U.S. Global Health Strategies and Funding: Compounding International Crises in Health [GUEST ESSAY]
Newsletter Edition #325 [The Files In-Depth]
Hi,
In this edition, we bring you a guest essay that helps us understand the implications, and the influence of American budgetary decisions on certain aspects of global health financing.
Scholars Sam Halabi and Lawrence Gostin from Georgetown University, take us through the back alleys of the political economy of how money is allocated to global health within the legislative and executive corridors in the U.S. They call for a more robust resistance from the U.S. Congress to the America First Global Health Strategy and wholesale cuts to global health assistance.
We hope you find this piece illuminating and timely. I am most grateful to the authors for sharing their expertise and perspectives on these issues with our readership.
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I. GUEST ESSAY
U.S. Global Health Strategies and Funding: Compounding International Crises in Health
By Sam Halabi and Lawrence O. Gostin
Gostin is University Distinguished Professor, Georgetown University; Halabi is Bette Jacobs Endowed Professor, Georgetown University. Email: gostin@georgetown.edu
Each year, the US President submits his proposed budget to the US Congress, requesting spending authorizations for its priorities, sometimes by responsible ministry and sometimes just by broad classification. The legislative response, which sometimes but certainly not always gives the President what he wants, is called the “appropriations” bill.
On January 11, 2026, Representative Tom Cole of Oklahoma introduced the appropriations bill for the remainder of the fiscal year ending in September 2026 which President Trump signed into law on February 2, 2026.
What become apparent in U.S. domestic politics is that both houses of Congress want to give far more to global health causes than the Trump administration requested. The purpose of this post is to unravel a bit of the mystery of the U.S. global health (and by extension every other) legislative funding process in Congress.
We also to emphasize – perhaps warn our international friends – that even with strong Congressional desire to maintain something approaching US leadership of the past, the Trump administration has, and will have, a devastating effect on global health funding and governance.
President Trump, Health Secretary Robert F. Kennedy, Jr., and Secretary of State Marco Rubio have slashed U.S. foreign assistance for global health, devastated federal agency capacities to serve the global public good, including the Centers for Disease Control and Prevention, the National Institutes of Health, and USAID. And, of course, there was the recent withdrawal from the World Health Organization, which in itself was deeply damaging to WHO, but also legally dubious.
