House Appropriations Committee Releases FY 2027 National Security, Department of State and Related Programs (NSRP) Appropriations Bill

Note: This resource was originally published on April 27, 2026 and has been updated to reflect additional information.

The House Appropriations Committee released its Fiscal Year 2027 appropriations bill on April 22, 2026 and accompanying report on April 27, 2026. The bill and report include discretionary funding for U.S. global health programs at the State Department as follows:

Global Health Programs (GHP) account: The main account that supports global health programs totals $8.9 billion in the bill, $532 million below the FY 2026 amount ($9.4 billion) and $3.8 billion above the President’s FY 2027 budget request ($5.1 billion). The bill provides two envelopes of funding: 1) President’s Emergency Plan for AIDS Relief (PEPFAR) and Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), which includes funding historically provided to the State Department, and 2) other global health activities, which includes funding historically provided to USAID.
- PEPFAR/Global Fund: The bill provides $5.53 billion to PEPFAR, which includes:
  - Bilateral HIV: The bill provides $4.28 billion for bilateral HIV programs, $350 million (-8%) below the FY 2026 enacted level ($4.63 billion).¹ Bilateral HIV is the only area that decreased among those where specific amounts are provided compared to the FY 2026 enacted level (the FY 2027 President’s budget request did not provide a specific amount to bilateral HIV or other program areas, as it proposed to “eliminate disease-specific accounts.” See the KFF summary of the FY 2027 President’s budget request here).
  - Global Fund: The bill specifies that the U.S. contribution for the Global Fund “shall be” $1.25 billion, flat compared to the FY 2026 enacted level (the FY 2027 request did not specify an amount for the Global Fund).
- Other global health activities: The bill also provides $3.35 billion for other global health activities, including HIV, TB, malaria, MCH, polio, nutrition, family planning and reproductive health (FP/RH), NTDs, and global health security through the GHP account (see the table for details). The explanatory report accompanying the bill provides specific funding amounts to all program areas except for FP/RH (see below) and global health security. After accounting for the amounts specified in the report, $957.6 million in unspecified funding remains. It is possible that this amount could be provided to FP/RH, global health security, or other activities.
  - Family Planning and Reproductive Health (FP/RH): The bill states that “not more than” $461 million “may be made available” for FP/RH. If the full $461 million is provided for FP/RH, this would represent a $114 million (-20%) decline compared to the FY 2026 enacted level of “not less than” $575 million from all bilateral accounts (the FY 2027 request eliminated funding for FP/RH).
  - Global Health Security (GHS): The bill and report did not provide a specific amount for GHS programs. It is possible that some or all of the remaining $957.6 million in unspecified GHP account funding may be provided for GHS activities. In FY 2026, $615.6 million was provided for GHS (the FY 2027 request did not provide a specific amount for GHS).
  - All other program areas: Funding for all other specified global health program areas is flat compared to the FY 2026 enacted amount (the FY 2027 request did not provide specific amounts to these program areas).
Eliminated funding: The bill eliminates funding for the United Nations Population Fund (UNFPA),World Health Organization (WHO), and Pan American Health Organization (PAHO) (see the KFF UNFPA Funding and Kemp-Kasten explainer here and the KFF WHO fact sheet here).
Policy Provisions:
- Period of availability: All funding under the GHP account is for 3 years (until September 30, 2029), with the exception of Gavi, which is for 1 year (until September 30, 3027). Historically, funding has been available for 5 years for PEPFAR and the Global Fund funding provided to State and for 2 years for other funding.
- Promoting Human Flourishing in Foreign Assistance (PHFFA): The bill codifies all three rules of the PHFFA policy (see the KFF Mexico City Policy explainer here).