The final Fiscal Year (FY) 2024 State, Foreign Operations, and Related Programs (SFOPS) appropriations bill lacks the boldness and vision needed to address a time of growing health, humanitarian, and development crises. Moreover, the bill was passed halfway through the fiscal year it’s meant to fund, delaying much needed support to U.S. global health agencies.

“Due to the constrained funding environment set forth by the Fiscal Responsibility Act, it is unsurprising, yet disappointing, that the FY24 SFOPS bill reduced global health resources by $530.5 million,” said Elisha Dunn-Georgiou, Global Health Council’s President & CEO. “Even maintaining current levels would have, effectively, been a decrease. With these cuts, we are further eroding our ability to reach global goals.”

A significant portion of the overall reduction can be attributed to a matching requirement limiting the amount the U.S. can contribute to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Though the $1.65 billion allocated for the Global Fund was the highest amount possible in FY24, advocates had pushed for the $350 million that was cut from its funding to be reallocated to bilateral programs; they were not. 

The approximately $10 billion provided in the bill means that many global health programs are funded at, or near, FY23 enacted levels. Even as needs to bolster essential health services continue to grow in the wake of the COVID-19 pandemic, climate change, and ongoing conflicts, critical areas were decreased. For example, USAID’s global health security program was reduced from $900 million (FY23 enacted) to $700 million.

On a positive note, for the first time, Congress appropriated no less than $10 million for the global health workforce to support and protect those who provide frontline care. In addition, funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) was maintained. It’s worth noting, however, that only a one-year extension was provided for the initiative’s expiring authorization, rather than the multi-year reauthorization for which advocates had been pushing.

“Given the current environment, these victories, small as they are, do speak to bipartisan support,” said Dunn-Georgiou. “They are evidence of the U.S.’s leadership and commitment to global health resources and programs.”