Prevent Catastrophic Deaths: Restore U.S. Funding for Global Health Programs

I urge you to support legislation restoring PEPFAR, TB programs, malaria initiatives, vaccine funding (Gavi), and USAID nutrition support to FY2024 levels. The 2025 cuts will have catastrophic consequences. Modeling projects approximately 120,000 preventable deaths by end of 2026, including 13,000 child deaths from untreated HIV/AIDS. TB program termination is projected to result in 10.6 million new TB cases and 2.2 million TB-related deaths by 2030. Sustained PEPFAR cuts alone could cause 6.6-8.7 million new HIV cases and 4.2-6.3 million AIDS-related deaths by 2029. Beyond HIV and TB, three additional disease areas face critical funding gaps: Malaria: The U.S. provided 37% of global malaria financing through 2023. Since 2000, malaria investments prevented over 2 billion cases and nearly 13 million deaths. Yet the 2025 freeze has derailed 40% of planned insecticide-treated net campaigns (425 million people) and 30% of seasonal malaria chemoprevention for 58 million children. In 2023 alone, malaria killed nearly 600,000 people, 95% in Africa. Vaccination: Gavi has vaccinated 1.1 billion children in 78 countries, preventing 18.8 million deaths. The U.S. is Gavi's third-largest donor. When 2025 cuts began, Gavi warned one million children could die from preventable diseases. Of 500 million children needing immunization globally, 75 million would miss out if U.S. support ends. Global Nutrition: Cuts equivalent to 44% of 2022 donor nutrition aid will be devastating. Research projects 369,000 additional child deaths annually due to cuts, with 163,500 linked to U.S. aid losses alone. Up to 2.3 million children with severe acute malnutrition risk losing life-saving treatment. The U.S. supplied half the world's ready-to-use therapeutic food—the gold standard treatment. Every $1 invested in nutrition returns $23 in economic value. These programs represent a tiny, tiny fraction the federal budget, yet return extraordinary value: PEPFAR has prevented 25 million deaths since 2003 (cost per life saved: $500-$1,500). TB treatment costs $300-500 per person globally. Recent announcements—$600M to Gavi, $661M to Global Fund, $220M for Ebola response—show that policymakers recognize global health security is American national security. However, these are temporary measures often just releasing frozen appropriations. Large amounts remain unspent or marked for agency closeout, with $1.35 billion potentially expiring September 30. I ask you to: 1) Co-sponsor legislation permanently restoring these programs to FY2024 levels through dedicated appropriations. 2) Publicly state your position so constituents understand where you stand. 3) Request briefings from State Department, CDC, WHO, and Global Fund on projected mortality impacts and clarify how the $1.35 billion in marked appropriations will be used. Sustaining these programs is more cost-effective than responding to preventable crises. Thank you for your consideration.