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Advocacy Update ~ April 17, 2017

By Danielle Heiberg, Senior Advocacy Manager, Global Health

Budget Update

Congress is in the middle of a two-week recess and when they return on Monday, April 24, they will face the expiration of the Continuing Resolution (CR) that is currently funding federal agencies and government programs for Fiscal Year (FY) 2017, and that is expiring on April 28.

A government shutdown seems unlikely, with members working through about 100 or so amendments, but wanting to avoid “poison pill” riders, such as paying for a wall at the border or defunding Planned Parenthood, on the final spending package. However, if negotiations breakdown, a short CR will be needed beyond April 28.

After FY2017 is finished, Congress will immediately turn to FY2018. President Trump’s full budget is expected to be released in mid-May.

Advocating for Foreign Assistance and Global Health Funding? GHC has developed topline messaging supporting global health and foreign assistance accounts, as well as a “leave behind” document for Congressional offices. We encourage you to use this messaging as you develop your own materials.

Defunding UNFPA

On March 30, the State Department issued a directive cutting off all U.S. contributions to the UN Population Fund (UNFPA). Citing UNFPA’s work in China, directive cited the requirements of the Kemp-Kasten amendment, which deems an organization ineligible for U.S. funding if it “supports or participates in the management of a program of coercive abortion or involuntary sterilization,” to cut off funding.

Although UNFPA does partner with China’s National Health and Family Planning Commission on family planning, there is no evidence that UNFPA engages in involuntary sterilization or coercive abortion, which the State Department’s justification even noted.

In FY2016, the U.S. was the fourth largest donor overall to UNFPA, totaling approximately $69.7 million in contributions – around $30.7 million making up core voluntary contributions and the remainder used to address reproductive and maternal health needs in humanitarian crises. For FY2017, the expected loss to UNFPA is about $71 million.

For a more detailed analysis, read PAI’s Phoning It In: State Department Determination Withholds U.S. Contribution to UNFPA.

Reorganization of the Federal Government

In a follow-up to the Trump Administration’s Executive Order to federal agencies to develop plans for reform and streamlining programs, the Office of Management and Budget (OMB) announced the “Comprehensive Plan for Reforming the Federal Government and Reducing the Federal Civilian Workforce.” The plan instructs agencies to reduce workforces; submit a plan to modernize and streamline operations; and identify areas that should be restructured, eliminated, or consolidated. Plans are to be submitted in June.

The administration created a website for the public to submit their ideas and comments on how to restructure the government.

GHC is monitoring these developments and working with the foreign assistance community to provide input.

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GHC Hosts First WHA Policy Scrum of 2017

Global Health Council (GHC) hosted a WHA Policy Scrum at InterAction’s headquarters in Washington, DC (and via webinar) on April 5, 2017. GHC’s WHA Policy Scrums are an annual series of meetings leading up to the World Health Assembly each year. They provide a space for the global health community to share priorities and concerns around WHA policy issues.

The 70th World Health Assembly will take place in Geneva, Switzerland from May 22 – 31, 2017.

Our first policy scrum attracted a total of 64 participants across 20 countries, including representatives from governments, private sector, nonprofits, and development partners. It was led by GHC President and Executive Director Loyce Pace. Useful links and major highlights from the meeting are listed below.

Useful Links:

Major Highlights:

WHA 2017 Agenda Topics

The main topics of interest brought up by participants included: non-communicable diseases, global health security, and global strategies. More in-depth conversations about these issues will be held in our upcoming webinars.

U.S. Leadership and Funding

There was a brief discussion on U.S. government priorities and budget cuts. The general feedback from government officials to the global health community is that cuts are a reality and will happen across several programs; including programs that the U.S. government considers priority areas, such as; epidemic preparedness, health research and development, and global health security. The current administration’s position is therefore to identify key priorities, and to fund them at a level which they believe is the U.S.’s appropriate share and responsibility to the global community.

Participants around the room commented that they had heard of heavy discussions around reworking assessed and voluntary contributions from the U.S. government. It was suggested that a good strategy in arguing for discretionary spending on particular programs is to capitalize on their economic benefits to the United States as a selling point, as this is the language that the current administration responds to.

How Should CSOs Respond to Imminent Budget Cuts?

The loss of funding will undermine progress in across several critical issue areas, and there are major concerns about how budget cuts will particularly impact WHO.

Loyce cited our need to work together as a global health community and develop a community advocacy message – something that we have already been working on. Loyce also highlighted the urgent need to broker more focused dialogue, on how to stay strong as a community. How do we prepare for the impact of severe budget cuts to our work and how can we move forward positively?

U.S. WHA 2017 Delegation

There were several questions in the room and online, about who would make up the U.S. delegation at WHA 2017. Some participants were able to confirm that Irene Koek from USAID; Price, Mitchell Wolfe, and Peter Mamacos from HHS; and Tracy Carson, U.S. Health Attache, would be a part of the U.S. contingent. There was a debate about whether there would be any representative from the Centers for Disease Control and Prevention (CDC), as CDC currently does not have a main lead at this time.

Loyce gave a quick summary of some of the main issues that the U.S. delegation would take a keen interest in. These include the WHO Director-General Election, Global Health Security, Epidemic Preparedness, the debate around the High-Level Panel on Access to Medicines, and U.S. leadership at the multilateral level.

Events and Coordination

Several participants shared details about a number of WHA side-events that their organizations will be hosting in Geneva, Switzerland. Common themes of side events include non-communicable diseases, maternal and child health, global health security, research and development, and gender equality.

GHC is compiling a complete calendar of all public WHA side events on our website, and we will be updating it regularly as details are made available. A special events update will also be sent out to our subscriber list (sign-up: http://tinyurl.com/ghcnewsletter) a week before WHA to facilitate your planning. Please forward details of any events that you would like to have featured on our calendar and in our events update to us at events@globalhealth.org.

Resolutions and Statements

A Cancer Prevention Resolution is on the WHA 2017 Agenda. There will be more details on this and other possible resolutions in our upcoming webinars.

There will be a flexible timeline for submission of statements by GHC member organizations (see statement guidelines: http://globalhealth.org/what-we-do/member-engagement/wha70). 

GHC Delegates and Logistics

With over 70 participants, GHC will host ones of the largest delegations at WHA. WHA Delegate positions for GHC individual members are currently filled up, but there are still spots left for our organizational members. More information about our delegation can be found on GHC’s website: http://globalhealth.org/what-we-do/member-engagement/wha70. For inquiries regarding logistics for WHA 2017, please contact Liz Kohlway, GHC Communications and Member Engagement Manager at ekohlway@globalhealth.org.

Please save the date for our next WHA Policy Scrum Webinar on April 25, 2017. More details will be made available soon.

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Advocacy Update ~ April 3, 2017

By Danielle Heiberg, Senior Advocacy Manager, Global Health Council

Trump Administration Recommends FY2017 Cuts

With all the focus on the Trump administration’s first budget, you would be forgiven for forgetting that the budget for Fiscal Year (FY) 2017 has yet to be finalized. Currently, the federal government is operating under a continuing resolution (CR) that funds the government at FY2016 levels and that expires on April 28.

The administration recently sent to Capitol Hill recommendations for FY2017, which includes $18 billion in cuts to discretionary spending, an amount that would offset a recommended increase to defense and an initial payment to begin construction on the wall at the Mexican border. The proposed cuts would have a profound impact on global health programs, and the larger foreign assistance budget, and is a signal of how the administration will approach these accounts in the full FY2018 budget.

It is unlikely that these cuts will be incorporated into a FY2017 spending bill, as Congress received them too late in the appropriations process. Members of Congress also do not respond favorably to the cuts, with Congressman Eliot Engle (D-NY) calling them “draconian.”

For global health, the administration proposed:

State, Foreign Operations Appropriations Bill

PEPFAR: -$242 million – “This reduction would achieve savings by requiring PEPFAR to begin slowing the rate of new patients on treatment in FY 17, by reducing support to low-performing countries, by reducing lower-priority prevention programs, or by identifying new efficiencies or other savings.”

Family Planning/Reproductive Health: -$62 million – “To achieve additional savings, this option reduces the FY 17 level for this program to the FY17 House committee ceiling.”

Global Health Security: Zeroed out (-$72.5 million) – “This proposal zeroes out global health security programs at USAID in FY 2017 to realize up to $72.5 million in savings. These programs are currently supported with 2-year funds and it is unlikely the agency will obligate a significant portion of these funds under the current CR. This proposal instead seeks legislative authority to repurpose $72.5 million in remaining Ebola emergency funds to support these programs in FY 2017.”

Other specific global health accounts: -$90 million – “To achieve additional savings, reduced levels for: Tuberculosis (-$44.6 million below FY 17 CR); Polio eradication (-$7.9 million); Nutrition (-$16.3 million); Vulnerable children (-$7.5 million); Neglected tropical diseases (-$13.3 million).”

Labor, Health and Human Services Appropriations Bill

CDC’s Public Health Preparedness and Response Grants (PHEP): -$49 million – “PHEP supports all States and 12 localities and territories to upgrade their ability to respond to a range of public health threats. There is overlap across HHS preparedness programs (PHEP and HPP) and the Federal Government has provided more than $18 billion to States since 2002 to improve preparedness capacity.”

Global HIV/AIDS (CDC): -$50 million – “CDC’s Global HIV/AIDS program provides the infrastructure and base support for CDC’s ongoing PEPFAR activities. CDC also receives additional resources for global health from transfers from State Department for PEPFAR and has unobligated balances from prior years.”

NIH Funding: -$1.232 billion – “These savings could be achieved by eliminating spending on new IDeA grants ($50 million) and reducing research grants ($1,182 million).”

Other Proposed Cuts of Note

International Operations and Programs: -$169 million – “This account provides for non-assessed contributions to international organizations. This reduction would eliminate such contributions to most organizations funded through the account including the UN Population Fund and some contributions to climate change programs but preserve flexibility to make contributions to some organizations such as UNICEF as well as those supporting global security functions.”

Development Assistance: -$562 million – “Proposed savings in the DA account include reducing support for bilateral climate change programs that are part of the previous Administration’s Global Climate Change Initiative. Further savings from the FY 2017 CR level can be achieved by reducing economic assistance in other sectors to programmatically sufficient levels, such as through reductions of up to 20 percent in basic and higher education (which has a large pipelines of unspent funds); biodiversity; democracy, human rights, and governance; agriculture and food security (while still addressing key objectives and priorities in the Global Food Security Act); and other sectors.”

GHC will continue to monitor and share more details as they become available.

Other Advocacy Highlights

Global Health Innovation Act Reintroduced
In late March, Congressman Albio Sires (D-NJ) and Congressman Mario Díaz-Balart (R-FL) reintroduced the Global Health Innovation Act (H.R.1660). The bill will require USAID to submit a report to Congress on the development and use of global health innovations in the agency’s programs, projects, and activities. To learn more, read Congressman Sires’s press release.

Championing Global Health in Washington, DC and Beyond
With the proposed budget cuts to foreign assistance programs, now more than ever it’s clear that advocacy is critical in ensuring that Congress continues to support global health investments. In a piece in the SaportaReport, Loyce Pace, Executive Director of GHC, highlights how advocacy efforts are not only up to those in Washington DC, but also those at the state level. Read more.

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Advocacy Update ~ March 20, 2017

By Danielle Heiberg, Senior Advocacy Manager, Global Health Council

Trump’s Proposed Budget Includes Cuts to State Department and USAID

On Thursday, the Trump administration released its first budget with recommendations for Fiscal Year (FY) 2018. Known as a “skinny” budget because only topline funding recommendations for federal agencies are provided, this initial budget provides insight into President Trump’s priorities. A fuller budget with funding recommendations for specific accounts and programs is expected in May.

As had been reported in the media prior to the release, President Trump has proposed a boost of $54 billion to defense spending and offsetting this increase by cutting nondefense discretionary spending by an equal amount, including “deep cuts to foreign aid.” (see page 2, President’s Message)

The administration proposed a 28% cut to the base budgets of the State Department and USAID. When reductions to the Overseas Contingency Operations account are included, the agencies are facing closer to a 30-31% reduction in their budgets. While it’s unclear at this point how these cuts will be applied to various accounts and programs, we can expect cuts to global health, development assistance, and humanitarian response. The administration also signals an intent to refocus “economic and development assistance to countries of greatest strategic importance to the U.S.” (see page 34, Department of State, USAID, AND Treasury International Programs).

Several global health programs were specifically mentioned: Gavi, the Vaccine Alliance, PEPFAR, malaria, and The Global Fund for AIDS, Tuberculosis, and Malaria (pages 33-34); however, the vague wording does not make it clear if current funding levels will be maintained or if the recommended funding will enable these programs to carry out robust programing. And noticeably missing from the budget are other key global health programs, including maternal and child health, tuberculosis, nutrition, family planning, and NTDs. One possibility is that these accounts could be targeted for cuts to maintain funding for the programs highlighted in the budget.

The administration also proposed a reduction in funding to the UN and affiliated agencies, with an expectation that “these organizations rein in costs and that the funding burden be shared more fairly among members.”

There was little information provided on the budget for CDC, with the exception of shifting $500 million to block grants for state. The administration did propose to create a new Federal Emergency Response Fund to ensure rapid response to public health outbreaks (see page 22, Department of Health and Human Services)

As noted previously, several members of Congress spoke out against the deep cuts to foreign assistance, citing its importance to the leadership role the U.S. plays in the world. As Congress ultimately determines the federal budget, it seems clear that appropriations bills will not mirror this budget request.

As the focus on the budget process shifts to Capitol Hill, the global health community will need to be vocal about maintaining funding for global health accounts, and foreign assistance more broadly. Read GHC’s full statement on President Trump’s Budget.

Ways to Get Involved:

USGLC “Leading Globally Matters Locally” Campaign (March 20-24):
Campaign to support the foreign assistance account; see social media toolkit

UN Foundation/Better World Campaign (ongoing):
Access fact sheet, press release, and social media toolkit on the importance of U.S. funding to the UN and the impact cuts will have

NTD Bill Reintroduced

In early March, Congressman Chris Smith (R-NJ) reintroduced the Neglected Tropical Diseases (NTDs) bill (H.R. 1415) in Congress. The bill is co-sponsored by Congressman Gregory Meeks [D-NY], who along with Congressman Smith, is a co-chair of the House Congressional Caucus on Malaria and NTDs. The bill focuses on facilitating effective research and treatment for neglected tropical diseases, including Ebola, through domestic and international coordinated efforts.

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Cuts to UN Funding Would Cost Millions of Lives

This blog was written by GHC Board Member Kate Dodson, Vice President of Global Health for the United Nations Foundation.

On March 16, the White House released an FY18 budget proposal that calls for drastic cuts to the State Department, US Agency for International Development (USAID) and other non-defense discretionary spending. This means a huge reduction in funding for the United Nations (UN), including its specialized agencies that play a central role in promoting and protecting the health of populations around the world – such as the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), UN Women, the Joint UN Program on HIV/AIDS (UNAIDS), and the World Food Program (WFP), among others. If adopted by Congress, such cuts would cripple vital humanitarian programs that contribute to global stability and economic growth, and would severely jeopardize the health and security of Americans at home and abroad.

Strong support for the UN is crucial to achieving many strategic goals that matter to people around the world and is essential to achieving U.S. objectives. While the U.S. President’s initial budget proposal acknowledges the importance of multilateral platforms such as Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis, and Malaria as well as bilateral initiatives like the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI), the proposed cuts to the UN and foreign assistance in general will severely undermine the effectiveness of these programs.

The UN system is well positioned with the international credibility, convening power, and organizational mechanisms to facilitate and coordinate health work on a global scale in a way that the U.S. cannot do alone. A strong and fully-funded UN is essential for U.S. health agencies like the Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) to fulfill their mandate of protecting Americans from health threats both foreign and in the U.S. These organizations rely on the extensive networks of UN agencies, including staff on the front lines, to access remote or unstable areas, and to leverage local infrastructure and resources. They also rely on the convening power of the UN system to provide a platform for multilateral collaboration on health – including the sharing of pathogen samples and timely reporting of outbreaks – and to harness the commitment of other countries toward mitigating and responding to shared health threats.

Funding for the UN amounts to only 0.1% of the overall federal budget but yields an enormous return on investment. For less than a penny per dollar, the U.S. government can play a key role in helping the UN vaccinate 45% of the world’s children, protect 376 million people from contracting malaria each year, and work with countries to prevent, detect, and respond to infectious disease outbreaks, potentially averting the next global pandemic. Republican Representative Ed Royce recently said that cuts to these programs “could damage efforts to combat terrorism, save lives, and create opportunities for American workers.” Even more, withholding full support to the UN could destabilize the international humanitarian order.

This is a make or break moment for global health progress. Due in large part to the efforts of the UN – with support from the U.S. – we are within sight of an AIDS-free generation, on the brink of eradicating polio and guinea worm, and getting closer each day to ending preventable child and maternal deaths. The UN’s work in these areas promotes fundamental American values and advances our nation’s core foreign policy, national security, global health, and economic objectives. A cut in funding to the UN would not make America stronger, safer, or healthier – it would do just the opposite.

Help us take a stand for the United Nations by sharing the following resources from the UN Foundation’s Better World Campaign:

Social Media Toolkit

Press Release

News Articles

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