Policy Updates

On August 6, 2026, the US announced nearly US$2 billion in partnerships with faith-based and community organizations to deliver global health and humanitarian assistance across more than 20 countries. The announcement represents the largest allocation of global health foreign assistance to faith-based organizations in over 20 years.

As a landmark commitment under the America First Global Health Strategy (AFGHS), the Department of State allocated US$1.4 billion to support integrated health services through faith-based and community hospitals and clinics in more than 20 countries. Through the Faith and Community Initiative (FCI) Award to World Vision and a consortium of local faith-based implementers, up to US$850 million was committed over five years to:

• strengthen over 2,500 faith-based hospitals, clinics, and community hubs to deliver high-quality healthcare across 17 countries;
• train, pay, and equip more than 30,000 community health workers with supplies to deliver critical health services; and
• provide an additional US$570 million to faith-based and community hospitals and clinics through memoranda of understanding signed with partner governments under the AFGHS.

The US also announced US$538 million in humanitarian response funding for Samaritan's Purse and a consortium jointly led by World Vision and Compassion International. The funding is expected to reach 7 million people across 16 humanitarian crises, with over US$100 million made immediately available for natural disaster response and preparedness across 23 disaster-prone countries.

On July 29, 2026, the US Departments of State and Health and Human Services announced the release of US$600 million in congressionally appropriated funding to Gavi, the Vaccine Alliance, resolving months of delay under Health Secretary Robert F. Kennedy Jr., who had withheld the funds over concerns about mercury-containing vaccines.

The Trump administration confirmed the release of the funding, which covers FY2025 and FY2026 and was set to expire on September 30, 2026. Kennedy had held up the disbursement for months, arguing that Gavi was using dangerous and outdated vaccines containing thimerosal, a mercury-based preservative. The departments stated that Gavi committed to work toward transitioning away from mercury-containing vaccines and expanding access to newer, mercury-free alternatives.

The US has largely phased out thimerosal-containing vaccines domestically, though the preservative remains in use in parts of the world with limited refrigeration capacity. Mainstream vaccine safety experts have affirmed that the vaccines Gavi uses are safe. The departments described the administration's position as "a pro-vaccine, pro-innovation policy."

Senate Appropriations Chair Susan Collins announced on July 28, 2026 that the State Department had agreed to disburse the funding. The US$600 million represents approximately 15% of Gavi's total annual budget. Gavi CEO Dr. Sania Nishtar welcomed the announcement, noting that the US has helped Gavi immunize over 1.2 billion children since 2000.

On March 9, 2026, the US State Department launched a US$4.5 billion funding platform for global health projects, inviting international NGOs, local NGOs, faith-based organizations, companies, universities, and government entities to apply for up to 100 awards ranging from US$500,000 to US$250 million over five years to complement bilateral health agreements.

The State Department created the platform to support projects that complement, extend, or fill gaps in the implementation of bilateral health agreements signed under the Trump administration's "America First" global health strategy. The platform will cover two initial priority areas: child development, care, and protection and rapid outbreak response. The child development, care, and protection priority offers up to five grants for up to five years with US$53 million in anticipated funding to address needs of children vulnerable to violence, exploitation, abuse, and neglect. The rapid outbreak response priority offers up to 10 awards for up to five years with US$290 million in funding to support countries with comprehensive responses to infectious disease outbreaks, prioritizing detection within seven days and rapid containment.

The program statement notes that no money can be made available to the United Nations Relief and Works Agency, or UNRWA, which supports Palestinians, and it prohibits funding that “Encourage Mass-Migration Caravans towards the United States Southwest Border.”

Dr. Jirair Ratevosian, senior global health security expert at Duke University Global Health Institute, noted that the approach allowed the US to encourage ideas from the field and adapt quickly to emerging health threats, while also building a portfolio of investments rather than a single, large program.

On January 7, 2026, US President Donald Trump ordered the US to withdraw from 66 international organizations, including 31 UN entities, cutting funding to organizations deemed contrary to US interests and alarming allies concerned about Washington's retreat from multilateralism.

Trump signed a presidential memorandum instructing all US government agencies and departments to cease participating in and funding 35 non- UN organizations and 31 UN entities. The White House stated the withdrawals would end US taxpayer funding and involvement in entities that advance globalist agendas over US priorities. The list of affected entities included:

• ECW;
• the IDLO;
• UNFPA;
• UNFCCC;
• IPCC;
• UNDESA;
• UNDEF; and
• UNCTAD.

The decision made no reference to major UN humanitarian agencies, including the IOM, the WFP, UN Human Rights, or UNICEF, though all faced severe US budget cuts during the past year. The announcement followed a February 4, 2025 presidential order directing a review of all international intergovernmental organizations.

On November 25, 2025, the US State Department approved a grant of up to US$150 million over three years to Zipline International Inc., an American robotics and autonomous drone delivery company, to expand healthcare operations in Rwanda, Ghana, Nigeria, Kenya, and Côte d'Ivoire, potentially reaching 15,000 health facilities and providing 100 million people with access to blood and medications.

The grant marked one of the first major US global health funding announcements since the Trump administration's foreign assistance freeze, dismantling of USAID, and release of its 'America First' global health strategy. US Undersecretary of State for Foreign Assistance, Humanitarian Affairs, and Religious Freedom Jeremy Lewin characterized the partnership as an example of innovative, results-driven partnership at the core of the America First foreign assistance agenda.

The funding was structured on a pay-for-performance basis, with initial payments unlocked when participating governments signed contracts committing to pay for ongoing logistics services. The five governments committed to pay up to US$400 million in utilization fees. Rwanda, where Zipline began operations in 2016, is expected to be the first to sign.

On November 21, 2025, the US pledged US$4.6 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria for 2026-2029 at the 8^th Replenishment pledging event in Johannesburg, South Africa.

The Global Fund reached US$11.3 billion of its US$18 billion target, with the US maintaining its matching pledge ratio requiring the Global Fund to secure US$2 from other donors for every US$1 contributed.

The pledge represented a modest decline from the US$6 billion the US committed in the previous funding cycle. Undersecretary of State for Foreign Assistance, Humanitarian Affairs and Religious Freedom Jeremy Lewin announced the pledge in a video message, noting the reduction was to account for needed reforms and efficiencies. Lewin praised Executive Director Peter Sands' leadership and the organization's track record, stating the Global Fund would play a role in America's new vision for global health engagement.

The pledge came amid uncertainty about whether the US would contribute at all, following the Trump administration's dismantling of the country's foreign assistance infrastructure and withdrawal from many multilateral commitments.

On November 21, 2025The Global Fund held its Eighth Replenishment Summit, in Johannesburg, South Africa, co-hosted by the governments of South Africa and the UK on the margins of the G20 Leaders' Summit, securing US$11.3 billion in pledges to sustain the fight against AIDS, tuberculosis, and malaria.

Partners from more than 30 countries pledged support to save lives and strengthen systems for health, marking the first replenishment held on African soil. The summit demonstrated global solidarity despite fiscal tightening, conflict, and global uncertainty, though total pledges fell short of the ambitious target set in the Investment Case and several donors had yet to confirm their pledges.

The US, the Global Fund's largest donor, committed US$4.6 billion. The UK pledged GBP850 million (US$1.1 billion), while Germany confirmed EUR1 billion (US$1.2 billion) and Canada pledged CAD1.02 billion (US$723 million). France noted that its support remained unchanged. Spain increased its pledge to EUR145 million (US$167 million), Italy pledged EUR150 million (US$173 million), the Netherlands contributed EUR146 million (US$169 million), and additional pledges came from many other donors. South Africa committed US$37 million, including US$10 million from the private sector. African countries made solidarity commitments totaling US$52 million. G20 member states reached US$9 billion in commitments.

Within the private sector, the Gates Foundation pledged US$912 million, the Children's Investment Fund Foundation pledged US$135 million, and (RED) committed US$75 million. Overall, private sector support reached US$1.3 billion.

On September 18, 2025, the US Department of State, under the leadership of Secretary of State Marco Rubio, released its America First Global Health Strategy, a comprehensive plan to align US global health programs with American national interests, security, and prosperity.

While the plan reaffirms commitment to goals for HIV/AIDS, malaria, and TB, the strategy marks a significant pivot from previous administrations, failing to mention previous administration and historically bipartisan priorities, including maternal and child health, routine immunizations, nutrition, and family planning. The document frames global health as a tool to counter Chinese influence, particularly in Africa.

The strategy is built on three pillars:

• "Making America safer" by improving disease surveillance and outbreak response;
• "Making America stronger" by shifting to bilateral agreements with partner countries; and
• "Making America more prosperous" by protecting the US economy from pandemics and promoting American health products.

The plan outlines a move away from NGO-led program delivery toward direct, multi-year bilateral agreements with recipient governments. The agreements will require co-investment from partner countries and will be tied to performance benchmarks. The US administration aims to finalize the deals with the 87 countries that received US health funding in FY2023 by the end of 2025, which is a timeline seen as highly challenging by global health experts, particularly in light of severe cuts to government global health staff.

The strategy justifies the shift by targeting “inefficient and wasteful” spending, asserting that 60% of current funding goes to overhead and program management rather than frontline services.

Critics raised concerns that the new model poses significant challenges, highlighting that a purely bilateral approach is seen as insufficient to tackle transnational threats, which require the broad, multilateral cooperation offered by institutions like the WHO. Another point of concern highlighted by health experts is the reduced funding for program management and technical assistance, which could weaken the detailed data collection and reporting that have historically allowed for close congressional oversight.

On September 11^th, 2025, the US State Department announced US$250 million in new public health assistance to the Philippines.

The new funding is intended to address public health challenges, with a focus on tuberculosis and maternal health. The assistance will also support investment in preparedness, detection, and response capabilities to reduce the threat of emerging diseases.

The programming builds on US$63 million in assistance announced during Philippine President Ferdinand Marcos Jr.’s official visit to Washington in July 2025. The US administration highlighted the announcement as a demonstration of its 'America First' foreign assistance approach.

On September 11, 2025, the US House Foreign Affairs Committee introduced two major pieces of legislation: the DFC Modernization Act of 2025, which proposes to increase the US DFC's lending cap to US$250 billion, and a series of bills aimed at reforming the US State Department.

The DFC Modernization Act, which closely resembles a proposal from the Trump administration, would increase the DFC's total lending cap from US$60 billion to US$250 billion. The bill would also allow the agency to invest in HICs for the first time, establish a revolving fund for equity investments, and raise the threshold for congressional notification of investments from US$10 million to US$100 million.

The second set of bills seeks to reform the US State Department by codifying changes made under US Secretary of State Marco Rubio. The proposals include the creation of an undersecretary for foreign assistance and a 'global health compact' model designed to shift funding responsibilities to partner countries, which would include a phase-out of PEPFAR funding. The legislation also suggests tying foreign assistance to a country's alignment with US policy positions.

Former OPIC CEO Robert Mosbacher Jr. expressed concern about linking the DFC bill to the more contentious State Department authorization. A short-term extension for the DFC may be necessary to allow more time for negotiation.