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After a year of billions of dollars of cuts to U.S. foreign aid under the Trump administration, money for global health programs has made its way back into the government funding package moving through Congress. And it is a lot more than the administration has signaled it wants to spend. NPR's Fatma Tanis reports.
FATMA TANIS, BYLINE: Congress is allocating $50 billion for foreign aid in the spending package. It includes some military aid to Egypt and Israel and funding for initiatives aimed at supporting democracy and health programs around the world. Last year, the administration dismantled much of America's foreign aid systems and sent back billions of dollars that Congress had earmarked for foreign aid in 2025. Those moves were largely approved by a Republican-led Congress, but this bill appears to signal a change of heart, says foreign aid expert Jonathan Katz.
JONATHAN KATZ: The surprising factor is that you see Congress saying, we want to fund foreign assistance, from global health to food security to even democracy support.
TANIS: Katz is with the Brookings Institution. He worked in foreign aid during the Obama administration. He says there's been concern from both sides of the aisle over how the reduction in funding last year impacted global health and humanitarian assistance. Many people lost access to clinics and medicine and food. And, Katz says, there's fear that this reduction in American aid could also lead to the U.S. losing influence around the world.
KATZ: I think there's a bit of buyer's remorse when it comes to U.S. engagement globally - meaning the soft power withdrawal of the United States that President Trump's policies have been leading to.
TANIS: But others in the foreign aid community wanted to see a Congress that's more aligned with the administration on foreign aid. The State Department's new strategy focuses on making one-on-one deals with low-income countries, investing in their health ministries and requiring those governments to chip in too. Max Primorac is an analyst with The Heritage Foundation. He previously held senior roles at USAID and thinks Congress has allocated too much overall.
MAX PRIMORAC: It's always the problem of overfunding.
TANIS: Primorac says he approves the lack of funding in the bill for programs that support gender equality, LGBTQ issues and climate solutions, which are in line with the Trump administration's views. But, he says, there was one surprise - $9.4 billion for programs aimed at curbing diseases like HIV/AIDS, malaria and addressing maternal and child health and other issues. The global health bucket is largely similar to funding levels from previous years.
PRIMORAC: It's too much money, and keeping alive an industry, quite frankly, that has been living off of the taxpayer money for far too long.
TANIS: He says aid groups spend too much taxpayer money on overhead costs rather than actual health issues. Instead, he says, the administration's new strategy encourages self-sufficiency in low-income countries.
PRIMORAC: My concern there is that it could actually upend the reforms of this administration by creating disincentives for these African states to take more financial ownership and therefore more responsibility if they see that this money has to be spent anyway.
TANIS: The package is expected to be signed if and when it lands on the president's desk, but both Katz and Primorac agree that the administration could ask Congress to take back the funds like it did last year.
Fatma Tanis, NPR News.
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