New Dashboard Tracks U.S. Government Global Health Spending

Federal funding decisions can often feel incredibly challenging to follow, and the process isn't always as linear as one might think. Tracking the flow of federal funds has become even more difficult during President Donald Trump's second term in office, as funding cuts have affected numerous sectors.

Vincent Lin, Partners In Health (PIH) Associate Director of Health Policy and Advocacy, joined forces with colleagues at the Health Security Policy Academy, a policy think-tank in the Division of Global Health Equity at Mass General Brigham, to create a new dashboard that provides a visual guide to public global health spending data.

"After the hundreds of project terminations in global health across USAID back in early 2025, our goal was to figure out where funding stopped flowing and what new spending took place," Lin said.

Congressional Appropriations

Upholding what is written in Article I of the U.S. Constitution, Congress possesses the "power of the purse" and determines how discretionary federal funds are distributed to federal agencies. The current administration-in direct conflict with Congress's power of the purse-has not consistently followed through with the timely disbursement of this critical funding.

In July, the federal government cut foreign aid funding by over $8 billion through a large rescissions package. Shortly thereafter, in September, the administration withheld $4.9 billion in congressionally-approved foreign aid by using a tactic called "pocket rescissions." Subsequent investigations found that additional funding was being withheld by not being distributed to core lifesaving foreign aid programs such as the Global Fund and PEPFAR, the U.S. President's Emergency Plan for AIDS Relief.

Due to this volatile aid landscape, the need for more transparency in global health spending has become increasingly clear.

"Historically, there has been a lot of interest in the global health budget, which is set by Congress. But this admin is different from previous ones," said Dr. KJ Seung, Associate Physician, Division of Global Health Equity, Brigham and Women's Hospital. "This admin might not spend what is budgeted, or spend it on something different, or spend it in a different way completely. The dashboard uses financial data to shed light on what's going on downstream. It's not the whole story, but an important part of it."

As of the writing of this article, the Global Fund is owed $3 billion by the U.S. State Department in already-approved funding from Congress. Based on analysis of public financial data, appropriated funds for PEPFAR are being significantly underspent. Additionally, PIH has stated our opposition to new massive funding cuts being written into global health-financing agreements by the United States State Department as part of the "America First Global Health Strategy."

The U.S. Global Health Spending Watch Dashboard

It's in this context that Lin, alongside partners including Seung and Leanne Friedrich, a TBFighter, helped develop the U.S. Global Health Spending Watch dashboard to track how much money the U.S. government commits to global health each year-and how that money is actually spent-to inform advocates and other global health organizations.

Friedrich helped develop the code after seeing how challenging it can be to parse data from existing public sources that report on federal spending. She hopes this new platform will be more user-friendly and easier to understand.

"The USASpending [application programming interface] is fairly gnarly," she said. "There are a lot of endpoints that are all slicing and grouping and summarizing data in different ways, and the input format for requests is pretty finicky."

At present, no other organizations have translated award-level data, spending reports, and related resources into a single, accessible format for the public. This project aims to change that.

Following the Funds

By consolidating spending information into a clear, digestible dashboard, the team has created a new tool to provide greater transparency and inform future policy-particularly as decisionmakers channel funds through new mechanisms and to new priorities.

"The data available provides a picture of spending trends we haven't seen before, and where there is either more or less funding for different areas of global health spending," Lin said.

At PIH, the terminations of programs have already undermined patient care, innovation, and health advancements for people around the world. In Lesotho, clinics were forced to close, leaving patients without access to necessary care or critical medication. In Peru, life-changing research screeched to a halt overnight, abandoning hundreds of adolescents going through treatment for HIV. In Sierra Leone, plans were being finalized for the opening of a new tuberculosis ward when funding was pulled, and Koidu Government Hospital lost a crucial resource.

These impacts are not hypothetical. They involve real patients, communities, and health systems being harmed by cut and withheld funds. By making federal global health spending more visible-what is promised, delivered, and withheld-the U.S. Global Health Spending Watch dashboard gives advocates and the public a clearer view of how funding decisions translate into real-world consequences.

Editor's note: If you are a member of the press and eager to learn more, please see PIH's full statement here.