Leaked State Department Budget Shows $888M Moving to US Firms While Eight Nations Lose All Health Aid

The Trump administration plans to direct $888 million (£672.2 million) into a US-focused global health innovation fund while reducing country-level allocations for eight nations to zero. The proposals emerged after internal State Department budget documents were made public on Saturday 14 November 2026.

The preliminary fiscal year 2026 report, sent to Congress in May, also outlines plans to withhold or redirect nearly all international family planning funding approved by lawmakers.

An analysis by Public Citizen, Partners In Health and PAI calculated a $1.66 billion (£1.26 billion) reduction in planned country-level health assistance compared with FY 2024.

The documents describe proposed allocations, not completed payments to private companies.

Eight Countries Face Zero Planned Health Allocations

Of 79 countries examined, 69 face lower planned health allocations than in 2024, according to the three organisations.

Eight have their allocations reduced to zero within the report's country-level Global Health Programs comparison.

They are Afghanistan, the Central African Republic, Gambia, South Africa, Somalia, Sudan, Timor-Leste and Yemen.

South Africa faces the largest reduction, at $437.1 million (£330.9 million). Tanzania and Zimbabwe follow with decreases of $137.4 million (£104 million) and $126.1 million (£95.5 million) respectively.

The changes extend to international family planning programmes.

Congress approved $607.5 million (£459.9 million) for family planning and reproductive health assistance, but the administration plans to withhold or redirect approximately $605 million (£458.5 million).

The preliminary report lists $523.95 million (£396.7 million) as 'To Be Programmed,' leaving its eventual allocation uncertain.

Another $32.5 million (£24.6 million) previously designated for the United Nations Population Fund is earmarked for alternative uses.

On 25 September, Secretary of State Marco Rubio authorised the potential redirection of up to $125 million (£94.6 million) in foreign assistance towards energy security.

The accompanying memorandum identified $48.498 million (£36.7 million) previously allocated for family planning.

Rubio cited urgent energy needs arising from supply disruptions and rising costs, particularly those attributed to Russia, China and Iran.

Advocacy groups argue the proposed changes undermine congressional spending decisions. The legality of these specific reallocations has not been established by a court.

US-Focused Innovation Fund Faces Oversight Questions

The proposed innovation fund represents a substantial increase from the $60 million (£45.4 million) set aside in FY 2025.

Its planned allocation has risen to $888 million (£672.2 million), supporting American companies working on health-related technologies.

However, the documents do not identify which businesses would receive the funding.

Public Citizen and its partners questioned how recipients would be selected and whether the government would use competitive procedures.

They warned that directing more money towards commercial innovation while cutting country-level programmes could weaken healthcare services in lower-income nations.

The State Department defended its approach when contacted by CNN.

A spokesman said the administration was reviewing foreign assistance to address critical needs within its appropriated budget and legal authority.

The department also said it was exploring American innovations to save lives more cost-effectively while working with Congress.

Representative Lois Frankel, a Florida Democrat serving on the House Appropriations Committee, criticised the family planning reductions.

She described the administration's refusal to spend congressionally appropriated funding as 'shameful and dangerous.'

The State Department did not answer CNN's specific question about how contracts would be awarded through the innovation fund.