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The U.S. Global Health Budget: Analysis of the Fiscal Year 2017 Budget Request

Table 1: Comparison of Global Health Funding to International Affairs Budget, FY 2012 – FY 2017 (i)
  FY12
(millions)
FY13
(millions)
FY14
(millions)
FY15
(millions)
FY16 Omnibus (millions) FY17 Request (millions)
Global Healthii $9,792 $9,571 $10,150 $10,135 $10,173 $10,269
of which International Affairs $8,793 $8,607 $9,019 $9,028 $9,076 $9,137
International Affairsiii $54,368 $51,906 $50,885 $51,865 $54,581 $54,147
of which Base (Enduring) $43,165 $41,084 $44,365 $42,500 $39,685 $39,252
of which Overseas Contingency Operations (OCO) $11,203 $10,822 $6,520 $9,365 $14,895 $14,895
Global Health share of International Affairs Budget (Base Funding) 20% 21% 20% 21% 23% 23%
NOTES:
i – FY12 through FY15 are final funding amounts. FY16 and FY17 are preliminary estimates.
ii – Global health funding provided through the Economic Support Fund (ESF) and Development Assistance (DA) accounts at USAID is not yet known for FY16. For comparison purposes, the FY16 global health total assumes that the ESF and DA accounts are funded at the lowest level between either the FY15 final or FY17 request amounts.
iii – International Affairs is Function 150 Account only and includes both Base (Enduring) and Overseas Contingency Operations (OCO) funding. OCO has historically included some funding for global health programs, but this amount is not yet known for the FY15 or FY16. The majority of U.S. global health funding is provided as part of Base (Enduring) funding.
Table 2: U.S. Funding for Global Health Programs, FY 2016 – FY 2017 (i)
Department / Agency / Area FY16 Omnibus (millions) FY17 Request (millions) Difference (millions, %)
USAID – Global Health Programs (GHP)
HIV/AIDS $330.0 $330.0 $0
(0%)
Tuberculosis $236.0 $191.0 $-45
(-19.1%)
Malariaii $674.0 $745.0 $71
(10.5%)
Neglected Tropical Diseases (NTDS) $100.0 $86.5 $-13.5
(-13.5%)
Global Health Securityiii $72.5 $72.5 $0
(0%)
Maternal & Child Health (MCH) $750.0 $814.5 $64.5
(8.6%)
of which GAVI $235.0 $275.0 $40
(17%)
of which Polio $51.5 $49.7 $-1.8
(-3.6%)
Nutrition $125.0 $108.5 $-16.5
(-13.2%)
Vulnerable Children $22.0 $14.5 $-7.5
(-34.1%)
Family Planning & Reproductive Health (FP/RH)iv $524.0 $544.0 $20.1
(3.8%)
Total USAID: $2,833.5 $2,906.5 $73.1
(2.6%)
State – Global Health Programs (GHP)
HIV/AIDS Bilateral $4,320.0 $4,320.0 $0
(0%)
of which UNAIDS $45.0 $45.0 $0
(0%)
Global Fund $1,350.0 $1,350.0 $0
(0%)
Total State: $5,670.0 $5,670.0 $0
(0%)
Total GHP – State & USAID
Total USAID & State GHP: $8,503.5 $8,576.5 $73
(0.9%)
State & Foreign Operations – Other Accounts
Family Planning & Reproductive Health (FP/RH)iv $51.1 $41.0 $-10.1
(-19.7%)
HIV Not Yet Known $0.2
Maternal & Child Health (MCH) Not Yet Known $105.2
Polio $7.5 $2.0 $-5.5
(-73.3%)
Nutrition Not Yet Known $46.4
Other Public Health Threats Not Yet Known Not Yet Known
Tuberculosis Not Yet Known $4.0
State & Foreign Operations – International Organizations & Programs (IO&P)
United Nations Children’s Fund (UNICEF) $132.5 $132.0 $-0.5
(-0.4%)
United Nations Population Fund (UNFPA) $32.5 $35.0 $2.5
(7.7%)
State & Foreign Operations – Contributions to International Organizations (CIO)
World Health Organization (WHO $112.7 $113.1 $0.4
(0.3%)
Pan American Health Organization (PAHO) $64.5 $63.3 $-1.2
(-1.9%)
National Institutes of Health (NIH)
HIV Research $431.1 $431.9 $0.8
(0.2%)
Malaria Research $171.0 $171.0 $0
(0%)
Fogarty International Center (FIC) $70.4 $69.2 $-1.3
(-1.8%)
Centers for Disease Control and Prevention (CDC)
Global HIV/AIDS $128.4 $128.4 $0
(0%)
Global Immunization $219.0 $224.0 $5
(2.3%)
Polio Eradication $169.0 $174.0 $5
(3%)
Other Global/Measles $50.0 $50.0 $0
(0%)
Parasitic Disease and Malaria $24.5 $24.5 $0
(0%)
Global Public Health Protection $55.2 $65.2 $10
(18.1%)
Global Disease Detection & Emergency Response $45.4 Not Yet Known
Global Public Health Capacity Development $9.8 Not Yet Known
Total CDC: $427.1 $442.1 $15
(3.5%)
Department of Defense (DoD)
HIV/AIDS $8.0 $0.0 $-8
(-100%)
Malaria $5.3 $7.0 $1.6
(30.9%)
Total Global Health Funding
Total Global Health Funding:i $10,172.9 $10,269.4 $96.6
(0.9%)
NOTES:
i – FY15 and FY16 are preliminary estimates. Global health funding provided through the Economic Support Fund (ESF) and Development Assistance (DA) accounts at USAID is not yet known for FY16. For comparison purposes, the FY16 global health total assumes that the ESF and DA accounts are funded at the lowest level between either the FY15 final or FY17 request amounts.
ii – In addition, the FY17 request proposes a transfer of $129.0 million in emergency Ebola funding, which was provided in the FY15 Omnibus bill (P.L. 113-235), to malaria programs.
iii – Formerly Pandemic Influenza and Other Emerging Threats.
iv – The FY16 Omnibus (P.L. 114-113) states that, of the funding appropriated for bilateral assistance, “not less than $575,000,000 should be made available for family planning/reproductive health,” and provides an additional $32.5 million as the U.S. contribution to UNFPA. In recent years, final FP/RH funding amounts have been greater than the amount specified in the annual appropriations bills. For instance, according to data on ForeignAssistance.gov, final FY15 funding for FP/RH totaled $621 million (includes both bilateral funding and the U.S. contribution to UNFPA).
Table 3: Other Related Non-Global Health Funding, FY 2016 – FY 2017
Department / Agency / Area FY16 Omnibus (millions) FY17 Request (millions) Difference (millions, %)
Development Assistance (DA) $2,781.0 $2,959.6 $178.6
(6.4%)
Economic Support Fund (ESF) $4,319.0 $6,080.6 $1761.6
(40.8%)
of which Overseas Contingency Operations (OCO) $2,422.7 $3,672.2 $1249.5
(51.6%)
Assistance for Europe, Eurasia and Central Asia (AEECA) $929.7
of which Overseas Contingency Operations (OCO) $438.6
Feed the Future (FtF) Initiativei $1,000.6 $978.0 $-22.6
(-2.3%)
Global Agriculture and Food Security Program (GAFSP)ii $43.0 $23.0 $-20
(-46.5%)
McGovern-Dole International Food for Education and Child Nutrition Program $201.6 $182.0 $-19.6
(-9.7%)
Food for Peace (FFP-Title II)ii $1,716.0 $1,350.0 $-366
(-21.3%)
Millennium Challenge Corporation (MCC) $901.0 $1,000.0 $99
(11%)
NOTES:
i – The FY16 Omnibus bill states that, of the funds appropriated for bilateral assistance, “not less than $1,000,600,000 should be made available for food security and agricultural development programs.”
ii – According to the Explanatory Statement, the Omnibus bill provides $1,466 million for Food for Peace Title II Grants and “an additional one-time increase of $250,000,000 . . . [for] ongoing food assistance requirements as a result of growing conflicts throughout the world . . . [and] to respond to areas suffering from natural disasters.”
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