Trump administration diverts billions in health funding from low-income countries, defying Congress

The Trump administration plans to redirect or withhold nearly all of the $605 million Congress allocated for international family planning aid this year, according to an internal US State Department budget report and a memo to lawmakers obtained by CNN. The move represents one of the most significant reductions in US global health spending in decades and marks a sharp break from decades of bipartisan support for international family planning programs.

The diversion: $605 million at stake

The preliminary Fiscal Year 2026 allocation report — called the Section 653(a) Allocation Report — reveals plans to redirect or repurpose almost all of the funding Congress had allocated to supply contraception and other reproductive health services to women overseas.

The budget plans also involve moving nearly a billion dollars into a global health innovation fund benefiting US corporations, while sharply cutting global health funding for low- and middle-income countries.

Tens of millions of the family planning funding are being diverted to support the “energy security needs” of US partners facing market disruptions amid the wars in Iran and Ukraine, according to a September memo signed by Secretary of State Marco Rubio. The memo offered few additional details on how that money would be spent.

Countries hit hardest: Eight nations at zero funding

Eight countries have had their health funding cut to zero since 2024: Afghanistan, Central African Republic, Gambia, South Africa, Somalia, Sudan, Timor-Leste, and Yemen. South Africa, Tanzania, and Zimbabwe each face more than $100 million in cuts to their health programs. These countries include some of the world’s most vulnerable populations. South Africa has the largest HIV treatment program globally. Yemen faces one of the world’s worst humanitarian crises. Sudan is in the midst of a devastating civil war. Somalia faces famine conditions.

Congressional backlash and legal challenge

The actions have drawn sharp criticism from nonprofit organizations and lawmakers who argue the administration is overstepping its authority. Under the US Constitution, Congress holds the power of the purse — the authority to decide how taxpayer money is spent.

Congresswoman Lois Frankel (D-FL), who serves on the House Appropriations Committee, said:

“The Trump administration’s refusal to spend Congressionally-appropriated funds for international family planning, as required by law, is shameful and dangerous. These decisions have real, life-changing consequences for women’s health around the world.”

Vincent Lin, associate director of health policy and advocacy at Partners In Health, told CNN:

“To see dollars that have been fought for and written into the law by Congress moved away or siphoned away to energy security needs, or to US private companies with a profit margin, or out of really important public health programs … I think it is devastating to see that happen. This is the clearest situation of the executive branch ignoring and or violating Congressional will.”

Public Citizen, a nonprofit consumer advocacy organization, has sued the State Department in an effort to force the release of records surrounding bilateral global health agreements. The lawsuit — Public Citizen v. Department of State — is ongoing in federal court, though some documents have been released following Freedom of Information Act requests by watchdog groups.

Human impact: 34,000 maternal deaths prevented in 2024 alone

In fiscal year 2024 — before Trump came back to office — US investment in global family planning is estimated to have prevented 34,000 maternal deaths, according to the Guttmacher Institute. The funding also prevented millions of unintended pregnancies and improved babies’ health and family incomes across the developing world.

For decades, US family planning aid has provided millions of women overseas with modern contraceptives, giving them the ability to prevent or space out pregnancies. Research shows this improves maternal mortality rates, family incomes, and babies’ health.

Public Citizen’s analysis of the leaked budget document — conducted in conjunction with Partners In Health (PIH) and PAI, a reproductive rights advocacy organization — found steep reductions in US health assistance for most countries when compared to 2024 funding levels.

Broader context: A pattern of health funding cuts

The Trump administration’s diversion of family planning funds is part of a broader pattern. Since returning to office, the administration has made several efforts to assume more control over US global health funding and make spending reductions. The administration previously redirected $1.35 billion in global health funding to cover the cost of closing the US Agency for International Development (USAID). There have been multiple efforts to stop transferring certain funds to the Centers for Disease Control. Previous reporting has covered the redirection of global health programs to cover USAID closure costs. Many of those changes have lacked public announcements or transparency, according to CNN reporting.

What happens next

The State Department has defended the moves, with a spokesman telling CNN that “the administration is consistently evaluating the use of foreign assistance to ensure it is used to meet critical needs, including unanticipated contingencies such as the current global energy crisis, within the context of its annual appropriated budget and the authorities available to the president and the secretary.”

On family planning specifically, the spokesman said: “Our focus is on implementing life-saving care, including in HIV/AIDS, tuberculosis, malaria, and maternal and child health, through new, landmark bilateral global health MOUs (memoranda of understanding).”

However, the administration’s refusal to spend Congressionally-appropriated funds sets up a potential constitutional confrontation between the executive and legislative branches. With Public Citizen’s lawsuit ongoing and congressional Democrats vowing to fight the cuts, the fate of the $605 million remains uncertain.

The countries affected — particularly South Africa, Somalia, Sudan, and Yemen — face immediate gaps in maternal health, HIV treatment, and basic healthcare services as the funding cuts take effect.

This is a developing story and will be updated as the State Department, Congress, and the courts respond to the funding diversion.