The State Department Is Asking the World for New Global Health Ideas

Breakdown of the State Department’s New “Advancing Global Health” APS Funding Opportunity

A relatively quiet development in U.S. global health policy arrived this week with the launch of the State Department’s long-awaited “Advancing Global Health” Annual Program Statement (APS). It may not generate headlines like a major PEPFAR authorization or a Global Fund replenishment, but it signals something more important.

At first glance, the program looks like another large federal funding opportunity. In reality, it is something more consequential. The APS creates a new mechanism for the State Department’s Bureau of Global Health Security and Diplomacy (GHSD) to fund projects that operationalize the America First Global Health Strategy.

What the Program Is

The Advancing Global Health APS is essentially a funding platform. Rather than announcing a single grant competition, it establishes a standing mechanism through which the State Department can release targeted funding opportunities over time.

The program is substantial in scale. In total, it authorizes up to $4.5 billion in potential funding, with individual awards ranging from $500,000 to as much as $250 million, and projects lasting up to five years.

Organizations from around the world—including NGOs, universities, private companies, and notably, international organizations—are eligible to apply.

However, applicants cannot apply directly to the overarching program. Instead, the State Department releases specific “addenda”—focused funding calls tied to particular priorities. Applicants submit proposals in response to those targeted opportunities.

Two such priorities have already been announced.

The first focuses on Rapid Outbreak Response, with up to $290 million available to support countries in detecting and containing infectious disease outbreaks quickly. The goal is straightforward: detect outbreaks within seven days and contain them before they spread across borders.

The second addendum focuses on Child Development, Care, and Protection, allocating roughly $52.6 million to strengthen child protection systems, support family-based care, and improve early childhood development outcomes in vulnerable settings.

Importantly, both priorities reflect a broader emphasis on health system resilience and prevention, rather than single-disease programs. More on this later.

Why the State Department Chose an APS

The funding mechanism itself offers an important clue about how the administration views the future of global health investment. This appears to be the first Annual Program Statement issued by the State Department’s Bureau of Global Health Security and Diplomacy under the new America First Global Health Strategy. While APS mechanisms are common in U.S. foreign assistance, this one functions as a new umbrella platform through which GHSD plans to fund projects that complement bilateral health agreements with partner countries.

An Annual Program Statement differs from traditional grant solicitations. Instead of publishing a highly prescriptive call for proposals, agencies use APS mechanisms when they want to encourage ideas from the field and fund multiple projects over time.

Applicants first submit short concept notes. If those concepts align with strategic priorities, they may be invited to develop a full proposal.

This structure gives the State Department several advantages.

First, it allows the government to adapt quickly to emerging health threats. If a new outbreak emerges or a geopolitical priority shifts, the Department can release a targeted addendum without launching an entirely new funding program.

Second, it creates space for new types of implementing partners, including universities, private sector innovators, and research institutions that may not traditionally apply for large foreign assistance grants. This includes organizations based outside the United States.

Third, it allows the government to build a portfolio of targeted investments rather than funding a single large program.

While the APS signals the potential for up to $4.5 billion in awards, the State Department is not creating new money. These grants must ultimately be funded through appropriations already authorized by Congress under the Foreign Assistance Act and the Global Health Programs account.

Priority Areas

The first funding calls provide insight into where the State Department sees immediate opportunities.

One priority is rapid outbreak detection and response. The COVID-19 pandemic revealed the enormous economic and human cost of delayed outbreak detection. Funding in this category will support surveillance systems, laboratory capacity, border health measures, infection control, and emergency response logistics to stop outbreaks before they become global crises.

Another priority focuses on child development and protection, particularly in settings where poverty, instability, or weak social services leave children vulnerable to abuse, exploitation, or neglect. Programs under this track aim to strengthen national child protection systems, build the social service workforce, and promote family-based care alternatives.

From my perspective, it is encouraging to see children and families elevated as a priority area. Historically, U.S. global HIV programs have included a specific focus on orphans and vulnerable children (OVC)—a recognition that the HIV epidemic does not only affect those living with the virus, but also the families and communities around them. When Congress reauthorizes PEPFAR, it always includes a dedicated set-aside for OVC programming, ensuring that a portion of funding supports children affected by HIV, poverty, and social instability.

While the PEPFAR authorization has currently expired and the administration is not formally obligated to maintain that OVC set-aside, the programs themselves have long played a critical role. OVC initiatives typically provide a combination of services—school support, nutrition, psychosocial care, household economic strengthening, and social services—to help stabilize families and reduce the vulnerability of children living in communities heavily affected by HIV and poverty.

These programs have historically been implemented through USAID and large implementing partners, often working closely with faith-based organizations and community groups that have deep local reach. Over the past two decades, these networks have become some of the most effective community-based safety nets in global health and development.

Seen in that context, it is positive that child protection and family strengthening appear as a priority area in this new funding mechanism. At the same time, the scale of funding announced so far is considerably smaller than what we have traditionally seen under OVC programming within PEPFAR. It will therefore be interesting to see what kinds of proposals emerge and how the State Department chooses to structure these investments.

It will also be worth watching which organizations apply. Given the long history of OVC work within faith-based networks, community organizations, and development NGOs, the applicant pool may look somewhat different from traditional global health implementers. The APS structure, which encourages new types of partners—including universities and private sector actors—could produce an interesting mix of proposals.

What Comes Next

Looking ahead, this program is likely to generate significant interest across the global health ecosystem. Universities, NGOs, private sector innovators, development implementers, and community-based organizations will all see opportunities to contribute ideas and proposals under this framework.

With an APS of this scale and flexibility, a large volume of concept notes and proposals is likely to emerge. That makes it especially important that the State Department has the capacity to review them in a coordinated, thoughtful, and strategic way—ensuring that the most impactful ideas move forward.

The APS notes that senior leaders within GHSD will have final decision-making authority. However, it provides limited clarity on how other technical agencies across the U.S. government will be engaged in the review process. Given the deep expertise that agencies such as the Centers for Disease Control and Prevention (CDC) and others bring to global health implementation, greater transparency around interagency consultation could strengthen confidence in the process.

The APS also includes a number of legal and policy safeguards that govern how funds can be used. Projects must comply with longstanding U.S. foreign assistance restrictions related to counterterrorism financing and human rights, including the Leahy Law, which prohibits support to foreign security units implicated in serious abuses. The framework also places limits on funding flows and activities tied to broader foreign policy priorities—for example prohibiting transfers to UNRWA, restricting the use of funds for activities that encourage migration caravans toward the United States, and banning the use of federal funds for certain foreign-manufactured drone systems. The APS also introduces compliance requirements related to domestic policy priorities, including certifications that programs operating in the United States do not run Diversity, Equity, and Inclusion (DEI) initiatives that violate federal anti-discrimination laws. In addition, recipients implementing large overseas programs must maintain safeguards and compliance plans to prevent human trafficking.

We should also expect additional topical addenda to emerge as the Bureau identifies new priority areas. The APS structure was designed precisely for this purpose—to allow the Department to signal evolving priorities and invite proposals accordingly. It is also possible that similar APS mechanisms could emerge from other parts of the Department of State, including the Office of U.S. Foreign Assistance Resources (the “F Bureau”) or other regional and functional bureaus, particularly if this model proves effective for advancing broader foreign assistance priorities.

At the moment, a few gaps stand out.

One is around new product introduction and innovation, particularly for breakthrough HIV prevention tools. The administration has repeatedly emphasized the importance of scaling up lenacapavir, a long-acting HIV prevention option that could transform prevention efforts if implemented effectively.

Another opportunity lies in the deployment of artificial intelligence and digital tools to support product introduction, risk prediction, service delivery, and differentiated care models. AI-enabled approaches could play an important role in accelerating the uptake of medical interventions and linking more people into care.

Finally, it will be important to see how this new funding platform interacts with the existing global health architecture. Long-standing U.S. programs—including PEPFAR for HIV/AIDS, the President’s Malaria Initiative (PMI), tuberculosis programs supported through USAID and global partnerships, and multilateral mechanisms such as the Global Fund—already form the backbone of U.S. global health engagement.

Ultimately, the success of this APS will depend less on the volume of proposals it attracts and more on how strategically it is implemented. If used well, it could become a flexible mechanism for accelerating innovation, supporting country priorities, and advancing the next generation of global health tools—from long-acting HIV prevention to AI-enabled service delivery. The real test will be whether this platform strengthens coordination across U.S. global health efforts—including PEPFAR, the President’s Malaria Initiative, tuberculosis programs, and multilateral partnerships such as the Global Fund.

The Bigger Picture

Beyond the mechanics of the funding announcement, the APS signals a broader shift in how the United States may organize its global health efforts in the years ahead. The model links three elements: a new national strategy, bilateral health agreements with partner countries, and a flexible funding platform to support implementation. In effect, the APS creates a pipeline through which ideas from universities, NGOs, private companies, and local organizations can be aligned with country-level priorities negotiated by the U.S. government.

It also reflects a growing role for the State Department in shaping global health investments. While agencies such as CDC continue to provide technical expertise and program implementation, the APS suggests GHSD may increasingly serve as a hub for directing resources and coordinating priorities across the system.