The FY19 Conference Agreement, which includes funding for State & Foreign Operations (SFOPs), was released on February 13, 2019. The SFOPs section of the bill includes funding for U.S. global health programs at the State Department and the U.S. Agency for International Development (USAID).

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

• Funding provided to the State Department and USAID through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totals $8.8 billion in the bill, approximately $150 million above the FY18 enacted level, and more than $2.1 billion above the President’s FY19 request.
• Funding for all global health programs at State and USAID either increased or remained flat compared to the FY18 enacted level (and were well above the President’s budget request). Details are as follows (unless otherwise specified, totals represent funding through the Global Health Programs account):
  • Bilateral HIV funding through the President’s Emergency Plan for AIDS Relief (PEPFAR) is $4,700 million in the Senate FY19 bill, $50 million above the FY18 enacted level, and $850 million above the President’s FY19 request.
  • The bill includes $1,350 million as the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), matching the FY18 enacted level and $425 million above the President’s FY19 request.
  • Funding for tuberculosis (TB) totals $302 million, $41 million above the FY18 enacted level and $124 million above the FY19 Request.
  • Funding for malaria totals $755 million, matching the FY18 enacted level and $81 million above the FY19 Request.
  • The bill provides $140 million in total funding for Global Health Security (GHS), of which $40 million is provided through a transfer of unspent emergency Ebola funding; $2 million of the Ebola transfer is directed to the Emergency Reserve Fund, which Congress established in 2017 with the purpose of enabling the U.S. to respond rapidly to emerging health threats.
  • The bill includes $835 million for maternal and child health (MCH), $5.5 million above the FY18 enacted level and $215 million above the FY19 Request. Component breakdowns are as follows:
    • Gavi, the Vaccine Alliance totals $290 million, matching the FY18 enacted level and $40 million above the FY19 Request.
    • Polio funding totals $59 million ($51.5 million through the GHP account and $7.5 million through the Economic Support Fund account), matching the FY18 enacted level and $34 million above the FY19 Request.
    • UNICEF funding totals $137.5 million, provided through the International Organizations and Programs (IO&P) account, matching the FY18 enacted level. No funding for UNICEF was specified in the FY 19 budget request which proposed to eliminate the IO&P account.
  • Family planning and reproductive health (FP/RH) funding totals $607.5 million in the bill, matching the FY18 enacted level and $277 million above the FY19 Request. Component breakdowns are as follows:
    • Bilateral FP/RH funding totals $575 million, matching the FY18 enacted level and $244.5 million above the FY19 Request.
    • United Nations Population Fund (UNFPA) totals $32.5 million, matching the FY18 enacted level. Funding for UNFPA was eliminated in the FY19 Request. The Administration will likely not provide this funding to UNFPA under the Kemp-Kasten Amendment (See KFF’s Kemp-Kasten Explainer) but the bill states that this funding would be redirected to family planning, reproductive, and maternal health.
  • Funding for nutrition totals $145 million in the bill, $20 million above the FY18 enacted level and $66.5 million above the FY19 Request.
  • Funding for neglected tropical diseases (NTDs) totals $102.5 million in the bill, $2.5 million above the FY18 enacted level and $27.5 million above the FY19 Request.
  • Funding for vulnerable children totals $24 million in the bill, $1 million above the FY18 enacted levels. Funding for vulnerable children was eliminated in the FY19 Request.

Note: Total funding for global health is not currently available as some funding provided through USAID is not yet available.

Resources:

• FY19 State and Foreign Operations Appropriations Bill – Conference Report
• FY19 State and Foreign Operations Appropriations Bill – Joint Explanatory Statement

The table (.xls) below compares the FY19 SFOPs conference report to the FY18 funding amounts as outlined in the “Consolidated Appropriations Act, 2018” (P.L. 115-141; KFF summary here) and the FY19 funding amounts in the President’s FY19 request (KFF summary here).