President Biden released the FY 2023 budget request to Congress on March 28, 2022. The request includes discretionary funding for U.S. global health programs at the State Department, the U.S. Agency for International Development (USAID), the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH). In addition, the request includes newly proposed mandatory funding for pandemic preparedness activities. Key highlights for the known amounts are as follows (see tables for additional detail):

State Department & USAID:

Funding for global health programs through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totaled $10.6 billion, an increase of $746 million (8%) above the FY22 enacted level, almost all of which was for the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) and global health security. The FY23 request also included mandatory funding to support pandemic preparedness activities at the State Department and USAID (see below).

• The request includes $2.0 billion for the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), an increase of $440 million (28%) above the FY22 enacted level, and states this funding would be the first contribution towards a $6 billion pledge to the Global Fund’s 7^th Replenishment (2024-2026).
• Funding for global health security totals $995 million, an increase of $295 million (42%) above the FY22 enacted level ($700 million).
• Bilateral HIV funding through the President’s Emergency Plan for AIDS Relief (PEPFAR) is $4.7 billion, a slight decrease of $20 million (-0.4%) compared to the FY22 enacted level ($4.72 billion).
• Funding for tuberculosis (TB) totals $350 million, a decline of $21 million (-6%) compared to the FY22 enacted level ($371 million).
• Funding for malaria totals $780 million, a slight increase of $5 million (0.6%) compared to the FY22 enacted level ($775 million).
• The request includes $880 million for maternal and child health (MCH), a slight decrease of $10.5 million (-1%) below the FY22 enacted level ($890 million). Other specific areas under MCH include multilateral contributions to:
  • Gavi, the Vaccine Alliance which totals $290 million, matching the FY22 enacted.
  • UNICEF which totals $135.5 million, a decline of $3.5 million (-3%) compared to the FY22 enacted level ($139 million).
• Funding for the nutrition program totals $150 million, a decline of $5 million (-3%) compared to the FY22 enacted level ($155 million).
• Bilateral family planning and reproductive health (FP/RH) funding totals $572 million through the GHP account (additional funding that may be provided through the ESF account is not yet known), an increase of $48 million (9%) above the FY22 enacted level ($524 million). Funding for multilateral contributions to the United Nations Population Fund (UNFPA) totals $56 million, $23.5 million (72%) above the FY22 enacted level ($32.5 million)
• Funding for the vulnerable children program totals $25 million, a decline of $2.5 million (-9%) compared to the FY22 enacted level ($27.5 million).
• Funding for neglected tropical diseases (NTDs) totals $114.5 million, an increase of $7 million (7%) compared to the FY22 enacted level ($107.5 million).
• The request also included $10 million for a newly established Health Resilience Fund to “support cross-cutting health systems strengthening in challenging environments or countries emerging from crisis.”

Centers for Disease Control and Prevention (CDC): Funding for global health provided to the CDC totals $748 million, an increase of $101 million (16%) above the FY22 enacted level ($647 million), almost all of which ($100 million) is to support global health security activities; all other areas declined slightly except for parasitic diseases funding. The FY23 request also included mandatory funding to support pandemic preparedness activities at the CDC (see below).

National Institutes of Health (NIH) [i]: Funding for the Fogarty International Center (FIC) at NIH totals $96 million, $9 million (10%) above the FY22 enacted level ($87 million).

Mandatory Funding for Pandemic Preparedness: The FY23 budget request proposes to establish mandatory funding to support both domestic and international pandemic preparedness efforts including $6.5 billion at USAID and the State Department as well as significant additional resources at CDC (it is not possible to determine a specific amount for global activities at the CDC as some funding is designated to support both global and domestic efforts; the table below highlights funding that was designated as either 1) specifically for global efforts, or 2) could potentially be used to support global activities).

Resources:

• White House FY 2023 Budget Resources
• State/USAID FY 2023 Congressional Budget Justification
• CDC FY 2023 Congressional Budget Justification
• NIH FY 2023 Congressional Budget Justification

Table 1 below compares global health funding in the FY 2023 request to the FY 2022 enacted funding amounts as outlined in the  “Consolidated Appropriations Act, 2022” (P.L. 117-103; KFF summary here). Note that total funding for global health is not currently available as some funding amounts provided through USAID, the Department of Health and Human Services (DHHS), and the Department of Defense (DoD) are not yet available. Table 2 below details mandatory funding for pandemic preparedness through the Department of State, USAID, and the Centers for Disease Control and Prevention in the FY 2023 request. The tables can be downloaded here.

See the KFF budget tracker for details on historical annual appropriations, including Senate and House amounts, for global health programs.