The latest from Washington:
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Fiscal year 2026 funding negotiations
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A new NIH mechanism related to foreign research collaborations
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U.S. departure from WHO
January 27, 2026 – Last week, the American Society of Tropical Medicine and Hygiene (ASTMH) issued a
statement publicly thanking the United States Congress for its continued bipartisan support of federal agencies and programs advancing biomedical research, public health and global health as lawmakers finalize the Fiscal Year (FY) 2026 appropriations process.
ASTMH remains actively engaged in Washington, DC, tracking developments and advocating for sustained investments that protect health in the United States and globally. Here is a recap of key policy movements in Washington, DC last week:
► FY 2026 Labor–Health and Human Services Appropriations:
► FY2026 National Security, Department of State, and Related Programs
► FY2026 Department of Defense
► NIH Releases New Mechanism for International Research Collaboration
► U.S. Completes Withdrawal from WHO
FY 2026 Labor–Health and Human Services Appropriations: Congressional Intent
The Committee on Appropriations released its FY 2026 Labor, Health and Human Services, Education, and Related Agencies (Labor HHS) conference bill and accompanying report on January 20. The agreement reinforces:
- Full inclusion of all authorized programs, projects, and activities in agency operating plans;
- Limits on reprogramming and reorganization absent Congressional approval;
- Timely publication and execution of competitive grant programs;
- Prompt responses to Questions for the Record; and
- Robust oversight of grant management, reporting, and budget transparency.
ASTMH views these provisions as critical to program stability, accountability, and the effective execution of federally funded research and global health activities.
From a funding perspective, here is a summary of key FY26 Health and Human Services funding outcomes related to global health and infectious diseases:
Centers for Disease Control and Prevention (CDC)
- Parasitic Disease and Malaria Program: $29 million (level-funded; ASTMH request met)
- Global HIV/AIDS: $129 million (level funded)
- Global Tuberculosis: $12 million (level funded)
- Measles and Other Vaccine-Preventable Diseases: $50 million (level funded)
- Global Public Health Protection: $293 million (level funded)
- Vector-Borne Diseases: $65 million (+$1 million)
- Advanced Molecular Detection: $43 million (+$3 million)
National Institutes of Health (NIH)
- Fogarty International Center: $95.16 million (level-funded, despite a $0 President’s Budget request)
- NIAID: $6.585 billion (Senate level; modest increase over FY25)
- Antimicrobial Resistance: Not less than $565 million
- Antiviral Drug Discovery Centers: $8 million
- ARPA-H: $1.5 billion (level funded)
The agreement also includes strong directive language on indirect cost recovery, NIH leadership and governance, and limits on multi-year grant obligations to protect application success rates and support new, meritorious awards.
- Multi-Year Funding -The agreement proposes to continue a fiscal year 2025 policy requiring NIH to reserve half of the agency's budget allocation for competing Research Project Grants (RPGs) for awards that fully fund their outyear commitments as part of the initial grant obligation. The agreement notes strong concern about the impact of this policy on application success rates and the consequent reduction in the number of grants NIH can fund; including on the impact for institutions who receive only a few NIH grants. The agreement includes a general provision to limit the amount of funds that can be obligated for awards that fully fund out-year commitments and directs NIH to fund as many new awards as possible based on meritorious applications. The agreement urges Institutes and Centers that receive funding increases in fiscal year 2026 to obligate additional funds to support new and competing research project grants. The agreement directs NIH to submit the report under this heading in Senate Report 119-55. Additionally, NIH is directed to 42 provide the Committees with an analysis of the types of research funded by this model in fiscal year 2025, and the selection criteria to identify grants to be funded by the multi-year approach. Throughout fiscal year 2026, NIH is directed to brief the Committees no less than monthly on the status of grant announcements, applications, awards, continuations, terminations or cancelations. Such briefing shall include a report on grant awards by Institute or Center that fund more than the current year of performance.
- Indirect Cost Update: The conferenced language prohibits the administration’s attempts to implement blanket changes to indirect cost rates. The agreement recognizes that indirect cost recovery has been essential for supporting research at universities, nonprofit laboratories, medical centers and other entities eligible for Federal research awards and is key to sustaining U.S. leadership in scientific research and technological innovation. The agreement acknowledges that there is room for improvement in the system used to identify and recover indirect cost rates under the Uniform Grant Guidance, particularly with respect to the need for greater transparency into these costs. Various models have been suggested to achieve these improvements, including the Financial Accountability in Research (FAIR) model advanced by the Joint Associations Group on Indirect Costs (JAG), which the Committees believe merit further consideration. Therefore, the agreement directs the departments and agencies funded in the Act to engage in discussions with the Committees on proposals to achieve these improvements, including on the FAIR model. Under this agreement, neither NIH, nor any other department or agency, may develop or implement any policy, guidance, or rule, including publication of a notice of proposed rulemaking, that would alter the manner in which negotiated indirect cost rates have been implemented and applied under NIH regulations, as those regulations were in effect during the third quarter of fiscal year 2017.
- On grant terminations and grant management - The Joint Explanatory Statement notes grant terminations can significantly and negatively impact the implementation of programs funded in this Act, as they are intended to be implemented by this agreement. HHS is directed to consult with the Committees prior to terminating grants. The agreement includes a provision requiring notification to the Committees no less than three days prior to announcing or providing notice of a grant termination.
FY2026 National Security, Department of State, and Related Programs
- Malaria - $795 million (level funded)
- Neglected Tropical Diseases - $108.8 million (cut of $5.7 million)
- Maternal and Child Health - $915 million (includes $300 million for GAVI) GAVI Alliance.-The agreement includes $300,000,000 for a contribution to The GAVI Alliance for the sixth strategic period and encourages other donors to increase their contributions.
- Global Health Security: The agreement includes funds for a United States contribution to the Pandemic Fund and funds for a United States contribution to the Coalition for Epidemic Preparedness Innovations.
- Global Fund to Fight AIDS, Tuberculosis, and Malaria.-The agreement supports the Administration's pledge of $4,600,000,000 for the eighth replenishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund).
- Other Global Health Issues
- Drug Resistant Forms of Infectious Diseases - The Secretary of State shall brief the Committees on Appropriations not later than 90 days after the date of enactment of the Act on the scale and potential health security impacts of drug-resistant infectious diseases overseas.
- Innovation Fund - The Secretary of State shall brief the Committees on Appropriations not later than 60 days after the date of enactment of the Act on planned efforts to support an Innovation Fund and related health investments, including efforts to ensure partnership with both private companies and non-profit organizations.
- Prevention - The agreement includes funding to support HIV prevention activities, including to scale-up the use of long-acting injectable antiretrovirals, to reduce HIV transmission in vulnerable populations. The Secretary of State shall rapidly rollout this intervention through the Global Fund and bilateral programs and prioritize these technologies in high-burden countries to stem new HIV infections, particularly among those most at risk, including young women, adolescent girls, and orphans, and enable a more rapid and effective transition toward country-led ownership of the HIV response.
- Transfers - To achieve the goals set forth in the September 2025 America First Global Health Strategy, the agreement supports continued transfer of funding and collaboration between the Centers for Disease Control and Prevention and the Department of State, to support functions related to key areas of collaboration, including: surveillance; laboratory, data, and health information technology systems; clinical service delivery for programs; and outbreak prevention, detection, and response.
FY2026 Department of Defense
The House and Senate’s conferenced Defense
bill and
JES were also released and the House passed the conference Defense bill last Thursday night. Key funding details for FY26 include:
- Total Unified Medical Budget: The FY26 budget request for the MHS reached $64.0 billion, a 4.1% ($2.5 billion) increase over the FY25 appropriation.
- Defense Health Program (DHP): The DHP account, which funds most Defense Health Agency (DHA) functions, was requested at $40.5 billion, a marginal 0.2% ($0.1 billion) increase above FY25 enacted levels. The final conferenced defense bill provided $41.8 billion for defense health programs.
- Medical Research: The final bill provided over $2 billion for defense medical research, including $897 million for the Congressionally Directed Medical Research Program (CDMRP), representing a rejection of earlier proposed cuts.
If the conferenced bills pass in the House and Senate over the coming days, and the President signs them into law, the U.S. will avert a partial government shutdown on January 30. As of January 26 when this was written, there were increasing concerns about passage due to renewed pushback from Democrats over funding to the Department of Homeland Security after a second ICE-related death in Minnesota over the weekend, a logistical challenge to reconvene the Senate amid severe weather in Washington, DC, and the House in recess until February 2.
NIH Releases New Mechanism for International Research Collaboration
ASTMH welcomes NIH’s long-anticipated release of a new grant mechanism for research involving foreign collaborators, now posted on Grants.gov (Opportunity ID 360581). This new structure replaces traditional foreign subawards with linked, transparent awards for domestic and foreign partners, aiming to strengthen accountability while preserving international scientific collaboration. There are many questions about the operationalization of this mechanism will work and ASTMH is working closely with partners to seek more information and clarify from NIH leadership.
U.S. Completes withdrawal from the WHO
On January 22, 2026, the United States formally completed its withdrawal from the World Health Organization (WHO), becoming the first nation to exit the UN health agency since its founding in 1948. Initiated by President Trump’s Executive Order 14155, the departure follows a one-year notice period and is driven by administration criticisms regarding the WHO's handling of the COVID-19 pandemic, a perceived lack of independence, and unfair financial burdens placed on U.S. taxpayers. The move means the immediate termination of all U.S. funding—which historically constituted roughly 15-20% of the WHO's budget—along with the recall of personnel and suspension of participation in WHO-led committees and technical working groups. ASTMH remains gravely concerned this move will hamper international pandemic preparedness, reduce global surveillance capacity, and limit U.S. access to real-time health data.
We will continue to closely track policy developments and actively engage with policymakers and federal agencies to advance a strong, effective U.S. research enterprise that supports health worldwide.