Updated: March 25, 2024

On March 23, 2024, the President signed the second package of final FY 2024 appropriations bills, otherwise known as the “Further Consolidated Appropriations Act, 2024,” which was released by the House and Senate Appropriations Committees on March 20, 2024, passed by the House on March 22, 2024 and passed by the Senate on March 23, 2024. The bill includes funding for U.S. global health programs at the State Department, U.S. Agency for International Development (USAID), Centers for Disease Control and Prevention (CDC), and National Institutes of Health (NIH).[i] Highlights are as follows:

• Total funding for global health in FY 2024 declined compared to the FY 2023 enacted level: Funding provided to the State Department and USAID through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totals $10 billion, or $531 million below the FY 2023 enacted level.
• The declines were largely due to a decreased contribution to the Global Fund and global health security: The bill provides $350 million less to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) in FY 2024 compared to FY 2023, though this is due to a funding match requirement that limits the amount the U.S. can contribute (a cap of 33% of total contributions to the Global Fund from all other donors). The bill also includes $200 million less for global health security, as well as a decrease for the Health Reserve Fund, which supports cross-cutting health activities such as health service delivery, health workforce, health information systems, access to essential medicines, health systems financing, and governance in challenging environments.
• Three global health areas increased slightly in FY 2024:
  • Funding for Gavi, the Vaccine Alliance, increased from $290 million in FY 2023 to $300 million in FY 2024 (this funding is part of the overall maternal and child health area).
  • Funding for nutrition efforts and for the vulnerable children program also increased slightly.
• All other areas remained flat: This includes funding for HIV through the President’s Emergency Plan for AIDS Relief (PEPFAR), TB, malaria (through the President’s Malaria Initiative, PMI), family planning and reproductive health, and neglected tropical diseases.
• Also of note:
  • The bill includes $10 million for the Global Health Worker Initiative, the first time Congress has provided funding for this initiative.
  • Funding for global health provided to the CDC and Fogarty International Center (FIC) at the NIH remains flat.
  • The bill contains a one-year reauthorization for the President’s Emergency Plan for AIDS Relief (PEPFAR) through March 25, 2025.

See the table below for additional detail on global health funding in the FY 2024 final bill; also included in the table is a comparison with the FY 2025 President’s budget request, which was released earlier this month on March 11, 2024. See other budget summaries and the KFF budget tracker for details on historical annual appropriations, including Request, Senate, and House amounts, for global health programs.

KFF Analysis of Global Health Funding in the FY24 Final Appropriations Bill

Resources:

• “Further Consolidated Appropriations Act, 2024” – Bill Text
• FY2024 Department of State, Foreign Operations, and Related Programs (SFOPs) Appropriations – Explanatory Statement
• FY2024 Department of Labor, Health and Human Services, and Education, and Related Agencies (Labor HHS) Appropriations – Explanatory Statement