Global Health Funding in the FY 2024 President’s Budget Request
President Biden released the FY 2024 President’s Budget Request on March 9, 2023. 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). Funding provided to the State Department and USAID through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totals $10.9 billion, an increase of $367 million above the FY 2023 enacted level. Most of the increase is for global health security (GHS), which totals $1.2 billion (an increase of $345 million above the FY 2023 enacted level) and includes $500 million for the Pandemic Fund. Funding also increased for family planning and reproductive health (FP/RH), Gavi, and the Health Reserve Fund, but is lower for bilateral HIV, tuberculosis (TB), and malaria. The FY 2024 request also includes new dedicated funding for the Global Health Worker Initiative. Funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), maternal and child health (MCH), nutrition, vulnerable children, and neglected tropical diseases remained flat. See the table below for additional detail on global health funding in the FY 2024 request (downloadable tables here). See the KFF budget tracker for details on historical annual appropriations for global health programs.
| Table: KFF Analysis of Global Health Funding in the FY24 President’s Budget Request | |||
| Department / Agency / Area | FY23 Omnibus (millions) |
FY24 Request (millions) |
Difference: FY24 Request – FY23 Omnibus |
| State, Foreign Operations, and Related Programs (SFOPs) – Global Healthi | |||
| HIV/AIDSii | – | – | – |
| Global Health Programs (GHP) account | $4,725.0 | $4,700.0 | -$25.0 (-0.5%) |
| State Department | $4,395.0 | $4,370.0 | -$25.0 (-0.6%) |
| USAID | $330.0 | $330.0 | $0.0 (0%) |
| of which Microbicides | $45.0 | $45.0 | $0.0 (0%) |
| Economic Support Fund (ESF) account | Not specified | Not specified | – |
| Global Fund | $2,000.0 | $2,000.0 | $0.0 (0%) |
| Tuberculosisii | – | – | – |
| Global Health Programs (GHP) account | $394.5 | $358.5 | -$36.0 (-9%) |
| Economic Support Fund (ESF) account | Not specified | Not specified | – |
| Malaria | $795.0 | $780.0 | -$15.0 (-2%) |
| Maternal & Child Health (MCH)ii | – | – | – |
| Global Health Programs (GHP) account | $910.0 | $910.0 | $0.0 (0%) |
| of which Gavi | $290.0 | $300.0 | $10.0 (3%) |
| of which Polio | $85.0 | Not specified | – |
| United Nations Children’s Fund (UNICEF) | $142.0 | $145.0 | $3.0 (2%) |
| Economic Support Fund (ESF) account | Not specified | Not specified | – |
| of which Polio | Not specified | Not specified | – |
| Nutritionii | – | – | – |
| Global Health Programs (GHP) account | $160.0 | $160.0 | $0.0 (0%) |
| Economic Support Fund (ESF) account | Not specified | Not specified | – |
| Assistance for Europe, Eurasia, and Central Asia (AEECA) account | Not specified | Not specified | – |
| Family Planning & Reproductive Health (FP/RH)iii | $607.5 | – | – |
| Bilateral FP/RHiii | $575.0 | Not specified | – |
| Global Health Programs (GHP) accountiii | $524.0 | $600.0 | $76.1 (14%) |
| Economic Support Fund (ESF) accountiii | $51.1 | Not specified | – |
| United Nations Population Fund (UNFPA)iv | $32.5 | $57.5 | $25.0 (77%) |
| Vulnerable Children | $30.0 | $30.0 | $0.0 (0%) |
| Neglected Tropical Diseases (NTDs) | $114.5 | $114.5 | $0.0 (0%) |
| Global Health Securityii | – | – | – |
| Global Health Programs (GHP) account | $900.0 | $1,245.0 | $345.0 (38%) |
| State Departmentv | – | $500.0 | $500.0 (N/A) |
| of which Pandemic Fund | – | $500.0 | $500.0 (N/A) |
| USAID | $900.0 | $745.0 | -$155.0 (-17%) |
| of which bilateral | Not specified | $435.0 | – |
| of which multilateral | Not specified | $220.0 | – |
| of which for the Coalition for Epidemic Preparedness Innovations (CEPI) | $100.0 | Not specified | – |
| of which Emergency Reserve Fund | iv | $90.0 | – |
| Economic Support Fund (ESF) account | Not specified | $2.0 | – |
| Assistance for Europe, Eurasia, and Central Asia (AEECA) account | Not specified | Not specified | – |
| Emergency Reserve Fund | vi | vi | – |
| Health Reserve Fundvii | $8.0 | $10.0 | $2.0 (25%) |
| Global Health Worker Initiative | Not specified | $20.0 | – |
| SFOPs Total (GHP account only) | $10,561.0 | $10,928.0 | $367.0 (3%) |
| Labor, Health & Human Services (LHHS) | |||
| Centers for Disease Control & Prevention (CDC) – Total Global Health | $692.8 | $764.8 | $72.0 (10%) |
| Global HIV/AIDS |
$128.9 | $128.9 | $0 (0%) |
| Global Tuberculosis | $11.7 | $11.7 | $0 (0%) |
| Global Immunization | $230.0 | $240.0 | $10.0 (4%) |
| Polio | $180.0 | $180.0 | $0 (0%) |
| Other Global Vaccines/Measles | $50.0 | $60.0 | $10.0 (20%) |
| Parasitic Diseases | $29.0 | $31.0 | $2.0 (7%) |
| Global Public Health Protection | $293.2 | $353.2 | $60.0 (20%) |
| Global Disease Detection and Emergency Response | Not specified | Not specified | – |
| of which Global Health Security (GHS) | Not specified | Not specified | – |
| Global Public Health Capacity Development | Not specified | Not specified | – |
| National Institutes of Health (NIH) – Total Global Health | – | – | – |
| HIV/AIDS | Not specified | Not specified | – |
| Malaria | Not specified | Not specified | – |
| Fogarty International Center (FIC) | $95.2 | $95.1 | -$0.03 (-0.03%) |
| LHHS Total | – | – | – |
| Notes: | |||
| i – Unless otherwise specified, funding amounts listed under the “State, Foreign Operations, and Related Programs (SFOPs) – Global Health” heading are provided through the Global Health Programs (GHP) account. | |||
| ii – Some HIV, tuberculosis, MCH, nutrition, family planning and reproductive health, and global health security funding is provided under the ESF and AEECA accounts, which is not earmarked by Congress in the annual appropriations bills and is determined at the agency level. | |||
| iii – The FY23 Omnibus bills states that “not less than $575,000,000 should be made available for family planning/reproductive health.” | |||
| iv – The FY23 Omnibus bills state that if this funding is not provided to UNFPA it “shall be transferred to the ‘Global Health Programs’ account and shall be made available for family planning, maternal, and reproductive health activities.” | |||
| v – The FY23 Omnibus bill states that “up to $90,000,000 of the funds made available under the heading ‘Global Health Programs’ may be made available for the Emergency Reserve Fund.” The FY24 Request includes funding for the Emergency Reserve Fund under Global Health Security. | |||
| vi – The FY24 Request states that this amount is for the Pandemic Fund to “strengthen global health security and pandemic preparedness and help make the world safer from infectious disease threats.” | |||
| vii – The explanatory statement accompanying the FY23 Omnibus states that these funds are “to support cross-cutting health activities, including health service delivery, the health workforce, health information systems, access to essential medicines, health systems financing, and governance, in challenging environments and countries in crisis.” The FY24 Request states that these funds are to “support cross-cutting global health activities in challenging environments or countries emerging from crisis. It will provide flexible, no year funding to ensure basic health services are accessible to those most in need and to build more resilient health services and systems. Activities will focus on six key areas: support for health service delivery, the global health workforce, health information systems, access to essential medicines, health systems financing, and governance.” | |||
Resources:
- White House, Office of Management and Budget (OMB), President’s Budget for FY 2024
- State Department, FY 2024 International Affairs Budget
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