Particularly in recent news (ukraine) a huge portion of the dollar amount is in the form of military aid. Say we give them 100 1 million dollar vehicles, that’s “100 million dollars” of aid, even though no money has changed hands. A lot of it is also stockpiled weaponry that is no longer considered good enough to be front line use by the us military so is earmarked for foreign sale or aid. We gave Ukraine a handful of himars, low double digits, and they are all over the news, but use the older and shorter range rockets (for the most part). Meanwhile, the us has over thousand of those same units in inventory with rockets that far outperform what we gave. They are like hand me downs for the poorer kid next door, that explode.
Some aid is purely monetary but usually comes with agreements. “We will give you this if you stop doing that.” Etc.
Most of it is voted on and in budgets just like any other government expenditure.
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