The FY 2020 appropriations conference agreement, released by Congress on December 16, 2019 and passed by both the House (12/17) and the Senate (12/19), includes 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). The agreement still needs to be signed by the President. Key highlights are as follows (see table 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 $9.1 billion, an increase of $255 million above the FY 2019 enacted level, and $2.7 billion above the President’s FY 2020 request.
• Bilateral HIV funding through the President’s Emergency Plan for AIDS Relief (PEPFAR) is $4,700 million, flat compared to the FY19 enacted level, but $1,350 million above the FY20 Request ($3,350 million).
• The bill includes $1,560 million as the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), an increase of $210 million above the FY19 enacted level ($1,350 million) and $602 million above the FY20 Request ($958 million). The bill states that this amount is for the first installment of the sixth replenishment. In addition, the explanatory statement accompanying the bill reaffirms the U.S. share of 33% of contributions.
• Funding for tuberculosis (TB) totals $310 million, $8 million above the FY19 enacted level, and $49 million above the FY20 Request ($261 million).
• Funding for malaria totals $770 million, $15 million above the FY19 enacted level ($755 million), and $96 million above the FY20 Request ($674 million).
• The bill includes $851 million for maternal and child health (MCH), an increase of $16 million above the FY19 enacted level ($835 million), and $231 million above the FY20 Request ($629 million). Specific areas under MCH include:
  • Gavi, the Vaccine Alliance funding totals $290 million, matching the FY19 enacted level, and $40 million above the FY20 Request ($250 million).
  • Polio funding through all accounts totals $61 million, $2 million above the FY19 enacted level ($59 million), and $38 million above the President’s FY 2020 Request.
  • The bill includes $139.0 million for the U.S. contribution to the United Nations Children’s Fund (UNICEF) provided through the International Organizations and Programs (IO&P) account, $1.5 million above the FY19 enacted level ($137.5 million). While the FY20 Request did not specify a funding amount for UNICEF and proposed to eliminate the IO&P account, it is possible that organizations such as UNICEF could receive funding through other accounts.
• Funding for nutrition totals $150 million, $5 million above the FY19 enacted level ($145 million), and $71 million above the FY20 Request ($79 million).
• Bilateral family planning and reproductive health (FP/RH) funding totals $575 million ($524 million through the GHP account and $51 million through the ESF account), matching the FY19 enacted level, and $316 million above the FY20 Request ($259 million).
• Funding for the United Nations Population Fund (UNFPA) totals $32.5 million, matching the FY19 enacted level; the FY20 Request proposed eliminating funding for UNFPA.
• Funding for the vulnerable children program totals $25 million, $1 million above the FY19 enacted level ($24 million); the FY20 Request proposed eliminating funding for this program.
• Funding for neglected tropical diseases (NTDs) totals $102.5 million, matching the FY19 enacted level, and $27.5 million above the FY20 Request ($75 million).
• Funding for global health security (GHS) totals $100 million in the bill. While this is a decrease compared to the FY19 enacted level ($138 million), $38 million of the FY19 amount was provided through a one-time transfer of unspent emergency Ebola funding. The FY20 conference agreement amount is a $10 million increase compared to the FY20 Request ($90 million).

Centers for Disease Control and Prevention (CDC): Funding for global health provided to the CDC totals $571 million, an increase of $75 million compared to the FY19 enacted level ($496 million) and $114 million above the FY20 Request ($457 million). The entire increase in CDC funding is to support global health security activities.

Fogarty International Center (FIC): Funding for the Fogarty International Center (FIC) at the National Institutes of Health (NIH) totaled $81 million, $3 million above the FY 2019 enacted level ($78 million) and $14 million above the FY20 Request.

Additional Global Health Legislation: The appropriations bill also included the “End Neglected Tropical Diseases Act” as well as the “Preventing Child Marriage in Displaced Populations Act.” Learn more about these two bills on the KFF U.S. Global Health Legislation Tracker here.

Additional Resources:

• “Further Consolidated Appropriations Act, 2020” – Bill Text
• FY2020 State and Foreign Operations Appropriations – Explanatory Statement
• FY2020 Labor, HHS – Explanatory Statement

The table below compares global health funding in the FY 2020 conference agreement to the FY 2019 enacted funding amounts as outlined in the “Consolidated Appropriations Act, 2019” (P.L. 116-6; KFF summary here), the President’s FY 2020 request (KFF summary here).