represents the bulk of global health assistance, would decline by more than $2.2 billion (-26%), from $8,725 million in FY 2017 to $6,481 million, which would be the lowest level of funding since FY 2008.
  • Funding for global health provided to CDC would decline by $85 million (-20%), from $435 million in FY 2017 to $350 million in FY 2018.
  • Funding for almost all global health programs is reduced or eliminated in the budget request:
    • PEPFAR funding for bilateral programs would decline overall by $860 million (-18%) including a decrease of $470 million (-11%) at State, $330 million (-100%) at USAID, and $59 million (-46%) at CDC.
    • The U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria would decline by $225 million (-17%).
    • Funding for the Family Planning and Reproductive Health (FP/RH) and Vulnerable Children (VC) programs under the Global Health Programs account, respectively, would be eliminated.
    • Funding would decrease for TB (-$63 million or -26%), Neglected Tropical Diseases (-$25 million or -25%), and nutrition (-$47 million or -37%).
    • Funding for malaria would also decrease (-$331 million or -44%) although a one-time transfer of $250 million in unspent emergency Ebola funding would be used for malaria efforts.
    • Gavi, the Vaccine Alliance, which is included under maternal and child health (MCH) funding, is the only area to increase – from $275 million in FY 2017 to $290 million in FY 2018.
    • Aside from Gavi, other MCH funding decreased by $80 million (-15%).
    • Funding for Global Health Security would be eliminated, although a one-time transfer of $72.5 million would be provided in unspent emergency Ebola funding.
    • Several international organizations (including UNICEF, UNAIDS, microbicides research, IAVI, and others) that have historically received specified funding amounts in the budget are not allocated any funding in the FY 2018 request. While it is possible that the Administration could provide funding to these organizations, such funding would have to be taken from either bilateral programs or other accounts.


The table (.xls) below compares the FY 2018 request to the FY 2017 enacted funding amounts as outlined in the “Consolidated Appropriations Act, 2017” (P.L. 115-31; KFF summary here). Note that total funding for global health is not currently available as some funding provided through USAID, Health and Human Services (HHS), and the Department of Defense (DoD) is not yet available.

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