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This week, the House Appropriations Committee advanced out of committee a funding bill for fiscal year 2026 that included some welcome surprises. While it is disappointing to see cuts and the loss of the US Agency for International Development (USAID), this bill indicates that there remains bipartisan congressional support for global health, especially in this challenging fiscal and political moment.

July 24, 2025 by Marissa Chmiola

In a surprising move, House appropriators advanced out of committee yesterday a fiscal year 2026 funding bill that codifies the closure of the US Agency for International Development (USAID) and cuts global health spending—yet delivers nearly $6 billion more than the White House requested, putting Congress on a collision course with the administration’s global health agenda.  

Funding highlights

The bill, covering National Security, State, and Related Programs, allocates $9.5 billion in funding for global health activities at the Department of State. This includes $5.9 billion for programs historically housed at State and $3.6 billion for programs formerly housed at USAID that have been absorbed into State following the administration’s official closure of the agency on July 1.

This development is a glass-half-full or glass-half-empty outcome, depending on how advocates choose to view it. While this funding represents a $511.7 million (5 percent) cut to global health programs overall compared to fiscal year 2025 (FY25) enacted levels, it is also $5.7 billion above what was proposed in the President’s Budget Request, which would have represented a massive 62 percent cut.

Many political observers had anticipated that the House would put forward a bill closely aligned with the President’s request, so it is both surprising and welcome news that House appropriators have advanced legislation maintaining substantial funding across many programmatic areas the administration has sought to drastically cut or eliminate.

Beyond topline funding, the bill and accompanying report also diverge from the president’s proposal in other key ways. While the administration proposed eliminating funding for family planning and reproductive health, neglected tropical diseases, vulnerable children, nutrition, maternal and child health activities (except polio), and certain HIV/AIDS activities (formerly at USAID) and announced it would stop financial contributions to Gavi, the Vaccine Alliance, the House bill retains funding across each of these aforementioned areas.  

Additionally, the bill and report include welcome language affirming that House appropriators believe—in agreement with advocates—that investments in global health make America safer, stronger, and more prosperous. They also included language advocated for by GHTC, allowing appropriated funds to be used to support research and noting that the committee “supports investments in research, development, and introduction of innovative technologies” for global health, alongside other language supportive of research and innovation for specific health areas. The report also directs that global health security funding be made available to support the Coalition for Epidemic Preparedness Innovations, an international vaccine development partnership, consistent with prior fiscal year levels, which was $100 million. It is positive to see the House send a clear and unequivocal message to the administration that investments in research and development (R&D) are essential to delivering on the United States’ global health goals, given that the vast majority of global health awards financing R&D were terminated earlier this year, following the administration’s foreign assistance review.

“Investments in global health programming are a fundamental pillar of America’s national security agenda. It makes America safer by supporting early detection and protection from dangerous outbreaks…and improving health infrastructure to bolster prevention, preparedness, and response….It makes American stronger and more prosperous by strengthening global economic stability…and unleashes American ingenuity in creating medicines, treatment, technology…and more.” – House FY26 National Security, State, and Related Programs bill

Concerning cuts

The cuts in the bill from FY25 enacted funding levels are spread across several initiatives and health areas, including reductions to the President’s Emergency Plan for AIDS Relief (PEPFAR); the Global Fund to Fight AIDS, Tuberculosis and Malaria; family planning and reproductive health; and topline funding for former USAID global health programs, which could potentially trickle down to cuts to global health security programming, given specific funding levels for this area were not specified in the bill or report. See the chart below for a more detailed comparison of funding lines in the House bill and percent changes compared to FY25 enacted and the President’s Budget Request.

Program 

House FY26 bill ($ million) 

FY26 House vs FY25 enacted (%) 

FY26 House vs PBR (%) 

Global Health Programs, all 

$9,518 

-5% 

+151% 

State Global Health Programs 

$5,895 

-2% 

+55% 

PEPFAR

$4,395 

0% 

+51% 

Global Fund 

$1,500 

-9% 

Undefined* 

Former USAID Global Health Programs, now State 

$3,623 

-9% 

Eliminated in PBR 

Maternal & Child Health 

$915 

0% 

+976% 

of which Gavi 

$300 

0% 

Eliminated in PBR 

Nutrition 

$172.5 

+5% 

Eliminated in PBR 

HIV/AIDS† 

$330 

0% 

Eliminated in PBR 

Vulnerable Children 

$32.5 

+3% 

Eliminated in PBR 

Tuberculosis 

$394.5 

0% 

+122% 

Malaria 

$800 

+1% 

+89% 

Neglected Tropical Diseases 

$114.5 

0% 

Eliminated in PBR 

Global Health Security‡ 

Undefined 

N/A 

N/A 

Family planning and reproductive health, across 

Up to $461 

-24% 

Eliminated in PBR 

UNFPA§ 

$0 

-100% 

Eliminated in PBR 

 *The PBR did not specify funding for the Global Fund but specified that a contribution could be made using Global Health Program funds. 
†  HIV/AIDS formerly at USAID are transferred to PEPFAR, adding to the PEPFAR amount reported in this table. 
‡ Funded at $700 million in FY25 and funded at $200 million in PBR but not specified in House FY26 bill.  
§ Funded at $32.5 million in FY25 but eliminated in House bill and PBR. 

These concerning proposed cuts could threaten decades of progress in advancing better health for families around the world and weaken America’s defenses against global disease threats. The bill also includes policy riders that prohibit funding for vital global actors, including the United Nations Population Fund and the World Health Organization, the latter in alignment with the administration’s executive order withdrawing from the organization. The bill also reaffirms the expanded “Protecting Life in Global Health Assistance” or “Mexico City Policy” restrictions, as well as forbids funding to organizations that provide transgender medical services, to any laboratories owned or controlled by adversary nations including China, or to support gain-of-function research, the last of which is written broadly enough to implicate both potentially dangerous research on pandemic risks as well as far lower-risk studies on infectious diseases.

While the more favorable-than-expected House funding numbers represent a relatively positive development, in the context of USAID’s closure, mass grant terminations, and recent large-scale reductions in staffing at State, the bill also raises concerns about whether the State Department has the technical expertise or operational capacity to manage the former USAID portfolio effectively. It could also tee up a constitutional showdown in the courts if the administration ultimately chooses not to dispense funding as directed by congressional lawmakers or could spur further administration-driven efforts to claw back funding through recissions.

What comes next

The bill also represents just the first step in a long political process ahead. It will next go to the full House for a vote, then the Senate will advance its parallel bill, and then the two bills will need to be conferenced to work out differences before being re-voted on by both chambers and sent to President Donald Trump’s desk for signature. 

With its higher-than-expected funding relative to the White House’s request, the House bill provides a better starting place for these bicameral negotiations than many advocates anticipated we’d see this summer. Historically, the Senate has proposed higher funding levels for global health than the House and rejected many of the lower chamber’s more controversial political policy riders, so if the two chambers are able to reach a compromise and pass a bill, we could hopefully see funding levels increase to even closer to FY25 enacted levels, with some riders removed.  

For many advocates and political observers, this bill and report represent a confusing split screen—the same Republican lawmakers who just recently voted to rescind millions in global health funds are now advancing relatively healthy funding for the same priorities. Does this indicate a change of heart? A divide between the beliefs of appropriators and other members of Congress? If such a bill advances, will the administration follow congressional directives, and will those same members push back if it doesn’t? Only time and the persistent work of advocates will tell.

About the author

Marissa ChmiolaGHTC

Marissa manages the development and implementation of the coalition’s communications activities, overseeing GHTC’s digital presence, media outreach, events, publications, and internal communication practices. She also manages GHTC's monitoring, evaluation, and adaptive learning and donor reporting...read more about this author