Global Health Programs (including PEPFAR Restructure)

(Global Health)

Department of State & International Programs

Proposed Cut

$4.3B

% Reduction

46.0%

Action Type

reduction

Who Is Served

20 million people on antiretroviral therapy; malaria prevention programs; 25-26 million lives saved by PEPFAR

Summary

The Global Health Programs account funds U.S. international health efforts, including PEPFAR (the President's Emergency Plan for AIDS Relief), malaria prevention, and maternal health programs run through the State Department. The FY2027 budget proposes cutting this account by $4,300 million, a 46% reduction, restructuring PEPFAR around fewer implementing partners while eliminating disease-specific malaria and maternal health funding lines.

Who Is Affected

PEPFAR currently supports about 20 million people receiving antiretroviral therapy and is credited with helping save roughly 25-26 million lives since 2003, working in more than 50 countries. The restructuring would eliminate HIV prevention services like voluntary medical male circumcision and reduce funding for the President's Malaria Initiative and maternal and child health programs that reach millions of women and children in low-income countries.

What this cut would actually mean

Independent USAID analysis found that halting malaria prevention funding permanently could cause 12.5 to 17.9 million additional malaria cases and 71,000 to 166,000 additional deaths each year, and one modeling study found over 100,000 lives could be lost this year alone without full PMI funding. Cutting PEPFAR's scale and shifting to fewer implementing partners risks interrupting antiretroviral therapy for people currently on treatment, which can lead to drug resistance, disease progression, and increased HIV transmission, while reduced maternal health funding would leave fewer resources for safe childbirth and newborn care in the poorest countries.

Sources

White House Releases Fiscal Year 2027 Global Health Budget Request Proposing Significant Reductions and Program Restructuring — Describes the FY2027 budget request's move to a 'sustainability-focused' model with reduced bilateral funding and consolidation of Global Health Programs accounts, including changes to PEPFAR oversight.
Proposed Cuts to Diplomacy and International Assistance Out of Step with Broad Bipartisan Consensus — Confirms the FY27 request includes $5.1 billion for Global Health Programs, a $4.3 billion (46%) reduction from the FY26 enacted level.
The Trump Administration's Foreign Aid Review: Status of PEPFAR — KFF background on PEPFAR, noting it has saved an estimated 26 million lives and operates in more than 50 countries.
The Trump Administration's Foreign Aid Review: Status of the President's Malaria Initiative (PMI) — Cites an internal USAID memo estimating 12.5-17.9 million additional malaria cases and 71,000-166,000 additional deaths annually if PMI funding halted permanently.
Malaria Resurgence Could Kill Nearly One Million By 2030 In Absence Of Funding, New Drug Tools — Health Policy Watch reporting on modeling showing malaria funding cuts could lead to significant increases in cases and deaths, including over 100,000 lives at risk this year without full PMI funding.
Global Health Watch: Proposed US budget cuts, HIV supply chain disruptions, Global Fund commitments — AVAC analysis of the FY2027 budget request's approximately 46% cut to Global Health Programs, including elimination of HIV prevention services like voluntary medical male circumcision.