President Biden released his full FY 2022 budget request to Congress on May 28, 2021 (an initial, topline discretionary FY 2022 budget proposal was released on April 9, 2021). The request includes an increase of almost $1 billion for global health programs, most of which (84%) is for global health security. Almost all other global health program areas were level-funded in the request, with the exception of small increases for maternal and child health (MCH) and family planning/reproductive health (FP/RH) compared to FY 2021 enacted levels. This marks a break from President Trump’s requests, which had proposed significant cuts to most global health programs throughout his term (Congress rejected those cuts). The FY 2022 budget request 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). Details on additional funding in these and other departments/agencies is not yet known but will be provided, when available. Key highlights for the known amounts are as follows (see table for additional detail). In addition, for an overview of historical trends in U.S. funding for global health, see our new analysis.

State Department & USAID:

Funding for global health programs through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totaled $10.05 billion, an increase of $855 million (9%) from the FY21 enacted level, almost all of which was for global health security.

• Funding for global health security totals $905 million, an increase of $715 million (376%) above the FY21 enacted level ($190 million).
• Bilateral HIV funding through the President’s Emergency Plan for AIDS Relief (PEPFAR) is $4.7 billion, matching the FY21 enacted level. In FY21, Congress appropriated an additional $250 million in emergency supplemental funding to address the impact of COVID-19 on bilateral HIV programs; this funding is not included in this analysis.
• The request includes $1.56 billion for the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), matching the FY21 enacted level. In FY21, Congress appropriated an additional $3.5 billion in emergency COVID-19 supplemental funding to the Global Fund; this funding is not included in this analysis.
• Funding for tuberculosis (TB) totals $319 million, matching the FY21 enacted level.
• Funding for malaria totals $770 million, matching the FY21 enacted level.
• The request includes $880 million for maternal and child health (MCH), a slight increase of $24 million (3%) above the FY21 enacted level ($856 million), all for bilateral MCH programs. Other specific areas under MCH include multilateral contributions to:
  • Gavi, the Vaccine Alliance which totals $290 million, matching the FY21 enacted.
  • UNICEF which totals $139 million, matching the FY21 enacted level.
• Funding for the nutrition program totals $150 million, matching the FY21 enacted level.
• Bilateral family planning and reproductive health (FP/RH) funding totals $584 million ($550 million through the GHP account and $33.7 million through the ESF account)[i], a slight increase of $9 million (2%) above the FY21 enacted level ($575 million, of which $524 million was through the GHP account and $51.1 million was through the ESF account). Funding for multilateral contributions to the United Nations Population Fund (UNFPA) totals $56 million, $23.5 million (72%) above the FY21 enacted level ($32.5 million)
• Funding for the vulnerable children program totals $25 million, matching the FY21 enacted level.
• Funding for neglected tropical diseases (NTDs) totals $103 million, matching the FY21 enacted level.
• Funding to replenish the Emergency Reserve Fund, which is used to “quickly and effectively respond to emerging infectious disease outbreaks,” totals $90 million; in FY21, no funding was appropriated for the Emergency Reserve Fund, but Congress provided the authority to transfer up to $50 million in funding from other areas to the Emergency Reserve Fund if needed.

Centers for Disease Control and Prevention (CDC): Funding for global health provided to the CDC totals $698 million, an increase of $105 million (18%) above the FY21 enacted level ($593 million), almost all of which (95%) is to support global health security activities; all other areas remained flat except for parasitic diseases funding which increased slightly.

National Institutes of Health (NIH) [ii]: Funding for global HIV/AIDS at NIH totals $617 million, essentially flat compared to the FY21 enacted level ($616 million). Funding for the Fogarty International Center (FIC) at NIH totals $96 million, $12 million (15%) above the FY21 enacted level ($84 million).

Resources:

• White House FY 2022 Budget Resources
• State/USAID FY 2022 Congressional Budget Justification
• CDC FY 2022 Congressional Budget Justification
• NIH FY 2022 Congressional Budget Justification

The table (.xls) below compares global health funding in the FY 2022 request to the FY 2021 enacted funding amounts as outlined in the  “Consolidated Appropriations Act, 2021” (P.L. 116-260; KFF summary here). Note that total funding for global health is not currently available as some funding provided through USAID, Health and Human Services (HHS), and the Department of Defense (DoD) is not yet available.

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