US congressional leaders have agreed on a $9.4 billion global health funding package, pushing back against President Donald Trump’s proposal for deeper cuts and signalling rare bipartisan support for sustaining US-backed health programmes worldwide.
The figure, reached by the House and Senate Appropriations Committees, is more than double the $3.7 billion requested by the Trump administration, though still below the $12.4 billion allocated in both 2024 and 2025. Both chambers of Congress must still approve the package and could face a presidential veto after passage.
Lawmakers face a 30 January deadline to pass the federal funding bill. If approved, it would then require the president’s assent to become law.
Part of wider foreign aid deal
The global health allocation forms part of a broader $50 billion foreign aid package for the 2026 fiscal year. While this represents a 16 per cent cut from 2024 levels, it is still nearly $20 billion higher than the administration’s initial request.
The broader bill includes $5.4 billion for humanitarian assistance, with portions allocated to health-related needs, including food security and nutrition, shelter and protection, and water, sanitation, and hygiene (WASH). It also reflects the administration’s plan to provide about $11 billion in direct bilateral assistance to low- and middle-income countries, some of which will support health programmes.
These bilateral arrangements replace parts of the assistance previously delivered through USAID, which had a budget of about $44 billion in 2023 before it was dismantled last year.
HIV/AIDS takes the largest share
Of the $9.4 billion earmarked specifically for global health, $5.9 billion is allocated to HIV/AIDS programmes. This includes:
- $4.5 billion for the President’s Emergency Plan for AIDS Relief (PEPFAR);
- $1.25 billion for the Global Fund to Fight TB, AIDS and Malaria;
- $45 million for UNAIDS.
While this is below the $7.1 billion provided under the 2024 Biden administration, it marks a sharp increase from the $2.9 billion requested by President Trump. The bill also calls for PEPFAR to gradually transition towards greater national self-reliance by beneficiary countries.
Other health priorities
Beyond HIV/AIDS, the package allocates:
- $795 million for malaria;
- $379 million for tuberculosis;
- $85 million for polio.
In a notable departure from past conservative resistance, the bill includes $524 million for family planning and reproductive health services. Despite the administration’s decision to withdraw from the UN Population Fund (UNFPA), Congress allocated $32.5 million to the agency within this envelope.
Additional funds are set aside for global health security, neglected tropical diseases (NTDs) and nutrition.
National security fund angle
Support for family planning, reproductive health and efforts to counter child marriage also appears in a proposed $6.77 billion National Security Fund, designed in part to counter China’s global influence. The fund also covers clean cookstoves, the Young African Leaders Initiative, peace process monitoring and trade capacity building, with at least 15 per cent earmarked for Africa.
Bipartisan divide in framing
Republicans have framed the agreement as a win for reducing overall foreign aid spending while aligning with President Trump’s foreign policy priorities.
House Appropriations Chair Tom Cole (R-OK) described the bill as an “unprecedented reduction of spending” consistent with the America First agenda, saying it eliminates funding for what he termed wasteful or ideological programmes and strengthens accountability at multilateral institutions.
Democrats, however, see the bill as a direct check on the administration’s approach. Senator Patty Murray (D-WA) said it “rejects Trump’s decimation of the US foreign assistance enterprise,” while renewing bipartisan investments in global health, humanitarian and development programmes long backed by Congress.
WHO funding absent
Notably, the bill does not include funding for the World Health Organization (WHO), nor does it provide for payment of $260.6 million in unpaid US dues as Washington proceeds with its planned withdrawal from the agency later this month.
If passed, the legislation would underscore Congress’s continued influence over US foreign aid spending, even as the administration presses for a sharper retrenchment.
