US President Donald Trump's proposed budget would slash nearly a third in funding for diplomacy and foreign aid including global health and food aid, peacekeeping and other forms of non-military foreign involvement.
If passed, the steep funding cuts in the plan released on Tuesday would mean much less non-military US government engagement abroad as the administration implements Mr Trump's "America First" world view.
The budget plan may face rough sledding in Congress, where both Republicans and Democrats have said they do not support such drastic cuts to US diplomacy and foreign aid.
"This budget reflects a commitment to ensure every tax dollar spent is aligned with mission-critical objectives," said Secretary of State Rex Tillerson in a statement.
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Mr Trump's budget would cut funding for global health programs including efforts focusing on HIV/AIDS, tuberculosis and malaria by 24 percent, to about $6.5 billion (NZ$9.2b) for 2018.
"Some programs were eliminated but every effort was made to ensure that the most critical priorities are maintained," the State Department's budget request stated. "Responding to global health challenges is a shared responsibility that cannot be met by one nation alone."
The budget envisions changes to the President's Emergency Plan for AIDS Relief (PEPFAR) program, a cornerstone of US global health assistance, which supports HIV/AIDS treatment, testing and counselling for millions of people worldwide. The budget document says within the PEPFAR budget, the State Department will "prioritise 12 countries in which the United States will continue to work towards epidemic control."
PEPFAR currently supports efforts in 65 countries, according to its website.
"This proposal would allow PEPFAR to continue to achieve impact within a lower budget by reprioritising resources and leveraging funding from other donors and host country governments," the document states.
The budget proposal also includes a 44 percent cut to funding for international organisations, but does not specify the cuts, other than "funding for organisations that work against US foreign policy interests." The budget proposal said the NATO military alliance "would continue to be fully funded."
Under Mr Trump's proposal, the Title II Food Aid program, which makes up the bulk of US international food assistance, would be eliminated entirely, representing a $1.7 billion cut. Under the program, the United States purchases agricultural commodities from American farmers and donates them to support food needs abroad.