Advocacy Update

Advocacy Update – June 19, 2017

This post was written by Danielle Heiberg, Senior Advocacy Manager, Global Health Council.

FY18 Hearings and USAID Administrator Nomination Hearing Part of Busy Week on Capitol Hill

Last week was a busy one on Capitol Hill. Secretary of State Rex Tillerson testified at four separate hearings on the proposed FY18 budget for the State Department (including USAID’s budget). He appeared before the State and Foreign Operations Appropriations Subcommittee in the House and Senate, as well as the Senate Foreign Relations Committee (SFRC) and the House Foreign Affairs Committee (HFAC). Secretary Price testified before the Senate Labor, Health and Human Services Appropriations Subcommittee to answer questions on the proposed budget for the Department of Health and Human Services.

Later in the week, Mark Green appeared before SFRC regarding his nomination to serve as Administrator of USAID.

Finally, the Africa, Global Health, Global Human Rights and International Organizations subcommittee of HFAC marked up the End Neglected Tropical Diseases Act (H.R.1415).

Tillerson Testifies on FY18 Budget for State and USAID

Secretary of State Rex Tillerson faced four different committees (State and Foreign Operations Appropriations Subcommittee in the House and Senate, as well as the Senate Foreign Relations Committee (SFRC) and the House Foreign Affairs Committee (HFAC)) last week to answer question on the administration’s proposed FY18 budget for the Department of State and USAID.

Republicans and Democrats alike lambasted the proposed cuts, of up to a third, to the foreign affairs budget. Citing multiple humanitarian crises, ISIS, and global health concerns, Chairman Lindsay Graham (R-SC) pointed out that these cuts would put lives at risk. Secretary Tillerson defended the cuts by stating that “Our budget will never determine our ability to be effective. Our people will.” He also stressed the need for other countries to do more.

Since the hearings focused on the entire budget for State and USAID, global health was only a small part of the hearings. Members raised questions about cuts to PEPFAR, maternal and child health programs, as well as the zeroing out of family planning funding. Senator Jeanne Shaheen (D-NH) and Congressman Ami Bera (D-CA) both raised questions about the expansion of the Mexico City Policy to cover all global health funding and the impact the expansion would have. Tillerson stated that the expansion would be minimal and that the State Department would assess in six months.

Price Testifies on FY18 Budget for Department of Health and Human Services

Secretary of Health and Human Services Tom Price testified before the Senate Appropriations Subcommittee on Labor, Health and Human Services on Thursday to answer questions about the FY18 budget for the Department of Health and Human Services, which includes funding for NIH and CDC. While much of the focus was on Republican-led legislation to replace Obamacare, several Senators did voice opposition to cuts to NIH and CDC and expressed support for the two agencies.

Green Nomination to Lead USAID Advances to Full Senate for Vote

Last Thursday, the Honorable Mark Green testified before the Senate Foreign Relations Committee on his nomination to serve as Administrator of USAID. Green is a former Ambassador to Tanzania and a former Congressman representing Wisconsin.

With the Trump administration recommending cuts of up to one-third for the foreign affairs budget, questions regarding the President’s proposed FY18 budget were a critical part of the hearing. Green stated that the organizing principle of foreign assistance should be on ending its need to exist, he assured the Committee that “USAID will not walk away from our commitment to humanitarian assistance, and we will always stand with people everywhere when disaster strikes.”

Senators also raised questions regarding the possible restructuring of USAID and the State Department, including the possibility that the two could be merged. When asked about restructuring, Green responded, “I believe that the State Department and USAID need to be closely aligned, but I believe they have different cultures.”

Green’s nomination was passed by the Committee and now advances to the full Senate.  

NTDs Bill Marked Up

Late last week the Africa, Global Health, Global Human Rights and International Organizations subcommittee of the House Foreign Affairs Committee marked up the End Neglected Tropical Diseases Act (H.R.1415). Introduced by Congressmen Christopher Smith (R-NJ) and Gregory Meeks (D-NY), the legislation would implement R&D and implementation activities to end neglected tropical diseases (NTDs). Overall the Committee was supportive of the bill, recognizing that diseases no know borders, and passed the legislation without amendment. The bill now advances to the full Committee for consideration. Since Title II falls under the jurisdiction of the Energy and Commerce Committee, the bill will also need to be considered and passed by that Committee.

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Advocacy Update ~ June 5, 2017

By Danielle Heiberg, Senior Advocacy Manager, Global Health Council

Trump Releases FY18 Budget
On May 23, President Trump released his recommended budget for Fiscal Year (FY) 2018. As expected, he drastically cut nondefense discretionary funding while increasing spending on defense and border security.

Standard Provisions Released for Mexico City Policy
In mid-May, USAID released the standard provisions for the expanded Mexico City Policy. Renamed the “Protecting Life in Global Health Assistance,” the expansion of this policy requires that all foreign NGOs certify that they do not provide abortion services, counsel or refer for abortion, or advocate for abortion law reform, even if using non-U.S. funds, in order to be eligible for U.S. bilateral global health assistance from any funding account or for any purpose. Very few exemptions were made: water and sewer infrastructure, Food for Peace, and American Schools and Hospitals abroad. Read PAI’s analysis. From the Kaiser Family Foundation: What is the Scope of the Mexico City Policy: Assessing Abortion Laws in Countries that Receive U.S. Global Health Assistance.

GHC will host a community meeting to discuss the standard provisions on June 6. Email advocacy@globalhealth.org for more information.

Frontline Health Workers Resolution Introduced
In May, Congresswoman Nita Lowey (D-NY) and Congressman Mario Diaz-Balart (R-FL) introduced a resolution acknowledging the contributions of frontline health workers to global health (H.Res.342). The resolution recognizes the role that frontline health workers have in advancing U.S. national security and global health goals.

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Trump Administration Releases FY18 Budget

On May 23, the Trump administration released its recommended budget for Fiscal Year (FY) 2018. “A New Foundation for American Greatness” includes sharp increases for defense and border security, while drastically cutting nondefense discretionary spending.

Overall Foreign Assistance was cut approximately 32 percent, with a cut of 26 percent to global health programs at USAID and the State Department. Of note, funding for family planning, vulnerable children, and the HIV/AIDS program at USAID were zeroed out.

Also of concern, is the zeroing out of the Development Assistance Account, USAID’s core poverty reduction tool and which includes programs for food security, WASH, and education among others. The administration proposes to roll development assistance into the Economic Support Funds to create a new account: Economic Support and Development Funds. This account would be administered by the State Department, which places more importance on strategic objectives and partnerships and minimizes the importance of development in how the U.S. engages globally.

Global health at the Department of Health and Human Services did not fare any better. The National Institutes of Health is facing a 21 percent cut, with the Fogarty International Center zeroed out. An approximate 20 percent cut was proposed for Global Health at the Centers for Disease Control and Prevention.

As the process moves to Capitol Hill, GHC will follow the appropriations process. From our meetings with Congressional offices, we know that global health and foreign assistance is widely supported, and the initial reaction from Congress to the President’s budget indicates that the final numbers will look much different.

Appropriations Budget Table (as of May 2017)

Key accounts (in thousands):

* Includes $250 million from remaining Ebola response funds
** Funding from remaining Ebola response funds
*** The International Organizations and Programs (IO&Ps) is zeroed out. UNICEF will most likely be funded through Maternal and Child Health.

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Advocacy Update ~ May 15, 2017

This post was written by Danielle Heiberg, Senior Advocacy Manager, Global Health Council.

FY17 Budget Approved
In early May, seven months after the start of Fiscal Year (FY) 2017, Congress passed and President Trump signed into law a spending package for the remainder of the fiscal year. Overall, global health accounts were flat funded compared to FY2016, but a few accounts received increases: maternal and child health (including an increase to meet the U.S. commitment to Gavi, the Vaccine Alliance); malaria; and TB. Congress also signaled strong support for programs at NIH and CDC, with the former receiving a $2 billion increase. See full funding chart below.

Congress appropriated flat funding for family planning/reproductive health (FP/RH) accounts, including voluntary contributions of $32.5 million to UNFPA. However, due to the Trump Administration’s Kemp-Kasten determination, funds will instead be shifted to USAID bilateral FH/RH accounts. In addition, no policy “riders” regarding abortion, such as codifying the Mexico City Policy, were included.

While Congress rejected last minute recommended budget cuts from the Trump Administration, we should not necessarily expect that FY2018 will be easy. A leaked Office of Management and Budget (OMB) document, details sharp decreases recommended by the administration. Early indications are that Congress considers any such budget “dead on arrival,” cuts to the overall foreign affairs account could still be a possibility. GHC, its members, and other development organizations will continue to meet with Congressional offices this summer to advocate for the importance of U.S. leadership and investments in global health and development.

Ambassador Mark Green Nominated to Serve as USAID Administrator
Last week, President Trump announced his intent to appoint Ambassador Mark Green to serve as the next Administrator of USAID. Ambassador Green has served as the U.S. Ambassador to Tanzania, as a U.S. Congressman, and as the President of the International Republican Institute. The announcement comes at a time when international development community is closing monitoring proposed budget cuts and possible reorganization of federal agencies and programs. A date has not been announced for a confirmation hearing. Read USAID’s statement.

Update on Mexico City Policy
Guidance on the implementation of the Mexico City Policy (as it would relate to global health accounts), originally expected on May 1, still has not been released, and it is unclear when it will be released. GHC continues to monitor and plans to host a community meeting shortly after the release. For more information email advocacy@globalhealth.org.

Appropriations Budget Table (as of May 2017)

Key accounts (in thousands):

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Advocacy Update ~ May 1, 2017

This post was written by Global Health Council Senior Advocacy Manager Danielle Heiberg.

Congress Passes Short-Term CR to Keep Government Open
Despite being six months into Fiscal Year (FY) 2017, Congress needs another week to finish the spending package for the year. On Friday (April 28), Congress passed a short-term Continuing Resolution (CR) to keep the government open until May 5. Senate and House negotiators were expected to work through the weekend to negotiate the remaining riders and finalize a final bill for the remainder of the fiscal year which ends September 30. House Republicans have a rule that legislation must be available for review at least three days before a vote, so text could be available by Wednesday for a Friday vote.

Draft FY18 USAID and State Budget
On April 28, Foreign Policy published a draft document with FY2018 budget figures for USAID and the State Department. The document is dated April 6, and there is the possibility that these numbers have changed, but it is another signal that the Trump administration has not made global health a priority. While exact figures are not given for most global health accounts, this document has a recommended total of $6.8 billion (a 20% decrease from FY2016 levels) for global health programs at State and USAID (with $5 billion to State programs, including PEPFAR and The Global Fund to Fight AIDS, Tuberculosis, and Malaria and $1.8 billion to USAID programs). The full budget is expected to be released in mid-May. Read the Foreign Policy article or Kaiser Family Foundation’s analysis of the draft document.

Release of Mexico City Policy Guidance
The guidance on how the Mexico City Policy (also known as the Global Gag Rule) will be applied to global health assistance is expected to be released on May 1. It is expected that the policy will exempt The Global Fund to Fight AIDS, Tuberculosis and Malaria and Gavi, The Vaccine Alliance; humanitarian assistance is also not likely to be included. According to the Kaiser Family Foundation, foreign NGOs face losing approximately $8 billion in U.S. foreign assistance due to the policy. GHC will host a community discussion on the policy on May 10. For more information on the community meeting, please email advocacy@globalhealth.org.

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