Overview
- The State Department released a plan that makes health aid contingent on enforceable country-to-country agreements requiring recipient co-investment and a transition to self-reliance, with most of 71 partner countries slated to have full plans by March.
- Funding will prioritize drugs, diagnostics, and frontline health workers over program management and contractors, with an added push to promote U.S. health innovations and products overseas.
- Washington will maintain coverage of previously funded frontline costs through the start of the next fiscal year and provide bridge funding while new compacts are negotiated and prepared for rollout.
- USAID has been integrated into the State Department, the fiscal 2026 proposal targets roughly $4 billion for global health versus about $10 billion in 2024, and adjustments are expected for PEPFAR alongside a tilt toward the Western Hemisphere and Asia-Pacific.
- The strategy includes a 72-hour response pledge for outbreaks that threaten Americans and omits areas such as maternal and child health and measles, prompting warnings from advocates about potential service gaps.