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The U.S. Government Engagement in Global Health: A Primer

Attention to global health by governments, policymakers, media, business leaders, and other institutions has increased markedly in recent decades. Over the past two decades, donor funding to address health challenges in low- and middle-income countries has grown substantially, new institutions and global goals have been established, and a burgeoning community of stakeholders has emerged around global health.

The U.S. government has long supported overseas health programs as an element of foreign aid and development assistance. In recent years, these programs have grown in size and prominence. In particular, under President George W. Bush, the U.S. government launched several large global health foreign assistance programs, most notably, the President’s Emergency Plan for AIDS Relief (PEPFAR), as well as the President’s Malaria Initiative (PMI), and was an initial supporter and funder of the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund). During the Obama Administration, support for these main pillars of the U.S. global health effort continued, and there was increased focus on other areas of global health, including maternal and child health and family planning and reproductive health. Most recently, the Administration and Congress have enhanced the U.S. response to emerging infectious diseases following the 2014 Ebola and 2015 Zika outbreaks.

The U.S. government is the largest funder and implementer of global health programs worldwide, although U.S. funding for global health has plateaued in recent years in the wake of the financial crisis and continuing fiscal constraint.

Presently, U.S. support for global health involves many different U.S. government departments and agencies, congressional committees, initiatives, and funding streams.1

As a multi-pronged, multi-billion dollar investment that targets a myriad of global health challenges, countries, and stakeholders, the U.S. global health response is complex. This primer provides basic information about global health and U.S. government’s response thus far. Although this document focuses primarily on the U.S. government, it is important to acknowledge the role played by other countries, multilateral organizations, and private sector actors such as non-governmental organizations (NGOs), foundations, corporations, and others, in the global health response.

The first several sections provide an overview of the field of global health and describe current global health issues. Subsequent sections describe U.S. government support for global health, including the programs addressing global health challenges, the organization of the U.S. response, the budgets and financing of U.S. global health programs, and the U.S. government’s relationship with multilateral institutions and international partners. Additional resources, information, and analysis are available at the Kaiser Family Foundation’s U.S. Global Health Policy Program’s website:


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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.