This post was written by Danielle Heiberg, Senior Advocacy Manager, and Melissa Chacko, Policy Associate at Global Health Council.
FY18 Appropriations: House Appropriations Committee Approves Bills
In mid-July, the House Appropriations committee approved the Fiscal Year (FY) 2018 State and Foreign Operations bill, which includes funding for USAID, State Department and other international activities. The House rejected the deep cuts proposed by President Trump earlier this year, signaling continued bipartisan support for foreign assistance. (Funding chart.)
On the surface, overall funding for global health programs at both USAID and State appears relatively flat ($8.32 billion for FY18 compared to $8.72 billion in FY17). However, the House recommended that approximately $322.5 million of unspent Ebola response funds be repurposed for Malaria and the Emergency Reserve Fund (which was also cut from $70 million to $10 million), so new funding for global health is actually down. This is also worrisome as this is bolstering accounts with funding that will not be available beyond FY19.
Most programs are at level funding, with the exception of Family Planning/Reproductive Health, which was recommended at a ceiling of not more than $461 million, a cut of 25%. With the ban on contributions to UNFPA (instituted by the Trump administration earlier this year), all funds would be available for bilateral activities. The bill also includes language expanding the Mexico City Policy to include all global health assistance and restricting voluntary contributions to UNFPA; if the language remains in the final bill, it will legislatively impose these two policies for the fiscal year. During the markup, amendments were offered to remove this language, but were defeated along party lines.
The House recommended the full commitment to Gavi, the Vaccine Alliance at $290 million (a $15 million increase); however, because the increase to Maternal and Child Health (MCH) is minimal, overall base funding for MCH is decreased ($814.5 million for FY18 compared to $814 million in FY17).
Also of note was included language of “extraordinary measures” that would allow the Secretary of State to take funding from other accounts, including ‘‘Global Health Programs,’’ ‘‘Development Assistance,’’ ‘‘International Disaster Assistance,’’ ‘‘Economic Support Fund,’’ ‘‘Democracy Fund,’’ ‘‘Assistance for Europe, Eurasia and Central Asia,’’ ‘‘Migration and Refugee Assistance,” “Millennium Challenge Corporation,” if an “international infectious disease outbreak is sustained, severe, and is spreading internationally, or that it is in the national interest to respond to a Public Health Emergency of International Concern.” This language could be a mechanism to move money from other accounts during an outbreak and avoid passing emergency appropriations.
The Appropriations committee also approved the Labor, Health and Human Services, and Education bill, which includes funding for NIH and CDC, and again the committee signaled its support for these programs. Topline NIH funding was increased by $1.1 billion, with Fogarty International Center and the National Institute of Allergy and Infectious Diseases receiving small increases. The Center for Global Health and Global HIV/AIDS, both in CDC, were flat funded, while recommended funding for the National Center for Emerging Zoonotic and Infectious Diseases was decreased by 14.5%.
Meanwhile, on the other side of Capitol Hill, the Senate has allocated $51.2 billion as the top-line spending for its version of the State and Foreign Operations bill. This is a 1.7% cut if you exclude the ISIS supplemental and famine relief funding that was included in the FY17 omnibus (or 10.8% if you include it). The Senate will not markup this appropriations bill until it returns from August recess.
In addition to following the FY18 process, GHC and the global health advocacy community have also begun work on the FY19 budget. The global health community will be submitting FY19 recommendations to the Office of Management and Budget (OMB) later this month.
- Funding Chart
- State and Foreign Operations Bill Text and Committee Report
- Labor, Health and Human Services, and Education Bill Text and Committee Report
Reach Act Reintroduced in Senate
Senators Susan Collins (R-ME) and Chris Coons (D-DE), led a bipartisan group of 10 Senators – Jerry Moran (R-KS), Jeanne Shaheen (D-NH), Marco Rubio (R-FL), Richard Blumenthal (D-CT), Mike Enzi (R-WY), Johnny Isakson (R-GA), Richard Durbin(D-IL), and Chris Murphy (D-CT) – in reintroducing the Reach Every Mother and Child Act (S.1730) on August 2. The Reach Act aims to accelerate the reduction of preventable maternal and child deaths, keeping USAID on track to end these deaths within a generation. The legislation is supported by more than 50 diverse non-profit and faith-based organizations working to end preventable maternal, newborn, and child mortality at home and overseas. Click here for GHC’s statement on the Reach Act.
Senate Confirmed Ambassador Mark Green to Lead USAID
Ambassador Mark Green’s nomination to lead USAID was unanimously approved by the Senate confirmation on August 3. Ambassador Green has previously served as the U.S. Ambassador to Tanzania, as a U.S. Congressman, and as the President of the International Republican Institute. Read GHC’s statement on Ambassador Green’s confirmation.
Statement on Global Health Security Agenda
The current endpoint for the Global Health Security Agenda (GHSA) is 2019. GHC’s Global Health Security Roundtable, Global Health Security Agenda Consortium, Global Health Security Agenda Private Sector Roundtable, and Next Generation Global Health Network released a statement in support of extending the GHSA beyond 2019 for a minimum of five years. In addition to building upon the successes of the GHSA, the statement emphasizes that GHSA “2.0” must focus on meaningful action, political will, and financing strategies to enact national roadmaps and fill existing gaps. Read the joint statement.