The administration of United States President Donald Trump is planning to redirect or withhold nearly all the $605m approved by Congress for international family planning assistance in 2026, according to internal government documents obtained by CNN.
The proposed changes also include transferring $888m from global health funding into an innovation fund intended to support American companies involved in science, technology and medicine, while reducing financial assistance to health programmes in several low- and middle-income countries.
The plans have attracted criticism from lawmakers and nonprofit organisations, who argue that the administration is diverting funds approved by Congress for specific purposes without sufficient justification.
A preliminary 2026 fiscal year budget allocation document reportedly shows plans to redirect or leave unallocated almost all the $607.5m Congress approved for contraceptives and other reproductive health services for women in foreign countries.
According to a separate memorandum signed by US Secretary of State Marco Rubio in September, more than $48m of the family planning allocation would be redirected towards addressing energy security challenges facing American partner countries affected by disruptions in global markets.
The memorandum provided limited information about how the diverted funds would be spent.
For several decades, American family planning assistance has supported access to modern contraceptives and reproductive health services for millions of women worldwide, helping them prevent or space pregnancies.
Research has linked access to these services with lower maternal mortality, improved household incomes and better health outcomes for children.
The Guttmacher Institute estimated that US investment in international family planning prevented approximately 34,000 maternal deaths in the 2024 fiscal year, before Trump returned to office.
An assessment of the leaked budget document by nonprofit organisations Public Citizen, Partners In Health and Population Action International also identified significant reductions in American health assistance to several countries compared with their 2024 funding levels.
South Africa, Tanzania and Zimbabwe were among the countries facing the largest reductions, with each recording cuts exceeding $100m.
The analysis further showed that health assistance to eight countries, including Afghanistan, the Central African Republic, The Gambia, South Africa, Somalia, Sudan, Timor-Leste and Yemen, had been reduced to zero from their 2024 levels.
Responding to questions from CNN, a State Department spokesman said the administration regularly reviews foreign assistance to ensure that available resources address critical priorities, including unexpected emergencies.
The spokesman said the government was also committed to delivering life-saving healthcare services, including programmes targeting HIV/AIDS, tuberculosis, malaria, and maternal and child health.
However, Vincent Lin, associate director of health policy and advocacy at Partners In Health, criticised the proposed funding changes, arguing that they contradicted spending decisions made by Congress.
He said the diversion of money originally approved for public health programmes towards energy security and private American companies was particularly troubling.
Lin added that the executive branch was disregarding Congress by failing to spend funds allocated for specific purposes, describing the family planning funding issue as a clear example of the administration going against legislative decisions.
Over the past two years, the State Department has taken several steps to exercise greater control over American global health assistance and reduce spending, including withholding some funding from the Centers for Disease Control and Prevention.
CNN had also previously reported that the Trump administration redirected $1.35bn initially intended for international health programmes to cover expenses associated with shutting down the United States Agency for International Development.
Meanwhile, Public Citizen has instituted legal action against the State Department, seeking the release of documents relating to bilateral global health agreements that the administration has largely kept confidential.
Although the case remains before a federal court, some records have emerged through Freedom of Information Act requests submitted by watchdog organisations.
Democratic Congresswoman Lois Frankel of Florida, a member of the House Appropriations Committee, also condemned the administration’s handling of the funds.
She said the decision not to release money approved by Congress for international family planning was dangerous and could undermine women’s health, financial stability and opportunities, as well as the welfare of their families and communities.
In another development, Rubio’s memorandum to Congress authorised the redirection of up to $125m in foreign assistance to address energy security concerns.
The document, obtained by CNN and previously reported by The New York Times, indicated that more than $48m would come from international family planning assistance.
Other proposed diversions included funding originally intended for peacebuilding initiatives between Palestinians and Israelis, as well as assistance for civilians affected by conflicts.
Rubio cited a legal provision allowing the government to redirect existing foreign assistance resources to address unforeseen emergencies.
He said the money would support countries facing supply disruptions, rising costs and energy-related challenges linked to the actions of Russia, China and Iran.
The decision comes amid disruptions to international energy markets caused by the war in Iran, which has contributed to rising global oil prices.
Separately, the State Department’s budget document indicated that $32m initially allocated to the United Nations Population Fund would also be transferred to other health programmes.
Another $524m in family planning assistance was reportedly listed as awaiting allocation, with no explanation provided for why the funds had not been made available for spending.
Nabeeha Kazi Hutchins, president and chief executive of Population Action International, said the decision contradicted decades of bipartisan congressional support for reproductive healthcare.
She maintained that Congress had the constitutional authority to determine how public funds were spent and warned that the administration’s actions raised concerns about the limits of executive power.
Hutchins also described the development as part of a broader policy direction that could further restrict access to women’s healthcare services.
Trump’s administration had previously indicated its opposition to funding certain international family planning programmes. During testimony before the House Appropriations Committee last year, Rubio said the United States would no longer be involved in such programmes globally.
The administration has also faced criticism from medical professionals for associating some contraceptive methods with abortion, a position they have disputed.
Beyond family planning, the 2026 budget proposal reportedly includes plans to transfer $888m into a global health innovation fund supporting American companies working in medical research, science and technology.
At the same time, more than $1.6bn in health assistance to foreign countries is expected to be removed, according to the analysis by Public Citizen, Partners In Health and Population Action International.
The proposed changes follow the introduction of the Trump administration’s America First Global Health Strategy last year.
The policy aims to encourage countries receiving American health assistance to strengthen their domestic healthcare systems while reducing their dependence on US funding.
However, the three nonprofit organisations argued that cutting direct assistance to countries while increasing funding for an innovation initiative could undermine the stated objectives of the policy.
They warned that reductions in country-level programmes would weaken local healthcare services and limit efforts to prevent the spread of diseases.
Peter Maybarduk, director of Public Citizen’s access to medicines initiative, also questioned the administration’s justification for the changes.
He said the government had previously argued that international non-governmental organisations were wasting resources and that assistance should instead go directly to foreign governments.
According to him, the proposed arrangement would ultimately transfer resources away from both governments and nonprofit organisations towards large private corporations.
The organisations also expressed concerns about transparency in awarding contracts through the $888m innovation fund.
They noted that the initiative initially received only $60m in the 2025 fiscal year, making the proposed increase a significant expansion.
In their assessment, the organisations said the State Department had not explained how companies would be selected or how applications for funding would be evaluated.
They also raised concerns about the department’s increasing reliance on non-competitive, single-source contracts.
Responding to questions about the innovation fund, the State Department spokesman said the administration was exploring ways to use American technological and scientific innovations to save lives more efficiently while working with Congress.
However, the department did not provide details about the specific process for selecting companies to receive the contracts.
Although information about the fund remains limited, the State Department has announced partnerships with several American companies, including drone delivery firm Zipline, pharmaceutical company Gilead Sciences and consumer products manufacturer SC Johnson.
Public Citizen and its partner organisations warned that without transparent procedures, funding could be awarded based on companies’ private access to the administration rather than the potential public health benefits of their proposals.
They also stressed that technological innovation should not replace direct financial support for countries seeking to strengthen their healthcare systems.
