9. Agency for International Development · Notable
Eliminate outdated and ineffective global health funding streams
Printed page 264 9. Agency for International Development
“The Bureau should identify and eliminate outdated and ineffective concepts and focus on funding innovation.”
What has happened
- Partially done
Congress funded the innovation half. The FY2026 appropriations act directs not less than $50,000,000 for a Prevention, Treatment, and Response Initiative for HIV/AIDS, malaria and other infectious diseases, to be awarded to eligible public and private entities including product development partnerships and in coordination with other donors, and to support the September 2025 America First Global Health Strategy. The 2025 rescissions act had already canceled $500,000,000 of Global Health Programs balances while protecting HIV/AIDS, tuberculosis, malaria, nutrition and maternal and child health. `partial`: no allowlisted record says the elimination sweep is complete.
- Partially done
The America First Global Health Strategy is, in State's own words to Congress, "the most significant overhaul of health assistance in over 20 years". It names the outdated concepts the Quote points at - disease programs "run in silos, with HIV/AIDS, tuberculosis, malaria, and outbreak response all running as separate programs"; an implementing-partner structure that is "often duplicative and highly inefficient" (Uganda alone had 57 implementing partners and more than 300 sub-recipients in FY2024, and implementing partners spent $678 million on program management that year); and technical assistance, program management and other overhead consuming the 60 percent of health foreign assistance funding that does not reach frontline commodities or healthcare workers - and commits to integrating them and shifting money to commodities and frontline workers. USAID's Global Health Bureau itself ceased to exist on 2025-07-01 and its programs are run by State's Bureau of Global Health Security and Diplomacy.
Research log
What was searched, and what didn’t count as evidence
Research notes
Researched 2026-08-28.
Correction, 2026-09-06. Status unchanged; a misattributed figure fixed. The 2025-09-18 note said technical assistance and program management consume “about 60 percent of PEPFAR’s bilateral budget”. The strategy does not say that. Its 60 percent figure is about health foreign assistance funding as a whole: “less than 40% of health foreign assistance funding goes to frontline supplies and healthcare workers … The remaining 60% of funding is spent on technical assistance, program management, and other forms of overhead”, restated later as “over 60% of health foreign assistance funding does not go to frontline investments in commodities or healthcare workers”. PEPFAR appears in the strategy as the program that “has saved 26 million lives and prevented 7.8 million babies from being born with HIV/AIDS”, not as the denominator of the overhead ratio. The Status note now quotes the document. This was found by opening the strategy itself rather than the fact sheet — see below.
The strategy PDF, not the landing page. The strategy’s page at state.gov/america-first-global-health-strategy/ is a landing page of about 1,500 characters that links the report; the 40-page document is at state.gov/wp-content/uploads/2025/09/America-First-Global-Health-Strategy-Report.pdf (PDF title “America First Global Health Strategy”, creation date 2025-09-17). The landing page remains the cited address across the Chapter 9 items because it is the strategy’s stable home and carries the release, the fact sheet and every bilateral memorandum of understanding; the PDF is where the quoted words are, and it was read in full on 2026-09-06.
- Action
- eliminate
- Object
- Outdated and ineffective Global Health Bureau programs and funding streams
- ID
- 690