On April 22, 2026, the House Appropriations Committee released its Fiscal Year 2027 appropriations bill. The bill includes discretionary funding for U.S. global health programs at the State Department as follows:
- Global Health Programs (GHP) account: The main account that supports global health programs totals $8.9 billion in the bill, $532 million below the FY 2026 amount ($9.4 billion) and $3.8 billion above the President’s FY 2027 budget request ($5.1 billion). The bill provides two envelops of funding: 1) President’s Emergency Plan for AIDS Relief (PEPFAR) and Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), which includes funding historically provided to the State Department, and 2) other global health activities, which includes funding historically provided to USAID.
- PEPFAR/Global Fund: The bill provides $5.53 billion to PEPFAR, which includes:
- Bilateral HIV: The bill provides at least $4.28 billion for bilateral HIV programs, $350 million (-8%) below the FY 2026 enacted level ($4.63 billion). The FY 2027 budget request did not include a specific amount for bilateral HIV, as it proposed to “eliminate disease-specific accounts” (see the KFF President’s FY 2027 budget request summary here).The bill indicates that more funding for HIV may be provided through the other envelope of funding mentioned above.
- Global Fund: The bill specifies that the U.S. contribution for the Global Fund “shall be” $1.25 billion, flat compared to the FY 2026 enacted level (the FY 2027 request did not specify an amount for the Global Fund).
- Other global health activities: The bill provides $3.35 billion for global health activities, including HIV, TB, malaria, MCH, polio, nutrition, family planning and reproductive health (FP/RH), NTDs, and global health security through the GHP account but does not include specific amounts for each (with the exception of FP/RH, see below). This represents a $182 million (-5%) decline compared to the FY 2026 enacted level ($3.53 billion) for these global health activities. More information may become available once the House report accompanying the bill is released.
- Family Planning and Reproductive Health (FP/RH): The bill states that “not more than” $461 million “may be made available” for FP/RH. This represents a $114 million (-20%) decline compared to the FY 2026 enacted level of “not less than” $575 million from all bilateral accounts (the FY 2027 request eliminated funding for FP/RH).
- Gavi, the Vaccine Alliance (Gavi): The bill does not specify an amount for Gavi but states that funds “may be made available” for one year.
- PEPFAR/Global Fund: The bill provides $5.53 billion to PEPFAR, which includes:
- Eliminated funding: The bill eliminates funding for the United Nations Population Fund (UNFPA) and the World Health Organization (WHO) (see the KFF UNFPA Funding and Kemp-Kasten explainer here and the KFF WHO fact sheet here).
- Policy Provisions:
- Period of availability: All funding under the GHP account is for 3-years (until September 30, 2029), with the exception of Gavi, which is for 1-year (until September 30, 3027). Historically, funding has been available for 5-years for PEPFAR and the Global Fund funding provided to State and for 2-years for other funding.
- Promoting Human Flourishing in Foreign Assistance (PHFFA): The bill codifies all three rules of the PHFFA policy (see the KFF Mexico City Policy explainer here).
This post will be updated as more information becomes available. See other budget summaries and the KFF budget tracker for details on historical annual appropriations for global health programs.
