Global Health: USAID Programs and Appropriations from FY2001 through FY2010

Tiaji Salaam-Blyther
Specialist in Global Health

A number of U.S. agencies and departments implement U.S. government global health interventions. Overall, U.S. global health assistance is not always coordinated. Exceptions to this include U.S. international responses to key infectious diseases—for example, U.S. programs to address HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR), malaria through the President's Malaria Initiative (PMI), and avian and pandemic influenza through the Avian Flu Task Force. Although a number of U.S. agencies and departments implement global health programs, this report focuses on funding for global health programs conducted by the U.S. Agency for International Development (USAID), a key recipient of U.S. global health funding. 

Congress appropriates funds to USAID for global health activities through five main budget lines: Child Survival and Maternal Health (CS/MH), Vulnerable Children (VC), HIV/AIDS, Other Infectious Diseases (OID), and Family Planning and Reproductive Health (FP/RH). From FY2001 through FY2009, Congress appropriated about $16.1 billion to USAID for global health programs (excluding contributions to the United Nations' Children's Fund [UNICEF] and the Global Fund to Fight AIDS, Malaria, and Tuberculosis [Global Fund]). Much of the growth in global health spending by USAID from FY2001 through FY2009 targeted three diseases: HIV/AIDS, malaria, and avian and pandemic influenza. During this period, Congress supported President Bush's calls for higher spending on these diseases through three key initiatives: the President's International Mother and Child HIV Prevention Initiative (FY2002-FY2004), PEPFAR (FY2004-FY2008), and PMI (FY2006-FY2010). Congress also endorsed the President's Pandemic Influenza Plan to address avian influenza and prepare for any pandemic influenza that might arise. 

Since PEPFAR was launched in 2004, the United States has apportioned the bulk of its global health spending on the plan. In light of the dominant role that PEPFAR has played in shaping U.S. global health assistance, analysis about funding for USAID's global health programs in this report is organized to reflect changes that occurred before and after PEPFAR authorization. 

President Barack Obama has indicated early in his Administration that global health is a priority and that his Administration would continue to focus global health efforts on addressing HIV/AIDS. When releasing his FY2010 budget request, President Obama indicated that his Administration would increase investments in global health programs and, through the Global Health Initiative, improve the coordination of all global health programs. The President requested that Congress approve $7.6 billion for global health programs funded through the Global Health and Child Survival (GHCS) Account, including $2.3 billion for USAID. Congress provided about $7.8 billion for GHCS, including $2.4 million for USAID global health programs. See CRS Report R40740, U.S. Global Health Assistance: Background, Priorities, and Issues for the 111th Congress, for more information on all U.S. global health funding.

There is a growing consensus that U.S. global health assistance needs to become more efficient and effective. There is some debate, however, on the best strategies. This report explains the role USAID plays in U.S. global health assistance, highlights how much the agency has spent on global health efforts from FY2001 to FY2010, discusses how funding to each of its programs has changed during this period, and raises some related policy questions. 


Date of Report: January 29, 2010
Number of Pages: 20
Order Number: RS22913
Price: $29.95