Advocacy Update

Advocacy Update ~ June 11, 2018

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

White House Withdraws Ebola Rescission

Early last week, the White House made a number of modifications to its proposed rescission package, including a removal of the rescission of $252 million in remaining unobligated Ebola response funding. The modifications to the package were expected after pushback from a number of Congressional Republicans on several of the proposed rescissions, including the Ebola response funding.  Late last week, the House voted on it modified bill, H.R. 3. The Senate has until June 22 to act on the rescission package, but it remains unclear if it will act on it. (Read more about the rescission process.)

The timing of the withdrawal also comes shortly after the administration committed an additional $7 million to respond to the current Ebola outbreak in the Democratic Republic of Congo. Health and Human Services Secretary Alex Azar announced the additional funding during the World Health Assembly in Geneva in late May. Read the Global Health Security Roundtable’s statement on the funding commitment.

The White House is reportedly working on another rescission package targeting unobligated funding from Fiscal Year (FY) 2018. The International Development Budget is expected to be a target and proposed rescissions will reflect the administration’s budget requests for FY2018 and FY2019.

FY19 Appropriations: Update on Bills and Pompeo Testifies on State Department Budget

Congress remains committed to completing the FY2019 appropriations process by the end of the fiscal year on September 30, with markups of the individual bills expected to begin this month. Last week, Senate Majority Leader Mitch McConnell (R-KY) canceled three weeks of the Senate August recess, in order to work on nominations and appropriations. The House is still expected to take all of August off. Despite all of this, many Beltway-insiders still expect that a Continuing Resolution (CR) will be needed to keep the government open after September.

In late May, Secretary of State Mike Pompeo testified in front of the House Foreign Affairs Committee and the Senate Foreign Relations Committee on the Fiscal Year (FY) 2019 State Department budget. Both hearings focused on a range of foreign policy issues including North Korea, Iran, and South Sudan, and on diplomatic security. There was little emphasis on global health issues. However, Representative Ami Bera (D-CA) and Representative Eliot Engel (D-NY) were concerned by the President’s rescission package which includes a $252 million cut to remaining unobligated Ebola response funding from the International Disaster Assistance (IDA) account at USAID (the White House has since withdrawn this rescission; see item above). In the Senate, Senator Jeff Merkley (D-OR) pushed on the administration invoking the Kemp-Kasten amendment and the withholding of funds from UNFPA without any evidence, to which Secretary Pompeo responded that he would follow up on the question.

Advocacy Update ~ May 21, 2018

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

The following advocacy update was written May 21. A few additional highlights:

1.) The rescission package has stalled in the House. There do not seem to be enough votes to pass the legislation in its current form. The administration reportedly is considering changes to the proposal, including changing or removing the proposed rescission of Ebola funding. A vote is not expected in the House until sometime in June.

2.) This week the House and the Senate released 302(b) allocations, or topline spending levels for the FY2019 appropriations bills. For the State-Foreign Operation bills, the House provided $54 billion ($46 billion in base funding and $8 billion for Overseas Contingency Operations (OCO)) and the Senate provided $54.4 billion ($46.4 billion in base and $8 billion in OCO). Compared to the FY2018 enacted level, the Senate provides an additional $400 million in funding, while the House provides level funding. For Labor-Health, Human Services, the House provided $177.1 billion, which is level funding compared to FY2018 enacted, and the Senate provided $179.288 billion.

3.) Due to the World Health Assembly, we are unable to provide a summary of Secretary of State Mike Pompeo’s hearings. A summary will be included in the next advocacy update.

Rescissions

On May 8, President Trump sent a “special message” to Capitol Hill with his recommendations for rescissions, or cuts to already appropriated funding. Included in the rescission package is a $252 million cut to remaining unobligated Ebola response funding from the International Disaster Assistance (IDA) account at USAID. The announcement of the rescissions came a day after the WHO declared a new outbreak of Ebola in the Democratic Republic of the Congo, although it is not expected to have an effect on any U.S. response.

House leadership is bypassing the Appropriations Committee and will bring the bill, H.R. 3, directly to the floor for a vote. However, it’s not clear if they have the 218 votes needed for passage. It’s also unclear when it would come up for a vote; it was expected to be on the floor this week, but the failure to pass the farm bill on Friday might have thrown the House schedule into turmoil. Congress is in recess next week for the Memorial Day holiday, so it might not be until early June. While this process plays out, the proposed funds for rescission are impounded, meaning agencies are unable to spend the funds. The Senate is not expected to act on rescissions until the House passes its bill (if the House does not pass the bill, it’s unlikely the Senate will do anything).

Many members of Congress have stated that they are opposed to rescissions, but there could be a little more support for rescissions targeting appropriated funding prior to FY2018. The White House is expected to send another special message to Congress with proposed rescissions for FY2018 accounts at later date.

GHC’s Global Health Security Roundtable and the Global Health Security Agenda Consortium sent a letter to Congressional leaders opposing the proposed Ebola rescissions. Read the letter to Senate Leadership (and the identical letter sent to House Leadership).

Rescission FAQ

Fiscal Year 2019 Updates

Congress is in full swing with the Fiscal Year (FY) 2019 appropriation process. Since USAID Administrator Mark Green testified in April, Congress has held a hearing with Secretary of Health and Human Services (HHS), Alex Azar, who testified on the FY2019 budget for HHS. This week, Congress will hold hearings with Secretary of State Mike Pompeo who will testify on the FY2019 State Department budget. Congress is preparing for markups for appropriation bills which are expected to begin in June.

Appropriations Mark Ups

The Appropriations committees are determined to get the budget process back on track. Senate Chair, Richard Shelby (R-AL), and House Chair, Hal Rogers (R-KY), would like the appropriations process to return to normal, with the 12 appropriations bills brought to the floor and voted on, and there are rumors that the Senate may cancel or shorten their August recess to finish up. The Senate Appropriations Committee announced that the committee will mark up the State and Foreign Operations (SFOPs) bill the week of June 18 and the Labor, Health and Human Services (LHHS) bill the week of June 25. Despite the motivation to stay on track, there are some who believe that Congress will still need to pass a Continuing Resolution for FY2018 through the midterm elections. Since President Trump has signaled his unwillingness to sign another omnibus during his term, the bills may need to pass as standalone legislation, or as several “minibuses” (several appropriations bills grouped together).

HHS Secretary Azar Testifies on FY 2019 Budget Request

In early May, Alex Azar, Secretary of Health and Human Services (HHS), testified in front of the Senate Labor, Health and Human Services, and Education Appropriations subcommittee on the Fiscal Year (FY) 2019 Budget Request for HHS. The two-hour hearing mainly focused on U.S. domestic health priorities. In Secretary Azar’s opening statement, he highlighted global health security and stated that “one of the most effective ways to protect Americans from the threat of infectious diseases is to enable other countries to follow through on their own commitments to contain and respond to disease threats.” During the hearing, Senator Jerry Moran (R-KS) advocated for continued funding for the CDC’s Center for Global Health, stating that, “the funding is necessary, as seen with the Ebola outbreak, which had huge consequences on Americans.”

Secretary of State, Mike Pompeo, to Testify on Fiscal Year 2019 State Department Budget

Secretary of State Mike Pompeo will testify in front of the House Foreign Affairs Committee on Wednesday, May 23, at 9:00 am and before the Senate Foreign Relations Committee on Thursday, May 24, at 10:00 am. This is Secretary Pompeo’s first appearance in front of the committees since he was sworn in.

Senate Webcast link: https://tinyurl.com/sfrchearing

House Webcast link: https://tinyurl.com/hfachearing

Ziemer Departs National Security Council

Also in early May, Rear Admiral Tim Ziemer was let go from his position as the head of global health security on the White House’s National Security Council (NSC). His departure came a day after the WHO declared an outbreak of Ebola in the Democratic Republic of the Congo. In addition to Ziemer’s departure, the global health office in the NSC was folded and staff shuffled into other offices. Although U.S. officials have stated that the United States remains committed to the Global Health Security Agenda, the timing of Ziemer’s departure, along with the proposed rescissions to Ebola funding and the new outbreak, has many worried. In a Huffington Post article, GHC Executive Director Loyce Pace stated, “We really need a strong leader in place from the U.S. who will help coordinate an interagency response and can really provide that kind of assurance and contribute to the progress made in global health security.”

In addition, Congressmen Gerry Connolly (D-VA) and Ami Bera (D-CA) sent a letter to the White House expressing concern that the administration is retreating from is commitment to global health security. Read the letter.

 

Advocacy Update ~ May 7, 2018

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

White House to Send Rescission Proposal to Capitol Hill

The White House is expected to send a “special message” to Capitol Hill today with its “first round” of proposed rescissions. This first package is expected to rescind, or cancel, unobligated funds from fiscal years prior to FY 2018. The package could include about $11 billion in rescissions, and cuts targeting the International Affairs Budget are expected. Additional rescissions could come later this month. Want to learn more about the rescission process? Check out our Rescission FAQ.

USAID Administrator Testifies on FY 2019 Foreign Assistance Budget, Mike Pompeo Sworn in as Secretary of State

At the end of April, Mark A. Green, USAID Administrator, testified in front of the House and Senate State and Foreign Operations (SFOPs) Appropriations subcommittee on the FY 2019 Foreign Assistance Budget. Across both chambers, members did not hold back on their concerns with the cuts proposed in the President’s FY 2019 Budget Request. Chairman of the Senate SFOPs subcommittee, Lindsey Graham (R-SC), said that the budget was “dead on arrival.”

In his opening statements, Administrator Green testified that the U.S. would continue to lead in humanitarian assistance and will look to grow its support in democracy and governance. He noted that the FY 2019 budget request is $1.3 billion more than requested in FY 2018. During both hearings, several global health issues came up such as Family Planning and Reproductive Health (FP/RH); Water, Sanitation, and Hygiene (WASH); and Global Health Security.

Senator Patrick Leahy (D-VT) asked about the 50% to cut to the family planning account and Senator Jeanne Shaheen (D-NH) called out the administration’s “outmoded policies” for women and girls, saying that funding decisions should be based on evidence. In response to both of the Senators’ points, Administrator Green said that the U.S. supports a wide-range of family planning methods and that  FY 2019 includes a request for $302 million for FP/RH (FP/RH was zeroed out in the FY 2018 President’s budget). He added that “voluntary family planning is an important part of women’s health and empowerment”.

In the House, Representatives Nita Lowey (D-NY) and Barbara Lee (D-CA) also asked questions on FP/RH. Representative Lowey questioned if expanding Mexico City Policy (MCP) to include all global health funding makes it harder to reach the most vulnerable and why more analysis of impact was not done before the expansion. Representative Lee also asked about the $68 million withheld from UNFPA under the Kemp-Kasten designation, and where the money is going and how will those gaps be filled. Administrator Green responded that efforts were undertaken to understand what the expansion would entail and that the next review could provide the evidence to support the expansion.

In addition, Representative Charlie Dent (R-PA) asked for updates on global nutrition programs.  Representative Lowey asked Administrator Green if he could answer whether cutting funding to Gavi, eliminating vulnerable children programs, and cutting Maternal and Child Health program funding by 25%, will harm mothers, children, and babies. In regards to the cuts to Gavi and Maternal and Child Health programs, Administrator Green cited the success of Feed the Future, emphasizing that the U.S. continues to make investments in all of these areas. On program cuts and specific dollar amounts, Administrator Green said that there are tough tradeoffs involved and he readily admits that “we are not meeting every need there is.”

On global health security, Representatives Dent and Grace Meng (D-NY) asked for updates and if it will be prioritized despite the budget cuts. Administrator Green responded that there is a reserve fund for what USAID does on pandemics, and it is a priority and he realizes that need is outstripping resources. He added that he has spent time talking to WHO Director-General Dr. Tedros Adhanom Ghebreyesus and pandemic experts about global health security.

Representative Lowey asked if USAID has determined how a 25% cut to WASH would impact women. Administrator Green stated that he has not seen analysis on impact and emphasized that the amount requested for the WASH program is the largest ever.

Mike Pompeo confirmed as Secretary of State

Last week, Mike Pompeo, former CIA Director, was sworn in as Secretary of State, after a narrow confirmation by the Senate in late April.

Representatives Meeks and Smith Urge Renewed U.S. Commitment to End Malaria

On World Malaria Day, Representatives Gregory Meeks (D-NY) and Chris Smith (R-NJ)senior members of the House Foreign Affairs Committee and Co-chairs of the House Caucus on Malaria and Neglected Tropical Diseases (NTD) issued a statement urging members of Congress to redouble the U.S. anti-malarial efforts. Both Representatives recognize the importance of ending malaria, and while U.S. investments have helped to make significant progress, the number of malaria cases around the world are still high, and we run the risk of rolling back progress.  Read the statement here.

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 ~ April 9, 2018

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

The past two weeks were relatively quiet on Capitol Hill as Congress was in recess. Below are items that we are tracking:

Possible Rescission package

President Trump and Republicans are in discussions to force a vote on a package that would cut billions from the recently passed FY 2018 $1.3 trillion Omnibus. Although, the Omnibus was passed with bipartisan support, Republicans are facing pressure over the large spending package. There is no word on which accounts would be targeted or when a vote would take place.

Pompeo Nomination for Secretary of State

Please see below the nomination hearing date for The Honorable Mike Pompeo of Kansas as Secretary of State. For more information, visit: https://bit.ly/2qgKvaZ

1) Committee: Senate Foreign Relations Committee
2) Date: Thursday, April 12, 2018
3) Time: 10:00 am
4) Location: SD-419

 Moving Forward – FY 2019

As the FY 2019 process moves along, we hope that Congress again rejects the cuts proposed in the President’s budget which contains a 30 percent decrease in the foreign affairs budget, including global health programs at the U.S. Agency for International Development (USAID) and Department of State and cuts that were recommended for programs at the Department of Health and Human Services that support global health, global health research and development, and global health security.

Since the time that the President released his budget, advocates have been on the Hill, lobbying for strong investments in global health and submitting appropriation requests to members of Congress.

See Global Health Council’s funding chart: Funding Chart (FY 2017 comparison to FY 2018, and includes FY 2019)

Global Health Innovation Act Reviewed in the Senate Foreign Relations Committee

The Global Health Innovation Act (H.R. 1660) introduced by Representative Albio Sires (D-NJ) was reviewed by the Senate Foreign Relations Committee and reported favorably without amendment. The bill supports global health research and development by encouraging the development of health products that are affordable, accessible, and culturally appropriate in low-resource health systems. This bill will require USAID to submit a report on the development and use of global health innovations at the agency.