What GAO Found Many countries, including the U.S., are experiencing an increase in both the number and the proportion of older adults in their populations. According to the World Health Organization, the share of the global population aged 60 and over is expected to more than double from one billion in 2020 to 2.1 billion by 2050. As countries experiencing population aging take steps to address the domestic effects, experts told GAO that global population aging may also affect the U.S. GAO identified three broad U.S. foreign policy interests that may be affected by aging abroad: national security, economic competitiveness, and global health and humanitarian assistance (see figure). Effects of Global Aging on U.S. Foreign Policy Interests GAO identified several key implications of global aging populations for the U.S. by interviewing experts and conducting a literature review. For example, U.S. national security interests may be affected as allies spend more on healthcare for their aging populations, likely resulting in fewer available resources for defense spending. U.S. economic interests may also be affected by shrinking labor pools abroad, which could affect labor force competition and worldwide migration patterns. Lastly, global health interests may be influenced by the prevalence of chronic disease in aging populations. As a result, U.S. global health priorities may have to be adapted to the health-related risks and vulnerabilities faced by aging populations. The Departments of Defense (DOD), Health and Human Services (HHS), and State have some efforts that indirectly address the implications of global aging. These agencies produce research and data, engage with partner nations, and provide health and humanitarian assistance. State’s regional bureaus train younger populations in other countries to replace skills lost when older individuals leave the workforce. Additionally, HHS researches the effects of aging and age-related conditions on populations both domestically and abroad. However, U.S. agencies do not provide foreign assistance that specifically addresses the needs of older populations, according to agency officials. Why GAO Did This Study According to the United Nations, population aging is occurring at an unprecedented pace and is poised to become one of the most significant social transformations of the twenty-first century. As the populations of partners and adversaries age, the U.S. may be affected by this trend. Stakeholders have increasingly identified global aging abroad as a potential strategic challenge for the U.S. Understanding the changes associated with global aging and their potential effects, including consequences for U.S. fiscal policy, may help inform U.S. strategic priorities and goals. GAO was asked to examine the U.S. foreign policy implications of global aging and how U.S. agencies are considering these implications in their programming. This report examines (1) the implications of aging populations worldwide on U.S. foreign policy interests; and (2) U.S. agencies’ efforts to identify and address the implications of aging populations worldwide on U.S. interests. To address these objectives, GAO interviewed experts and conducted a literature review to identify the implications of aging populations worldwide on U.S. foreign policy interests. GAO selected experts from academia and nongovernmental organizations to represent a balance of views. To identify agency efforts to address global aging, GAO reviewed relevant agency documents, policy guidance, and program documentation. GAO also spoke with officials at DOD, HHS, and State. GAO selected these agencies based on their roles in foreign assistance programming and policy development relevant to demographic change. For more information, contact Chelsa Kenney at kenneyc@gao.gov.

What GAO Found The Federal Assets Sale and Transfer Act of 2016 (FASTA) established a temporary process to reduce the inventory of federal civilian real property and the time it takes to dispose of such property. FASTA created the Public Buildings Reform Board (Board) to recommend properties for disposal for approval in each of several rounds. Once approved, the General Services Administration (GSA) takes a primary role in implementation. FASTA also established a fund to help with disposal costs. The last year of FASTA implementation is underway, with two approved rounds—2019 and 2025—and a final round expected to be released before the Board ceases operations in December 2026. As of August 2026, 14 properties (of 23 recommended and approved) have been disposed of for a total of about $576 million in sales proceeds. Most of these disposals were from the 2019 round. Timeframes for completing disposal on many 2025 round properties are not clear due to shifting cost and schedule estimates. Stakeholders said that FASTA’s main benefit is the potential for funding to offset disposal costs, but the uncertainty of accessing this funding has been a significant challenge. Proceeds from initial FASTA disposals are deposited into a fund—the Asset Proceeds and Space Management Fund—that can be accessed to cover the costs of future disposals, subject to congressional appropriation. While Congress appropriated $90 million from 2016 to 2022 for the fund, it did not provide additional FASTA appropriations from 2023 to 2025. Without this appropriation, GSA could not access the full amount of sales proceeds. Timeline of Cumulative Amounts Deposited into and Appropriated from the Asset Proceeds and Space Management Fund In 2026, Congress appropriated an additional about $143 million in FASTA proceeds. However, other longstanding disposal challenges remain. For example, stakeholders said relocating tenants is a challenge, particularly for the 2025 round, as most of these properties remain occupied by federal tenants. GSA and the Board suggested improvements to FASTA if it were extended beyond 2026, including greater access to FASTA sales proceeds. Why GAO Did This Study The federal government owns hundreds of thousands of buildings that cost billions of dollars annually to occupy, operate, and maintain. Disposing of real property that federal agencies no longer need—but continue to pay for—has been a longstanding challenge. The process for disposing of unneeded property may take years, with the federal government bearing the property costs until the disposal is completed. FASTA includes provisions for GAO to review the Board’s recommendations and selection process and annually review agencies’ efforts to implement the FASTA recommendations. This report describes (1) the status of the FASTA disposal process and (2) insights from FASTA implementation as of the Second Round (2025). GAO reviewed published reports, relevant federal laws and regulations. GAO interviewed officials from the Board, GSA, and four selected tenant agencies occupying properties recommended under FASTA. GAO also conducted site visits to four selected FASTA properties included in the 2025 round recommendations. In addition, GAO analyzed GSA real property disposal data from January 1, 2020, through August 5, 2025, to review the amount of time it takes to dispose of federal properties.

What GAO Found The Food and Drug Administration’s (FDA) Center for Devices and Radiological Health (CDRH) administers the Third Party Review Program, a voluntary alternative review process for selected low-to-moderate risk medical devices, such as diagnostic ultrasound systems and surgical lasers. Under this program, which is intended to facilitate faster reviews, device sponsors can contract with FDA-accredited entities. These entities, known as Third Party Review Organizations (third parties), conduct the initial review of certain premarket applications, known as 510(k) submissions. These third party reviews occur prior to agency officials making the final decision about whether the device can be marketed. According to FDA officials, the agency received approximately $8 million for Third Party Review Program operations in fiscal years 2023 through 2027. FDA’s administration of the program includes overseeing third parties’ accreditation and reaccreditation applications to ensure participation standards are met, and reviewing third parties’ recommendations on 510(k) submissions and making final decisions. From fiscal years 2018 through 2025, third parties provided FDA with 617 510(k) submission reviews and recommendations, which accounted for about 2 percent of CDRH’s 510(k) submission reviews annually. Center for Devices and Radiological Health (CDRH) and Third Party 510(k) Medical Device Submission Reviews, Fiscal Years 2018–2025, as of November 2025     Fiscal Year 2018 2019 2020 2021 2022 2023 2024 2025 Number of 510(k) submissions reviewed by CDRH only 3,276 3,464 3,504 3,731 3,554 3,684 3,461 3,476 Number of 510(k) submissions reviewed by Third Party Review Organizations and CDRH 75 78 85 90 77 77 68 67 Source: GAO analysis of Food and Drug Administration data. | GAO-26-108499 FDA is required to audit third parties periodically to ensure they remain in compliance with the standards for program participation. The agency conducted 25 periodic audits of third parties from 2000 to 2026, according to FDA officials. These audits were conducted in four phases: 13 audits from 2000 through 2003, five audits from 2011 through 2013, two audits in 2022, and five audits from 2025 to 2026. Results of these audits varied in terms of the deficiencies identified. GAO found that FDA’s audit policies have gaps and are missing key details. For example, FDA has not established time frames specifying how long it should take the agency to complete an audit and communicate results to third parties. As a result, GAO identified several recent audits with findings of deficiencies, such as language in standard operating procedures being too vague, that took FDA more than 6 months to close. Ensuring the agency has detailed policies, such as time frames for completing audits and communicating results, would strengthen FDA’s efforts to ensure third parties meet program requirements and are therefore eligible to continue reviewing 510(k) submissions, which provide recommendations to FDA as to whether devices should be allowed on the market and thus available for patient use. Why GAO Did This Study FDA, within the Department of Health and Human Services (HHS), is responsible for ensuring that medical devices sold in the U.S. are regulated to provide reasonable assurance of safety and effectiveness. The review process FDA uses to make this determination represents a substantial investment of time and resources for both the agency and the device sponsor. The Food and Drug Administration Modernization Act of 1997 created the Third Party Review Program, which FDA oversees. Since program inception, FDA said it accredited 32 third parties to participate in the program; as of May 2026, there were nine third parties with active accreditations. The Consolidated Appropriations Act, 2023, includes a provision for GAO to report on the Third Party Review Program. This report (1) describes FDA’s roles and responsibilities in administering the Third Party Review Program; and (2) examines the extent to which FDA audits third parties’ performance. GAO reviewed the statute authorizing the Third Party Review Program and FDA’s related policy and guidance documents. GAO analyzed FDA third party performance metrics from fiscal years 2018 through 2025. GAO also reviewed documentation and internal communications from completed third party audits. GAO interviewed FDA officials and representatives from six third parties.

What GAO Found The Federal Aviation Administration (FAA) has identified electromagnetic spectrum-related threats, including spoofing and jamming, to the National Airspace System (NAS) and international flight routes. However, FAA has not completed risk and mitigation assessments, and updated security documentation needed to address these threats. Additionally, FAA did not have a defined, real-time monitoring and detection capability for all spectrum-related threats. Without comprehensive risk and mitigation assessments, complete security documentation, and real-time monitoring capabilities, FAA may not have sufficient information to identify, prioritize, and respond to evolving spectrum-related threats. As a result, spoofing, jamming, and other attacks could disrupt aviation communications, degrade situational awareness, and increase the risk of operational disruptions. Potential Cyberattacks Impacting Aircraft Communications FAA participates in multiple collaborative efforts with other federal agencies as well as non-federal aviation industry stakeholders regarding cybersecurity. FAA's collaborative efforts fully addressed two of the eight leading practices and partially addressed six. While FAA has defined roles and responsibilities within interagency groups, it has not established policies or procedures for information sharing, reporting, and coordination with non-federal partners outside those groups. Fully implementing leading collaboration practices could strengthen FAA's ability to effectively coordinate with key partners to mitigate cybersecurity threats affecting the aviation sector and thereby avoid fragmented and inefficient responses to incidents. The communication applications that FAA, pilots, and aviation stakeholders use to exchange text-based information are vulnerable to cyber threats, including interception and spoofing, due to limitations related to authentication, encryption, and protocol design. For example, a malicious actor could transmit fraudulent clearance cancellations, possibly leading to flight delays or safety issues. Until FAA develops and implements a plan to strengthen authentication and data protection for these applications, malicious actors could exploit weaknesses and increase the risk of disrupted flight operations, aviation accidents, or safety incidents. Why GAO Did This Study Commercial flight operations rely on interconnected systems that reside onboard an aircraft and on the ground in the NAS. These systems use radio frequency signals transmitted through the electromagnetic spectrum to communicate. The Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 includes a provision for GAO to review the vulnerability of the NAS to spectrum attacks and to assess efforts to prevent and prepare for such attacks. This report examines, among other objectives, the extent to which FAA has identified and mitigated spectrum-related cybersecurity threats; the extent to which FAA has collaborated with federal partners to defend against cybersecurity threats; and what specific cybersecurity vulnerabilities exist in key communication applications. To address these objectives, GAO analyzed FAA vulnerability assessments to identify spectrum-related threats to the NAS. GAO selected eight spectrum-dependent systems and assessed them against National Institute of Standards and Technology guidance. GAO also assessed key FAA collaboration mechanisms against leading practices. In addition, GAO reviewed FAA documentation to identify vulnerabilities with communication applications. GAO interviewed FAA officials and federal and non-federal stakeholders.