U.S. Global Health Assistance: Background, Priorities, and Issues for the 111thCongress

Tiaji Salaam-Blyther
Specialist in Global Health

Kellie Moss
Analyst in Global Health

U.S. funding for global health activities has grown significantly over the past decade, from $1.8 billion in FY2001 to $8.5 billion in FY2010. During this time period, Congress has significantly increased funding for responses against infectious disease outbreaks, including the 2009 influenza pandemic (H1N1), H5N1 avian influenza (avian flu), human immunodeficiency/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis (TB), and malaria. U.S. agencies and departments also supplement funds that Congress appropriates for these purposes with funds from their discretionary budgets. 

Through FY2009 Supplemental Appropriations (P.L. 111-32), Congress appropriated $100 million to the U.S. Agency for International Development (USAID) for an additional contribution to the Multilateral Global Fund to Fight AIDS, Tuberculosis and Malaria and $50 million for international pandemic preparedness and response efforts. The Act also provided $200 million for domestic and global pandemic preparedness response programs conducted by the U.S. Centers for Disease Control and Prevention (CDC), though it did not specify how the funds should be apportioned. 

President Barack Obama sent Congress a FY2010 budget request of $9.1 billion for global health initiatives. Of those funds, he proposed that $7.6 billion be funded through the Global Health and Child Survival Account (GHCS), which is funded through Foreign Operations Appropriations and supports USAID global health programs, global HIV/AIDS programs managed by the Office of the Global AIDS Coordinator (OGAC) at the Department of State and a U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund). The President asked that Congress support his new Global Health Initiative that would provide $63 billion over six years "to shape a new, comprehensive global health strategy" that would focus on "broader global health challenges, including child and maternal health, family planning, and neglected tropical diseases, with cost effective intervention." He also requested $1.5 billion in emergency funds to support U.S. domestic and international responses to the 2009 influenza pandemic and more than $319 million for CDC global health programs. Through the FY2010 Consolidated Appropriations Act (P.L. 111-117), Congress provided more than $8 billion for global health activities. 

Foreign assistance reform, including global health aid, has emerged as a key issue in the 111th Congress. This report discusses some of the policy questions Congress may face as it considers proposals to improve U.S. global health aid, including defining U.S. global health aid, identifying the scope of U.S. global health spending, determining oversight and leadership roles, and coordinating global health and development programs.


Date of Report: January 29, 2010
Number of Pages: 35
Order Number: R40740
Price: $29.95

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