The Trump administration is trying to divert $2 billion in global health funding to pay for USAID shutdown

By Lauren Kent, CNN

(CNN) — The Trump administration plans to redirect $2 billion in funding intended for global health programs to cover the cost of closing the US Agency for International Development (USAID), according to a copy of the notification obtained by CNN.

The funds would be pulled from money that Congress appropriated for health programs tackling malaria, tuberculosis, maternal and child health, nutrition, global health security, HIV/AIDS and more, two federal health policy experts told CNN. Roughly $1.2 billion originally intended for foreign development assistance would also be redirected.

Instead, the administration aims to use those billions to pay for things like legal costs, pending invoices and asset sales in the wake of its abrupt dismantling of USAID.

Last year, the Trump administration temporarily froze nearly all foreign aid and canceled thousands of aid work contracts, as it dismantled USAID and folded the few remaining programs under the State Department.

In total, the US government told Congress that it has reserved more than $19.1 billion to pay for USAID closeout costs, most of which is money coming from previously terminated USAID contracts, according to the notification obtained by CNN that was sent on April 20. The notification to Congress was first reported by Devex.

A group of 17 Senate Democrats is demanding that the administration reverse the budget notification “and put the funds to their intended use to save lives and advance U.S. interests as directed by Congress last year.”

“The Administration should immediately begin using these foreign assistance funds to deliver results for the American people. There is no reason for this FY25 funding to be withheld to cover the wasteful costs this Administration has incurred because it chose to dismantle USAID,” the senators argued in a letter to Secretary of State Marco Rubio, Director of the Office of Management and Budget (OMB) Russell Vought and acting USAID administrator Eric Ueland.

CNN reached out to the State Department and OMB for comment on the proposal to redirect the funds. A State Department spokesperson confirmed receiving CNN’s questions but did not respond to them.

Redirecting funding meant for global health programs could result in tens of thousands of people dying and thousands getting sick, health policy experts told CNN.

A $2 billion reduction in funding could lead to an estimated 121,000 preventable deaths from tuberculosis, and at least 47,600 preventable deaths from malaria, according to analysis by the Health Security Policy Academy think tank, based on the current allocation plan for the money. And those are just two of the many program areas that would face effective cuts.

The effective funding cut to nutrition programs could lead to the loss of lifesaving nutrition for 22.9 million children under the age of 5 and of safe childbirth facilities for more than 5.7 million women, one source who crunched the numbers told CNN.

The redirection of funding comes after a year of deep cuts to global humanitarian aid by the United States and other donor countries. A study published in The Lancet journal in February found that previous global aid cuts could lead to at least 9.4 million additional deaths by 2030, if the current trend of funding reductions continues.

Withholding $1.7 billion in HIV program funding

The administration is also underspending money that Congress has already approved for the US flagship HIV/AIDS program, health policy analysts say – to the tune of roughly $1.7 billion.

The HIV program, called the President’s Emergency Plan for AIDS Relief (PEPFAR), was established by the Bush administration in 2003, and is credited with saving more than 26 million lives and preventing millions of infections, mostly in Africa.

The budgeting process for PEPFAR funding is complex – Congress gives a five-year window for much of the money to be spent, but analysts say that the current rate of spending on the program is way behind compared to previous years. One source called it “money that’s being held in an unprecedented way.”

Budget documents show that at the end of last fiscal year in September, the program had an estimated $976.5 million in unspent balances from the funding approved by Congress the previous year (FY 2024). A further $700 million intended for the branch of PEPFAR implemented by the US Centers for Disease Control has yet to be transferred to the CDC, health policy analyst sources told CNN.

Budget analysts, as well as advocates for preserving these global health programs, have raised concerns that the Trump administration will seek to rescind the money currently sitting in those accounts or simply hold it until the end of their administration.

CNN reached out to the State Department for comment on the HIV/AIDS program underspend.

It comes as figures were just published on how the HIV/AIDS program is doing, which showed that the number of people on antiretroviral treatment for HIV has remained roughly constant – a result that State Department senior official Jeremy Lewin said was “very, very good.”

But health policy experts raised alarm bells over a steep decline in the number of people being tested for HIV, as well as a reduction in people diagnosed and newly enrolled in treatment.

The number of PEPFAR-funded HIV tests declined by 14 million in 2025 compared to the year before – a 17% decrease – according to analysis of the data by amfAR, the Foundation for AIDS Research.

“When you see the number of people being tested going down… it suggests that people are being missed. They’re not being diagnosed,” said Jennifer Kates, director of global and public health policy at KFF, who argued the overall PEPFAR results appear mixed.

“That would be consistent with the disruptions that happened last year,” Kates said, referring to the Trump administration’s aid freeze in 2025 and terminations of many grants. She added that the decline in HIV testing is also consistent with the administration placing more emphasis on HIV/AIDS treatment and less on prevention.

“All the evidence we have points to serious drop-offs in coverage in sort of January through the middle of the last year, and that will have made people sick,” said Charles Kenny, a senior fellow at the Center for Global Development think tank. “Some people will have dropped off permanently from getting meds.”

Kenny and other analysts also raised concerns that nearly 70,000 community healthcare workers were laid off last year, according to the PEPFAR data release, and many specialized outreach services were shut down.

“Those who will suffer most from that are the hardest to reach. So: men having sex with men, adolescent girls, pregnant women, and especially young pregnancies, drug users – those groups are going to be ones where outreach is stopping, and it’s likely the infection rates will go up,” Kenny said. Experts say those groups are less likely to pursue testing and treatment at government-run health clinics.

Dawie Nel, the director of OUT, a South African LGBTQ+ organization, said that it has already seen hundreds of HIV patients drop out of care following the closure of one of its USAID-backed healthcare programs last year.

“You can see it in the numbers that we can’t get back into care, that trust is already lost,” Nel said. “It’s quite a bleak sort of picture.”

Cutting community healthcare workers also has implications for future preparedness for other pandemics, experts have warned.

Brian Honermann, deputy director of public policy at amfAR, warned that epidemic control for HIV is “fragile and progress can erode quickly when the systems falter.” He added that the “destructions of data systems… raises the real risk that such HIV resurgence will go unnoticed and undiagnosed.”

That concern has been echoed by other experts, as the Trump administration never released official Q1-Q3 data on the HIV/AIDS program last year.

“Funding from PEPFAR being taken away will kill people,” said Asia Russell, the executive director of the advocacy group Health Gap. “What they (the administration) are doing now is pulling a veil of secrecy over their actions, refusing to invest in technologies that save lives, and putting the burden on the countries themselves. And saying, ‘Good luck, goodbye.’”

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