The clock is ticking on more than a billion dollars in congressionally approved funding for global health programs that’s being held up by the Trump administration.
According to an analysisby Partners in Health, the Office of Management and Budget (OMB) is withholding $1.35 billion in bilateral funding that was previously approved by Congress for tuberculosis (TB), malaria, HIV, and maternal and child health programs. The funding is set to expire on September 30, the end of the federal government’s fiscal year.
The group says the continued withholding of the money could have a devastating impact in countries that rely on the funding.
If that money is continuously withheld, that would
“If that money is continuously withheld, that would cause tens of thousands of preventable deaths from infectious diseases—including TB, malaria, and HIV—and among moms and babies from illness in childbirth and delivery,” Vincent Lin, an associate director of Health Policy and Advocacy with Partners in Health, said at a press briefing today.
According to reportingby theNew York Times, OMB told Congress in April that it planned to use $2 billion in approved funding to cover the cost of closing down the US Agency for International Development (USAID), which was dismantled by the Trump administration last year. Of that money, roughly $650 million has been diverted for response to the Ebola outbreak in the Democratic Republic of Congo.
The remaining $1.35 billion would cover the costs of terminating leases for office space used by the agency and paying severance for USAID employees. Lin said it’s his understanding that the closeout costs for USAID are much less than OMB is claiming.
If that money is continuously withheld, that would cause tens of thousands of preventable deaths from infectious diseases—including TB, malaria, and HIV—and among moms and babies from illness in childbirth and delivery.
Partners in Health also warned that the State
Partners in Health also warned that the State Department has been delaying routine funding of the Presidential Emergency Plan for AIDS Relief (PEPFAR), the program that is estimated to have saved 26 million lives since it was established by the George W. Bush administration in 2003. The group estimates that, through July of this year, PEPFAR has spent $2.3 billion less than it did two years ago.
“If we hit September 30th with that level of a gap, we’re going to see huge drop-offs in service delivery around the world,” Lin said.
Lin said OMB Director Russell Vought sent a letter to Congress this week about the funding, but he does not know what Vought said in the letter. OMB did not respond to a request for comment.
A changing landscape for global health funding
Partners in Health is not the only group
Partners in Health is not the only group raising the alarm. In August, 134 members of Congress signed on to a letterwritten by a group of Democratic lawmakers demanding OMB release the funds before they expire.
“These funds were enacted into law for specific purposes that support life-saving assistance, strengthen partners against shared threats, and reinforce American leadership, and the Administration has a legal obligation to execute such appropriations consistent with the law,” Reps. Gabe Amo (D-RI), James Walkinshaw (D-VA), Robin Kelly (D-IL), and Sen. Edward Markey (D-MA) wrote.
It’s the latest example of the Trump administration withholding congressionally approved funding for global health. In May, lawmakers pressured Secretary of State Marco Rubio to release $600 million in funding that was being withheld from Gavi, the Vaccine Alliance, over objections from Health and Human Services Secretary Robert F. Kennedy Jr. The State Department agreed to disburse the moneyin late July.
US funding for global health and humanitarian assistance
US funding for global health and humanitarian assistance is in the midst of profound changes that the Trump administration argues will make America safer while reducing countries’ dependency on foreign assistance. Before its dismantling, most US funding of global health was administered through USAID to organizations around the world. Under the America First Global Health Strategy, the administration is negotiating memorandums of understanding (MOUs) with recipient nations.
An analysisof 18 of these MOUs by Public Citizen and Partners in Health indicates that, across the 18 countries, US funding would be reduced by 43% to 97% compared with baseline (2024) levels—even though Congress has called for global health spending to remain steady.
“The steep decline in funding compared to baseline levels over the course of the MOUs raises concerns about how, or if, the administration intends to spend appropriated money,” the groups wrote.
