Alliance News

USG Recap: President’s Budget Request, Good News Gates, Scientific Research, Tracking Impact, and More

May 16, 2025

Since our USG April update, disruptions and cuts to global health continue. Our recap will be brief this month, but our reading list is long for more details. A few highlights:

President’s Budget Request

  • On May 2, the White House released its FY26 budget request, calling for up to a 47.7% cut to State and international programs and the rescission of an additional $20 billion — amounting to an estimated 84% reduction in the foreign affairs budget. Global health faces some of the steepest cuts, despite broad bipartisan support. The U.S., the world’s largest global health donor at $12.3 billion in 2024, would see that funding halved, with the administration citing abortion concerns — despite a decades-old legal ban on using foreign aid for abortion services. While antiretroviral treatment for current PEPFAR beneficiaries is preserved, funding for prevention, testing, and broader HIV services remains unclear. The budget also proposes cuts to the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH). Two budget proposal beneficiaries are the U.S. International Development Finance Corporation (DFC), set to receive nearly $3 billion in additional funding, and the World Bank’s International Development Association, which is slated for $3.2 billion over three years. The budget still has a ways to go and additional details are expected later this month. (Devex, KFF)
  • On May 14, the House Ways and Means Committee advanced parts of Trump’s proposed budget, concerning nonprofits and foundations. It includes provisions to increase taxes on private foundations from 1.39% to 10% for the wealthiest foundations, impose a 5% tax on remittances sent by non-U.S. citizens, raise taxes on university endowments from 1.4% to as high as 21%, and require corporations to donate at least 1% of their pre-tax profits (up from the current average of 0.92%) to qualify for a charitable tax deduction. The bill would also allow the government to revoke the tax-exempt status of organizations it deems supportive of terrorism, with limited due process. Now that it has cleared committee, the bill is expected to be bundled with other legislation and could reach the House floor for a vote as early as next week. (Devex)
  • More proposed cuts at the Department of Health and Human Services (HHS) spell further trouble for global health. The budget would eliminate funding for the NIH’s Fogarty International Center, which trains U.S. and international scientists in low- and middle-income countries, and for the CDC’s Global Health Center, which plays a critical role in tracking and responding to global outbreaks. The Global Health Center is also central to PEPFAR implementation—about 30% of PEPFAR’s programming, over $1 billion, flows through HHS. If the Center disappears, the future of PEPFAR’s reach and effectiveness is deeply uncertain. (Devex)

Gates Foundation to Double Spending

  • In a glimmer of good news, last week, Bill Gates pledged to double the Gates Foundation’s spending to $200 billion over the next 20 years, until it closes its doors in 2045. (NYTimes)

USAID and State Department Reorganization

  • In just 100 days, the Trump administration has effectively dismantled USAID — eliminating over 85% of its programs, gutting most of its 10,000-person workforce, and setting plans in motion to fold its remnants into a dramatically downsized and restructuring State Department.
  • On April 17, the administration extended the foreign aid review for another 30 days from the original deadline of April 20, 2025. Additionally, the Department of Government Efficiency (DOGE), is now demanding detailed justifications before reimbursing aid organizations. The delays are further disrupting global health and development programs, creating uncertainty for nonprofits relying on U.S. funding. (KFF) (Devex)
  • On April 22, Secretary Rubio announced the Department of State’s reorganization plan and new organization chart. The plan states that it would consolidate functions and remove non-statutory programs that are “misaligned with America’s core national interests.” While initially created through Executive Order in 1961 as part of the State Department, the Foreign Affairs Reform and Restructuring Act of 1998 established it as an independent agency within the executive branch. As such, the Executive branch does not have authority to dissolve it without Congress, and Congress also requires notification first as well as consultation on any proposed changes. (KFF)

Scientific Research: NIH and NSF

  • “It is almost certainly the most consequential 100 days that scientists in the United States have experienced since the end of World War II,” wrote David Malakoff and Jeffrey Brainard of Science. “Many fear that in just 14 weeks, Trump has irreversibly damaged a scientific enterprise that took many decades to build, and has long made the U.S. the envy of the world.” New grant funding has decreased by 53% on average across four agencies. (Science)
  • The Trump administration’s sweeping NIH cuts have led to the cancellation of $1.8 billion in research grants, severely disrupting global health research, including vaccine development, disease surveillance, and health equity initiatives — undermining the very infrastructure needed to respond to future health threats. (STAT) In California alone, Trump administration officials have terminated at least $296 million in NIH grants and $16 million in NSF grants. (SFChronicle)
  • NIH also will begin prohibiting the awarding of new grants to any institutions that have DEI programs or boycott Israeli companies, in an escalation of the Trump administration’s use of research funding as leverage to dismantle activities at universities that it deems discriminatory or antisemitic. (STAT)
  • The Trump administration has proposed slashing the National Science Foundation’s (NSF) budget by more than half — $4.7 billion. NSF already halted all new and existing grant funding and terminated over a thousand previously approved awards. The cuts come as NSF Director Sethuraman Panchanathan abruptly resigned earlier this month, citing he had done “all I can.” (NPR) NSF has also canceled research grants related to misinformation and disinformation. (NeimanLab)
  • Grant Tracker provides open source airtables of NIH Grant Terminations in 2025 and NSF Grant Terminations 2025.

WHO, WFP and UNAIDS

  • The World Health Organization (WHO) has proposed a $4.27 billion base budget for 2026–2027, a 14% cut from the current cycle, reflecting rising financial pressures and shifting global health priorities. (Devex) The WHO is undergoing a major restructuring amid deep funding cuts. Following the U.S. Executive Order on January 20 to withdraw from the WHO, the U.S. halted all financial contributions — $500M for 2025. “There is a tragic disconnect between the needs of member states being greater than ever and the WHO’s ability to deliver being lower than ever, without new resources and partnerships,” said Anil Soni, WHO Foundation CEO, at a briefing for Alliance members on May 13. 
  • Facing steep declines in donor funding amid escalating global hunger crises, the World Food Programme (WFP) plans to reduce its global workforce by up to 30% by 2026.
  • UNAIDS is also cutting its workforce by more than half and scaling back its country presence. (Devex)

 

Resources

Tracking Impact

  • A new Impact Metrics Dashboard visualizes the human impact of funding changes for aid and support organizations. The site has an impact tracker for PEPFAR, tuberculosis (TB), and Medicaid and is looking for additional collaborators. Read more. 
  • GHTC tracks how US investments in global health R&D are paying economic and health dividends in each state. (Learn more
  • Also see Center for Global Development I How Many Lives Does US Foreign Aid Save?
  • KFF has a new series of fact sheets on the status of U.S. global health programs, from maternal and child health to TB and malaria. Two quick summaries follow. 
  • PEPFAR: The U.S. foreign aid freeze and dismantling of USAID have brought PEPFAR — the world’s largest HIV/AIDS program — to a breaking point, halting services, cutting staff, and threatening decades of global health progress. A January stop-work order froze all programming, and while a limited waiver allowed some treatment to resume, most prevention and community services remain suspended. With 71% of USAID’s HIV awards canceled and the CDC facing major cuts, disruptions now span dozens of countries — from ARV stockouts to shuttered clinics and mass layoffs. The disruption also jeopardizes the rollout of long-acting injectable PrEP, a major global health innovation. Modeling estimates over 100,000 additional HIV-related deaths from a 90-day pause and up to 16 million deaths if the program ends. (KFF)
  • Global Health Security: The U.S. is rapidly dismantling its global health security infrastructure just as experts warn of a high risk of future pandemics. A stop-work order froze USAID programs, staff were let go, and funding for outbreak response was halted or delayed. With USAID dissolved, key global health activities are being absorbed into the State Department, while cuts at CDC and the Department of Defense (DoD) further erode capacity. Experts warn the fallout could mean tens of thousands of preventable infections each year and a slower, costlier response to the next global health threat. (KFF)

Advocacy and Mobilization

Navigating the Legal Questions and Resources for Workers

Sources

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For further sources, see our previous recaps here and here.