April 14, 2026
Sustaining progress against AIDS, tuberculosis and malaria as countries transition to growing self-reliance: The crucial role for Congress in protecting a lifesaving legacy
American leadership to combat AIDS, tuberculosis (TB) and malaria has saved tens of millions of lives, improving the future for communities worldwide while advancing U.S. interests and reputation abroad. The Administration’s America First Global Health Strategy, released in September 2025, seeks to transition leadership on health, including the three epidemics, to partner countries, steadily reducing U.S. investments as partners invest more. We want aid transition to be successful.
Significant U.S. funding cuts and ambitious co-financing targets included in bilateral agreements to implement the Strategy pose risk for many countries’ efforts against AIDS, TB and malaria.
Our new issue brief examines the challenges and opportunities in the shift from donor to national financing in the fight against AIDS, TB and malaria. It identifies opportunities to scale new game changing technologies; engage partners in the private sector, faith communities and civil society; and utilize the Global Fund as a continued driver of successful transition.
The stakes could not be higher.
Successful transitions will put governments and communities in the lead and continue progress towards ending the three epidemics as public health threats.
Failed transitions will result in epidemic resurgence, unnecessary death and suffering, and the squandering of decades of U.S. leadership and investment.
Our recommendations for Congress include:
- Ensure all current and past appropriated support for AIDS, TB and malaria are obligated, spent and utilized for global health as Congress has specified.
- Track newly created global health funds closely.
- Maintain appropriations as transition financing, services and outcomes are monitored
- Require a formal midpoint review of the implementation of the strategy in 2027. Track early warning markers of program success or backsliding.
- Protect vulnerable populations.
- Don’t withhold health services for unrelated interests.
- Ensure multistakeholder engagement.
- Include detailed oversight language for malaria and TB programs in FY27 appropriations legislation, like that for HIV in the FY26 Consolidated Appropriations bill.
- Require transparency and verified data systems. Require MOUs and transition plans be public and preserve data-driven programming. Ensure quality data systems are in place.
- Protect procurement and supply chain management.