Policy Updates

On August 13, 2025, a US court ruled that the Trump administration could continue to withhold billions of dollars in foreign assistance, clearing the way for the administration to cut already-appropriated spending for foreign assistance.

The court found that development organizations that receive government funding do not have cause to challenge the funding cuts. The decision overturned a lower court’s March 2025 order that had required the administration to continue processing foreign assistance payments, including nearly US$4 billion for global health activities through September 2025 and more than US$6 billion for HIV/AIDS programs through 2028. The new ruling noted that the administration had already paid out substantially to existing contracts since the lower court's ruling in March 2025.

The panel also ruled that under the Impoundment Control Act of 1974, only the GAO, Congress's independent watchdog, could legally challenge the president’s efforts to withhold foreign assistance funding. The Impoundment Control Act of 1974 was enacted to limit the president's power to withhold funding that has been appropriated by Congress. While the GAO has the power to sue to force the release of funds, it has not yet done so.

On August 7, 2025, the US Department of State announced a US$93 million grant to UNICEF to provide lifesaving food aid to nearly a million children suffering from malnutrition across 13 countries.

The grant will provide 11,000 metric tons of American-made RUTF for approximately 800,000 children through June 2026 in Haiti, Mali, Niger, Ethiopia, Sudan, South Sudan, Nigeria, Madagascar, Central African Republic, Democratic Republic of Congo, Djibouti, Kenya, and Chad and support the transport of an additional 1,200 metric tons of abbrRUTF for 87,000 children. However, UNICEF noted that a further two-to-three-month delay is expected before the products are delivered. UNICEF USA President and CEO Michael J. Nyenhuis welcomed the commitment, which according to a department spokesperson will draw down the entire prepositioned stock of RUTF.

The funding was authorized after months of delays and is UNICEF's first large grant for 2025 from the US. The amount is less than half of what the US government has typically allocated for this purpose. In 2024, the former USAID spent about US$200 million on similar work.

The US has historically funded roughly half of the world's supply of RUTF, and the US funding freeze in early 2025 severely disrupted the global supply chain of nutrition commodities. US funds for 2025 still have not yet been released to manufacturers, the WFP, transporters, or many organizations that operate malnutrition programs. In Nigeria, the WFP has had to shut down 150 clinics, and other assistance organizations reported similar clinic closures and dangerously low supplies across Africa and Asia that put thousands of children's lives in immediate danger.

On August 1, 2025, the French health ministry stated it could not legally intervene to stop the planned destruction of US$10 million in contraceptives held in Belgium, which were purchased by the USAID under former President Joe Biden and set to be destroyed by the administration of President Donald Trump, despite strong public outcry to intervene.

The US decision sparked criticism in France, with rights groups and left-wing politicians urging their government to halt the plan. France's health ministry, however, stated it had no legal basis to seize the products, as the products are not drugs of major therapeutic interest and no supply shortage exists in France. Multiple organizations, including MSI Reproductive Choices, offered to purchase the contraceptives at no cost to the US government, but their offers were rejected.

The contraceptives, mostly long-acting products like IUDs and birth control implants, were intended for countries in SSA and stored in Geel, Belgium. A US State Department spokesperson stated the decision to incinerate the unexpired products was based on the Mexico City Policy. The policy, reinstated in early 2025 by the Trump administration, prohibits providing assistance to NGOs that perform or promote abortions, though none of the products held in Belgium align with that description. The destruction was estimated by the US State Department to cost US$167,000.

On July 23, 2025, the US House Appropriations Committee advanced a US$46.2 billion 2026 spending bill for the State Department and foreign assistance, a 22% decrease from 2025 but significantly more than requested by US President Donald Trump.

The bill, advanced on a party-line vote, cuts over US$5.5 billion from economic development and global health programs and nearly US$4 billion from international organizations, reflecting some of the administration's priorities.

However, the legislation defied Trump's wishes for more drastic cuts by salvaging key programs. It provides more than four times the requested funding for international broadcasting and restores funding for programs the administration sought to eliminate, including anti-tropical disease initiatives, nutrition support, and Gavi. Funding for PEPFAR was set at over US$6.2 billion, more than double the administration's request.

Despite restoring this funding, the bill also included a measure to increase the executive branch's power to cancel congressionally approved spending by removing standard language that protects congressionally approved funds. The move drew sharp criticism from Democrats, who warned that the steep reductions in foreign assistance would allow countries such as China and Russia to increase their global influence.

Following the committee's approval, the bill will advance to the full House of Representatives for a vote. To become law, it must also pass the Senate and be signed by the president. The Senate will likely advance its own version, and differences would need to be reconciled before a final vote in both chambers.

On July 22, 2025, the US announced its decision to withdraw from UNESCO, citing concerns over the agency's perceived anti-Israel bias and promotion of divisive causes.

The US State Department stated the withdrawal, effective December 2026, was due to UNESCO's agenda and its admission of Palestine as a member state. This marks the third time the US has left the agency, having last rejoined in 2023 after a 2018 departure under the previous Trump administration. The US first left in 1984 due to security concerns around the Soviet Union before rejoining in 2003.

Alongside its cultural programming, UNESCO supports a number of education, SRHR education, literacy, clean water, and gender equality initiatives. It also helps set standards for ocean protection and AI ethics and protect cultural heritage and education in conflict zones.

UNESCO’s Director-General Audrey Azoulay noted her regret over the decision but stated it was anticipated. She denied the accusations of anti-Israel bias, pointing to the agency's work on Holocaust education and fighting antisemitism. Azoulay noted that the reasons cited by the US were the same as cited in the previous departure, despite significant changes and reduced political tensions within the organization.

The withdrawal will impact UNESCO's budget, as the US contributes 8% of its funding. However, the agency has diversified its funding sources and stated that it does not anticipate any immediate staff layoffs.

On June 25, 2025, US Secretary of Health and Human Services Robert F. Kennedy Jr. announced via video at Gavi’s pledging conference in Brussels that the US will halt contributions to Gavi until the organization re-earns public trust.

The US previously pledged at least US$1.6 billion to support Gavi from 2026 to 2030, which is now uncertain. The US is one of Gavi’s six founding donors and has contributed US$3.9 billion since 2001, plus US$4 billion to COVAX, making up around 13% of Gavi’s funding.

The Trump administration’s 2026 budget request excludes Gavi funding, citing the organization’s US$7 billion reserve, however, Congress, not the administration, ultimately decides funding for Gavi. Congress did approve US$300 million for 2025, which the administration has proposed to rescind.

Critics argue that ending US support would reverse gains in global vaccination, put millions of children at risk, and damage US credibility in global health. Gavi estimates that without US funding, 75 million children may miss vaccinations and 1.2 million children could die over five years. Gavi has faced shortfalls in its US$11.9 billion budget target for 2026–2030, only securing US$9 billion in pledges at the replenishment event.

On June 3, 2025, the US Congress received a US$9.4 billion rescission request to claw back previously approved funding, with US$8.3 billion to be cut from the State Department and USAID.

The request is the first of several expected before the end of the discal year. The package includes funds already targeted by DOGE. If Congress passes the package, which requires only a simply majority, the cuts will become law.

Assistance to Europe, Eurasia, and Central Asia would be eliminated entirely. Other notable cuts included:

• US$1.7 billion cut from the Economic Support Fund, nearly half of its approved funding for 2025;
• US$500 million cut from USAID programs for MCH, HIV/AIDS, and infectious diseases;
• US$437 million cut from voluntary contributions to UN agencies, including UNICEF, UNDP, and UN Population Fund;
• US$400 million cut from the State Department's global health programs for HIV/AIDS;
• US$496 million cut from USAID's international disaster assistance fund;
• US$200 million cut from assessed contributions to the Contributions to International Organizations account, impacting UN organizations;
• US$83 million cut from the Democracy Fund's appropriated budget of US$345 million;
• US$57 million cut from the Transition Initiatives account from its appropriated budget of US$75 million; and
• US$27 million cut from the Inter-American Foundation and US$22 million from the US African Development Foundation, both around half of their respective budgets.

Congress controls the federal budget, approving annual funding for government operations, with the president needing congressional consent to defer or withhold funds. The rescinded funds can then be redirected or returned to the Treasury. Congressional committees have 25 days to review the request. After committee approval, the package moves to the House and Senate for expedited votes, where Congress has 45 days to act on the request.

The Congressional Budget Office estimates the US government is on track to spend ~US$7 trillion in 2025, with the rescission request equivalent to 0.1% of government spending.

On May 30, 2025, officials from the US government announced the termination of a US$258 million program for HIV vaccine research at Duke University and the Scripps Research Institute.

A senior agency official stated that NIH leadership reviewed the consortia for HIV/AIDS vaccine development and immunology and decided not to support its continuation, stating that it will focus on using existing approaches to battle HIV/AIDS.

While ongoing clinical trials based on the work may continue, ending the programs indicates that no new candidates will enter trials in the future.

Public health experts have criticized that the cuts will hinder progress against HIV. Since 2010, new HIV infections have decreased steadily, but in 2023, the WHO still reported 1.3 million new cases, of which 120,000 were found in children.

On May 20, 2025, at the Qatar Economic Forum, US government advisor Elon Musk responded to estimates from UNAIDS predicting that the discontinuation of PEPFAR could result in 4 million additional AIDS-related deaths by stating he would ‘fix’ the crisis stemming from the withdrawal of US funding for HIV/AIDS services.

Musk, who implemented significant cuts to USAID under DOGE, previously stated when pressed that that useful parts of USAID had been transferred to the State Department. UNAIDS published a positive reaction to Musk's assertion and emphasized the urgent need to resume funding for global HIV/AIDS prevention and treatment services.

Many HIV/AIDS prevention programs supported by PEPFAR have not resumed operations, despite a limited waiver for some testing and treatment efforts focused on pregnant or breastfeeding women to continue.

On May 20, 2025, US Secretary of Health and Human Services Robert Kennedy Jr. criticized the WHO and asserted that it was unfit to lead global health cooperation in a video address shown at the 78^th WHA.

Kennedy asserted that the WHO has not addressed its COVID-19 failures or made significant reforms to its bureaucratic structure. He also criticized the agency's recently adopted pandemic agreement, reiterating the US will not participate. He acknowledged the WHO's historic role in smallpox eradication but claimed its priorities now reflect corporate medicine biases and political agendas, including promoting harmful ‘gender ideology.’

Kennedy urged national health ministers to join the US in a "new era of cooperation." The US did not send an official delegation to the WHA and withdrew from the WHO in January 2025.