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Advocacy Update ~ April 23, 2018

This post was written by Danielle Heiberg, Senior Policy & Advocacy Manager, and Melissa Chacko, Policy Associate.

Changes Announced at USAID
In early April, USAID unveiled a proposed reorganization of the agency designed to support Administrator Mark Green’s mission to end the need for foreign assistance. The plan is the latest step in the “redesign,” now known as “transformation” plan, that had been launched in spring 2017 by the Office of Management and Budget. The plan outlines several broad goals that include elevating humanitarian assistance; building resilient communities and countries; and focusing on conflict prevention and stabilization. Several new bureaus would be created to oversee these areas of work including a Bureau for Resilience and Food Security, which would house two “Centers of Excellence” focused on nutrition and water, and a Bureau for Development, Democracy, and Innovation, which would bring together existing work on technical and program design. In addition, a new bureau is proposed for better integration of policy and budget, which would include coordination of new “self-reliance metrics” – indicators measuring the progress of countries toward transitioning from foreign assistance.

No changes were proposed to the Bureau for Global Health, and global health is largely absent from the proposal. In briefings with stakeholders, USAID staff have stated that they will ensure coordination between global health and the new centers for nutrition and water under the new structure.

Comments on the proposed plan can be made to USAID by May 4 (to receive a copy of the plan, please email advocacy@globalhealth.org). A final plan is expected to be presented to Congress this summer.

Appropriations Update

  • FY 2018 – Update on Rescission: As we reported in the last Advocacy Update, President Trump and a few House Republicans are considering a rescission bill, which would cut appropriated funds from the final Fiscal Year (FY) 2018 spending package. In the absence of a line item veto, rescission is a way for President Trump to cut funding to specific accounts. Senate Majority Leader Mitch McConnell (R-KY) has dismissed a rescission, saying that it would be a bad idea to “walk back” from a deal made with Democrats on the Omnibus. The administration, however, seems to continue to push the idea and will send Congress its rescission requests by early May. Both chambers would need to approve the cuts by a simple majority.
  • FY 2019 Update: Chairman Richard Shelby (R-AL), who took over the Senate Appropriations Committee upon Senator Thad Cochran’s (R-MS) retirement on April 1, has stated that he would like to have FY 2019 bills marked up and on the Senate floor by June. President Trump has said that he does not want to sign another omnibus, so it’s expected that Congress could pass several “minibuses” or individual appropriations bills combined into small spending packages.

USAID Administrator Mark Green is on the Hill this week to testify before the House and Senate Appropriations subcommittees on State Foreign Operations and Programs (SFOPs) on the FY 2019 budget request for USAID. Administrator Green will appear before the House subcommittee on April 26 at 2:00 pm. He is expected to appear before the Senate subcommittee on April 24.

Senate Foreign Relations Committee Holds Nomination Hearing for Mike Pompeo
On April 12, the Senate Foreign Relations Committee held a nomination hearing for Mike Pompeo to serves as Secretary of State. While the hearing touched upon State Department funding and human rights, there was no focus on development or global health. On funding, Pompeo said that he would defend needed resources for the State Department. Further when asked by Senator Ben Cardin (D-MD) if Pompeo would spend the funds that Congress appropriated to the agency Pompeo stated that “he had a legal requirement to do so and would try to make sure he’s doing so in a way that delivers value.” With Pompeo’s hearing behind us, we are now waiting for a decision from the Senate Foreign Relations Committee, with a vote possible as early as this week.

Dr. Kenneth Staley named the New U.S. Global Malaria Coordinator
In early April, the White House announced Dr. Kenneth Staley as the new U.S. Global Malaria Coordinator with the  U.S. President’s Malaria Initiative (PMI). Previously Dr. Staley worked on product development and innovation as a Director of Medtronic, and for the last few years, he was with McKinsey and Company, where he led teams working on public health crisis response, including Ebola and Middle Eastern Respiratory Syndrome (MERS). Dr. Staley takes over a newly expanded PMI: in September 2017 USAID Administrator Mark Green announced new country programs in Cameroon, Cote d’Ivoire, Niger, and Sierra Leone and an expanded country program in Burkina Faso.

Advocacy Update ~ March 12, 2018

This post was written by Danielle Heiberg, Senior Policy & Advocacy Manager, and Melissa Chacko, Policy Associate.

 

Are we Nearing a Vote on a Final Bill for FY18?

As we get closer to March 23, when the current Continuing Resolution (CR) expires, it seems that Congress is close to voting on a final spending package for the remainder of Fiscal Year (FY) 2018. We are hearing that the spending bill will be released on March 14 and the House of Representatives will vote on it shortly thereafter. This will give the Senate about a week to vote on the legislation in order to avoid another government shutdown.

The topline numbers, known as 302b, for each spending bill have not been released, so at this time we still don’t know how the International Affairs budget, and therefore the Global Health Programs at State and USAID, will fare.

As Congress finalizes FY18 appropriations and starts on the FY19 appropriations process, it is prime time for the global health community to advocate on Capitol Hill for maintaining robust global health funding. Global Health Council created a graphic with a list of “Hill Days” when the community is advocating on Capitol Hill. View the graphic.

Tentative Hearing Schedule Released

Originally scheduled for late February, the hearings to discuss the FY19 budget with Secretary Rex Tillerson and Administrator Mark Green were rescheduled to mid-March in both the House Foreign Affairs and Senate Foreign Relations Committees. At this time, hearings before the Appropriations committees have not been set.

Tentative dates are:

Secretary Tillerson:
-Senate Foreign Relations Committee – Thursday, March 15 – 10:00 am
-House Foreign Affairs Committee – Tuesday, March 20 – 9:30 am

Administrator Mark Green:
-Senate Foreign Relations Committee – Tuesday, March 20 – TBD
-House Foreign Affairs Committee – Wednesday, March 21 – 9:30 am

Representative Smith Introduces Cardiovascular Disease Resolution

At the end of February, Representative Chris Smith (R-NJ) introduced H.Res.752, a resolution recognizing the rise of cardiovascular disease (CVD) as the world’s leading cause of preventable death and disability. The resolution calls on the Department of State, USAID, and CDC to comprehensively examine the impact of CVDs on health and development in U.S. priority assistance countries. It also calls for the development of a coordinated strategy by integrating CVD into existing programs. Read the resolution.

Reflections from the Global Health Community: Changing the Way We Operate

By Melissa Chacko, Policy Associate, Global Health Council

As global health organizations in Washington, DC are preparing to hit quarter one goals, they are juggling advocacy around both the Fiscal Year 2018 and 2019 U.S. budgets as well as advocating for global health legislation and policy. This robust agenda requires the global health advocacy community to stay one step ahead of possible roadblocks. But sometimes, it’s worth stepping away from the routine and reflect on how our community operates, which gives us the opportunity to understand the “why” of how we work and if our approaches are appropriate in the current global health landscape.

While there are multiple perspectives on this topic, we spoke with a few members of the global health community and compiled five ways that the community can change how it operates. These perspectives range from rethinking global health assistance to working toward bold goals. While these interviews do not represent the perspectives of the entire community, it springboards discussions about how we can think outside of the box to reach our advocacy goals.

1.) Putting LMIC Priorities First

“The global health community needs to embrace a new way of operating in global health assistance. Global health assistance is primarily framed around donor priorities, and low – and middle – income countries (LMICs) then work to develop a plan for using related funds. While we have seen successes in priority areas, particularly around HIV/AIDS, malaria, and child health, these efforts have not transformed health systems. To transform health systems we need to change how we engage with LMICs, especially those experiencing economic booms. Many middle-income countries have transformed their health systems by prioritizing primary health at the community level. Donors should collaborate with these countries to help other LMICs improve their health systems through South-South partnerships. The United Nations defines  South-South cooperation as a broad framework of collaboration among countries of the South in the political, economic, social, cultural, environmental and technical domains. Triangular cooperation occurs when traditional donors facilitate such initiatives. The global health community should support these types of partnerships and donors should leverage them to ‘work ourselves out of a job.’ ”

 

Tiaji Salaam
Global Health Specialist
Congressional Research Service


2.) Rethinking Public-Private Sector Partnerships

 “In addition to changing the way we operate with countries we need to reconsider how we use the term ‘public-private partnerships.’ At the moment, most public-private partnerships supported by donors in the health sector are collaborations between industrialized nations and large private companies based in those respective countries. The global health community could benefit from broadening those partnerships and including more frequently entrepreneurs and private companies in LMICs. Engineers in Cameroon and Uganda, for example, have developed inexpensive devices for expanding access to cardiologists and diagnosing pneumonia, respectively. We need to increase our support for local private companies. Broader use of innovative technologies developed in the field can increase sustainability, decrease costs, and may be more suitable for the local environment, both culturally and technologically.”

 

Tiaji Salaam
Global Health Specialist
Congressional Research Service

 

3.) Building Equal Gender Representation in Global Health Leadership

“One of the moments in 2017 that I believe pushed the global health community to do better and change the way we operate was the lack of equal gender representation in global health leadership. An example of this was the photo taken of global health leaders at the Universal Health Coverage Forum in Japan that perfectly depicted the lack of equal gender representation in global health leadership, where only one leader was a woman. This lack of representation is evident throughout global health, as women make up 75% of the health workforce yet occupy less than 25% of the most influential leadership positions. We can change the way we operate by identifying these discrepancies in global health leadership and push for equal representation in global health leadership.”

 

Roopa Dhatt
Executive Director
Women in Global Health

 

4.) Breaking Out of Silos

With the UN High-Level Meeting on Tuberculosis (TB) taking place later this year, I think there is a worldwide understanding that Tuberculosis cannot go any further as the leading global infectious killer. As a global health community, we need to break out of our silos and understand what it takes in terms of resources and programs to stop the TB epidemic from growing.”

“While it’s easier said than done, there are opportunities to break out of our silos and work together. From a science perspective, there are naturally sort of communities that find themselves as key stakeholders on cross-sectoral global health issues. For example, we know that TB is the leading cause of death for people living with HIV. Knowing this, the TB and HIV/AIDS communities often work together to share best practices and tactics based on historic wins from both the domestic and global level. However, some connections are not as obvious as HIV and TB and it is up to organizations to have the courage to cut through the red tape that limits the NGO space and cooperate better. For example, Treatment Action Group (TAG) connected with the maternal and child health community to collaboratively lead advocacy on a federally-mandated task force on the inclusion of pregnant and lactating women who have tuberculosis in clinical trials who for unfound reasons are often categorically excluded. TAG and other grassroots activists saw this is as opportunity to put pregnant women with TB on the map and connect with maternal and child health stakeholders and understand how TB affects maternal and child health issues.”

 

Suraj Madoori
U.S. and Global Health Policy Director
Treatment Action Group

 

5.) Working Toward Bold Goals through Incremental Improvements

In our interactions with policymakers, their staff, and others who shape key funding and legislative decisions that affect global health, we need to keep striking the right balance of being passionate advocates for our issues, deeply committed to solving big problems and savvy partners who can propose targeted policy solutions that are workable in a challenging environment. We can continue working towards big, bold goals through measurable, incremental improvements. The maternal and child health advocacy community’s effort to pass the Reach Every Mother and Child Act is a great example. This bill sets an incredible goal – to end preventable child and maternal deaths globally – and outlines specific, targeted steps the U.S. government can take to contribute to achieving it: by focusing on the poorest and most vulnerable populations; improving coordination among U.S. government agencies, foreign governments, and international organizations; and requiring a coordinated strategy with ambitious, measurable targets annually reported to ensure accountability and maintain the pace of progress towards our goal – a world where no mother or child dies needlessly. As advocates, we’re able to accomplish tremendous things when we’re smart, strategic, and persistent, with an eye towards the steps we can take year by year to continue progress towards goals with decades-long horizons.”

 

Emily Conron
Senior Advocacy Associate
World Vision US

Be the Catalyst!

When we question how we operate, we are also challenging our community to do better by addressing the “elephant in the room” and thinking strategically of who we are missing in our discussions. However, it is important to emphasize that these conversations, while fruitful, can end in wishful thinking when we do not follow them with action. Moving from discussion to action requires courage and the ability to work beyond our comfort zones and hold each other accountable. But when we do it, we become catalysts and more effective global health advocates.

Danielle Heiberg, Senior Advocacy Manager

Danielle Heiberg is the Senior Advocacy Manager at Global Health Council (GHC). In this role, she manages GHC’s domestic and global advocacy strategy and coordinates GHC’s relationship with the global health advocacy community. She oversees GHC’s appropriations and legislative work; manages the publication of “The Global Health Briefing Book” and other advocacy resources; and coordinates the work of several thematic roundtables. Prior to joining GHC, she was a Senior Program Associate at InterAction, where she was responsible for managing thematic working groups on global health, food security and agriculture, and climate and development. Danielle also managed communications and outreach for NGO Aid Map, an initiative to map the work of InterAction members. Previously, she worked in the Public Policy office of Yahoo and in the Congressional and Public Affairs office of the Institute of Museum and Library Services, an independent federal agency. She also worked on Capitol Hill for Senator Dianne Feinstein (D-CA). Danielle holds a BA in International Relations from Mills College.