Policy Updates

On October 12, 2026, the UN General Assembly adopted a political declaration on pandemic prevention, preparedness, and response without consensus, after objections from the US and a few other states blocked approval at a high-level meeting on September 25, 2026.

The non-binding declaration calls for stronger national, regional, and international cooperation guided by science, equity, and respect for human rights. It welcomes the WHO Pandemic Agreement, adopted in 2025.

Chile's representative said no country can address a cross-border threat alone. WHO Director-General, Tedros Adhanom Ghebreyesus, urged countries to finalize the PABS annex so the Pandemic Agreement can open for signature, begin ratification, and enter into force.

The US said it could not support text that overlooks national policy boundaries. The US objected to language implying commitments to agreements or negotiations it had not joined. It also objected to references to WHO-led processes, including the amended IHR, the Pandemic Agreement, and the PABS annex negotiations, as well as the excessive and repetitive use of 'equity' and its variants.

On October 1, 2026, The US Department of State intends to launch new implementation plans that would overhaul global health assistance for 35 partner countries, shifting toward increased G2G health financing, without having shared the plans with the US Congress, according to a congressional source.

The State Department had already notified Congress of its intention to establish G2G financing arrangements for Kenya, Malawi, and Uganda, offering an early indication of how the new funding model would operate. As of the October 1, 2026 launch, the implementation plans had not been publicly released or provided to Congress.

The plans were drafted in cooperation with partner governments and expanded on memoranda of understanding that US officials began establishing with countries in December 2025. They would determine how billions of US dollars in health financing were spent. The implementation plans had originally been scheduled to take effect in April 2026, but were delayed without explanation. In the interim, the State Department maintained existing global health programs through three- or six-month grants.

On September 30, 2026, on the eve of the U.S. State Department launching its new implementation plan for bilateral healh agreements, it was announced that the Trump administration terminated US global health funding to Zimbabwe, including support for HIV and other infectious disease programs, after Zimbabwe's government rejected an "America First" foreign assistance agreement with Washington.

The US Department of State confirmed the decision in a statement, noting that implementing partners in Zimbabwe would receive a short window to responsibly close out all US government-funded programs. The department said it remained committed to an orderly handover of operations.

The termination followed months of negotiations in which the Trump administration sought new terms from recipient countries in exchange for continued US development assistance. Zimbabwe declined to sign such an agreement. Health advocates and officials from other recipient countries criticized the negotiation process, arguing that the administration pressured governments into accepting unfavorable terms. Limited analysis of the agreements indicated that they reduced tens of billions of US dollars in global health funding worldwide, even as the US Congress continued to appropriate funding for these programs.

On September 28, 2026, Four Democratic members of the US House of Representatives sent a letter to Secretary of State Marco Rubio, warning that the State Department was considering ending funding for the FEWS NET, which would need to begin terminating staff by September 30, 2026 absent continued funding.

The letter, signed by Rep. Gregory Meeks, the top Democrat on the House Foreign Affairs Committee, and Reps. Angie Craig, Sara Jacobs, and Shontel Brown, said FEWS NET had monitored global hunger hotspots and helped anticipate famine since 1985. The lawmakers said the program gave humanitarian organizations and donors advance time to direct food assistance to emerging crises, helping prevent further deterioration, save lives, and reduce the cost of emergency relief.

FEWS NET had sufficient resources to operate through the end of 2026, but faced staff terminations starting September 30, 2026, without continued State Department funding. The warning comes as a forecasted "Super El Nino" threatened to push tens of millions more people into acute hunger.

On September 25, 2026, a political declaration intended to strengthen global pandemic preparedness failed to secure unanimous support at a high-level UN meeting, after the US and EU objected to provisions on technology transfer, financing, and pathogen and product sharing.

European Commissioner for Equality, Preparedness, and Crisis Management Hadja Lahbib, speaking for the EU, said the declaration contained valuable commitments but also setbacks on issues the bloc considered essential, including technology transfer terms and the balance between domestic and international financing.

US CDC Director Erica Schwartz cited unresolved concerns over undefined ideological language and the unfinished PABS annex to the WHO Pandemic Agreement.

The declaration will stil proceed to the UN General Assembly for a vote, though departing from the practice of securing member-state endorsement before formal adoption. UN General Assembly President Khalilur Rahman said broad support existed for the text, but that some concerns remained, to be addressed in the General Assembly.

On August 30, 2026, Public Citizen and Partners In Health published a joint analysis which found that the Trump administration planned a 59% reduction, approximately US$2 billion, in US health spending across 18 low-income partner countries by 2030, despite congressional directives to maintain relatively steady global health funding levels.

In response, State Department spokesperson Tommy Pigott said the department planned to spend all congressionally appropriated health foreign assistance. Pigott added that the administration was "defining the next phase of US global health foreign assistance" in a way that prioritized efficiency, transparency, country self-reliance, and American innovation, as part of its broader America First foreign policy.

As part of the America First Global Health Strategy, the State Department had been negotiating bilateral health assistance agreements following the dismantling of USAID. By August 2026, it had signed deals with 34 countries, totaling US$14.5 billion in US assistance alongside over US$10.1 billion in co-investments from recipient countries.

The process faced criticism for its lack of transparency. Public Citizen sued the State Department after it failed to release the agreements in response to a Freedom of Information Act request. The lawsuit resulted in the release of 15 deals, including six that had not previously been made public. The analysis also found that countries missing "steep" co-financing requirements could face penalties that would worsen funding cuts, with some countries set to lose significantly more than others.

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.