U.S. Global Health Budget Breakdown: HIV, TB, Malaria, Maternal Health, Nutrition, and More

The U.S. Government remains the largest donor to global health in the world, with funding distributed across key program areas including HIV/PEPFAR, tuberculosis, malaria, maternal and child health, nutrition, family planning and reproductive health, global health security, and neglected tropical diseases, according to a Kaiser Family Foundation (KFF) fact sheet published on April 21, 2026.

The fact sheet provides a historical overview of U.S. Funding for global health over the past decade, based on amounts specified by Congress in annual appropriations bills and agency-level determinations. Since the beginning of the second Trump administration, the U.S. Global health response has undergone significant change, including a restructuring of foreign assistance, the elimination of the U.S. Agency for International Development (USAID) as the main implementing agency, and the cancellation of most awards to organizations implementing programs.

The full impact of these changes, including whether all funding appropriated by Congress for global health will be fully spent by the administration, is not yet clear. KFF notes that further detail on historical funding, ongoing appropriations discussions, and country-specific funding can be found in its Budget Tracker, Budget Summaries, and Country-Level Funding Tracker.

Most U.S. Funding for global health has been provided by Congress for bilateral efforts, accounting for approximately 80% of the total. Of the multilateral share, the majority is directed to The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).

HIV Funding Through PEPFAR Remains Largest Single Disease Investment

The U.S. Government’s investment in global HIV initiatives, primarily through the President’s Emergency Plan for AIDS Relief (PEPFAR), represents the largest investment ever made by any nation in a single disease, exceeding $110 billion cumulatively. PEPFAR was launched in 2003 by President George W. Bush and accounts for 89% of U.S. Global HIV funding, which also includes support for UNAIDS and international HIV research.

Recent Trends in U.S. Global Health Funding

According to data from the Office of Management and Budget cited in Wikipedia, the U.S. Government contributes less than 1% of the federal budget to foreign aid, including global health activities. In 2023, the U.S. Contributed $12.9 billion toward global health activities across HIV, tuberculosis, malaria, and COVID-19. In 2024, total U.S. Global health funding through regular appropriations reached approximately $12.3 billion in fiscal year 2024, up from $5.4 billion in fiscal year 2006.

Policy Shifts Under the Second Trump Administration

In 2025, President Trump’s administration paused U.S. Foreign aid, affecting global health programs such as PEPFAR and leading to legal challenges. The administration also withdrew from the World Health Organization, citing concerns over its effectiveness and political influence. Budget cuts reduced funding for the National Institutes of Health and global health initiatives, raising concerns about research setbacks.

USAID faced restructuring, disrupting climate, health, and education projects, particularly in the Indo-Pacific region. These changes have sparked debate over the future of U.S. Leadership in global health and the potential humanitarian consequences of reduced support.

Congressional Response to Funding Proposals

In response to administration proposals for deeper cuts, U.S. Congressional leaders agreed to $9.4 billion for global health funding, as reported by Health Policy Watch and aggregated in Google News. This figure reflects an effort to counter more severe reductions proposed by the executive branch.

As of April 21, 2026, the trajectory of U.S. Global health funding remains subject to ongoing appropriations debates and administrative decisions, with long-term implications for disease prevention, treatment access, and global health security.