President Obama wants the United States to spend $8.6 billion next year - $63nb over the next six years - to fight global diseases and provide more aid for prenatal and postnatal care, children’s health and fighting tropical diseases - see White House press release.

The President repeated his view that, “We cannot wall ourselves off from the world and hope for the best, nor ignore the public health challenges beyond our borders”. He said he wanted to launch “a new, comprehensive global health strategy”.

However, critics are concerned that what he is proposing for global health will fall short of the expectations he created before his election. For example, the President’s Emergency Plan for AIDS Relief (PEPFAR), begun by former President Bush, seems likely to receive next year a $460 million increase over this year’s budget, whereas Obama’s 2007 Global AIDS Day statement spoke of a $1bn increase in PEPFAR funding annually. The Global Fund to Fight Aids, Tuberculosis, and Malaria will receive $900 million next year, the same as it received in 2009, and way below the $2.7 billion it requested from the US to help it meet a $5 billion funding gap.

Interviewed by Associated Press, Christine Lubinski, director of the Center for Global Health Policy said, “With this spending request, Obama has broken his campaign promise to provide $1 billion a year in new money for global AIDS, and he has overlooked the growing threat of tuberculosis.”

Joanne Carter, executive director of the advocacy group Results told the Chronicle of Philanthropy that the president’s plan “halts the dramatic scale up of funding we’ve seen” for AIDS under the Bush administration, provides “disturbingly low” support for fighting tuberculosis, and provides no increase in support for the Global Fund.

IRIN News reports Dr Paul Zeitz, executive director of the Washington-based Global AIDS Alliance as saying that Obama’s 2010 budget “essentially flatlines support for global health”.

Serra Sippel, executive director of the Centre for Health and Gender Equity, was also disappointed that funding had not increased, but welcomed the comprehensive approach as a “more effective use of our aid”.

Meanwhile, a Kaiser Family Foundation survey found that 71% of Americans do not believe their country can afford to spend more on global health when the US is experiencing a severe recession.