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White House Releases FY20 Budget Request

The White House released its FY 2020 budget request to Congress on March 11, 2019, which includes significant cuts to global health programs compared to FY 2019 enacted levels (the overall levels in the request are similar to the FY 2019 budget request).

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

  • Funding provided to the State Department and the U.S. Agency for International Development (USAID) (through the Global Health Programs account), which represents the bulk of global health assistance, would decline by $2.5 billion (-28%), from $8,837 million in FY 2019 to $6,344 million, which would be the lowest level of funding since FY 2007. Funding declined for each global health program area as follows:
    • Funding for bilateral HIV programs through the President’s Emergency Plan for AIDS Relief (PEPFAR) would decline overall by $1,350 million (-29%), from $4,700 million in FY19 to $3,350 million in the FY20 Request. This includes a decrease of $1,020 million (-23%) at State and $330 million (-100%) at USAID.
    • The U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) would decline by $392 million (-29%), from $1,350 million in FY19 to $958 million in the FY20 Request. In addition, the administration proposes to make a pledge of up to $3.3 billion over three years for the next Global Fund replenishment period, matching $1 for every $3 contributed by other donors (in the previous replenishment period under the Obama administration, the U.S. pledged up to $4.3 billion, matching $1 for every $2 provided by other donors). For the first year of this pledge, the administration is proposing to provide a total of $1.1 billion to the Global Fund: $958 million from FY20 and $142 million in unmatched carryover funding from the previous pledge.
    • Funding for family planning and reproductive health (FP/RH) would decline by $287 million (-55%), from $524 million in FY19 to $237 million in the FY20 Request.
    • Funding for global health security (GHS) would decline by $48 million (-35%), from $138 million in FY19 (which included a transfer of $38 million from unspent Emergency Ebola funding) to $90 million in the FY20 Request.
    • Funding for tuberculosis would decline by -$41 million (-14%), from $302 million in FY19 to $261 million in the FY20 Request.
    • Funding for malaria would decline by -$81 million (-11%) from $755 million in FY19 to $674 million in the FY20 Request
    • Funding for maternal and child health (MCH) would decline by -$215 million (-26%) from $835 million in FY19 to $620 million in the FY20 Request. Gavi, the Vaccine Alliance, which is included under MCH funding, would decrease by $40 million (-14%).
    • Funding for neglected tropical diseases (NTDs) would decline by -$28 million (-27%) from $103 million in FY19 to $75 million in the FY20 Request
    • Funding for nutrition would decline by -$66.5 million (-46%) from $145 million in FY19 to $79 million in the FY20 Request.
    • Funding for vulnerable children would be eliminated.
  • Funding for global health provided to the Centers for Disease Control and Prevention (CDC) would decline by $32 million (-6%), from $489 million in FY 2019 to $457 million in FY 2020. The FY20 Request includes $100 million for global health security activities at CDC.
  • Funding for the Fogarty International Center (FIC) at the National Institutes of Health (NIH) totaled $67 million, $11 million (-14%) below the FY 2019 enacted levels ($78 million).

Note: This summary will be updated as more information becomes available.

Resources:

The table (.xls) below compares the FY 2020 request to the FY 2019 enacted funding amounts as outlined in the “Consolidated Appropriations Act, 2019” (P.L. 116-6; KFF summary here) and the FY 2019 request (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.