Advocacy Update

Advocacy Update ~ October 9, 2018

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

Appropriations Update

Determined to get the appropriations process back on track this year, Congress passed and the President signed five of the 12 appropriations bills before the end of the Fiscal Year (FY) on September 30. On September 28, the President signed an appropriations minibus that includes the Labor, Health and Human Services and Defense spending bills, as well as a Continuing Resolution (CR) that funds remaining appropriations bills, including the State, Foreign Operations, and Related Programs (SFOPS) bill, until December 7. The differences in the House and Senate versions of the FY 2019 SFOPS appropriations bill, which funds global health programs at USAID and the State Department, will be worked out in conference during the next few months. Votes on the remaining appropriations bills are expected to occur in a lame duck session after the midterm elections.

BUILD Act on the Move

The FAA Reauthorization Act, which includes the Better Utilization of Investments Leading to Development Act of 2018 (H.R. 5105/S. 2463), also known as the BUILD Act, passed in the House and Senate.

The BUILD Act is aimed to assist economic growth in developing countries through U.S. business investments and will create the U.S. International Development Finance Corporation (IDFC), assuming the activities of the Overseas Private Investment Corporation (OPIC), USAID’s Development Credit Authority, USAID’s Enterprise Funds, and other programs.

The IDFC will have broad authority to perform multiple tasks, some of which include issuing direct loans, providing technical assistance, and assisting in making limited grants to unlock larger investments. Under the BUILD Act, the IDFC will prioritize projects in low- and lower-middle-income countries where it furthers U.S. national security and economic interests.

In a joint press statement released by the Senators Bob Corker (R-TN) and Chris Coons (D-DE), cosponsors of the Senate bill, Senator Corker stated, “Our legislation will advance American interests for stability abroad by using the free-market to help countries become more self-reliant and put U.S. foreign aid programs out of business.” Senator Coons added, “The bipartisan BUILD Act will create a 21st century development finance institution with the full suite of tools to bring U.S. private sector investment to low income countries around the world. These new investments will reduce poverty in countries that are critical to our national security while helping U.S. businesses grow and succeed.”

The President is expected to sign the FAA reauthorization and BUILD Act bill in the next few days.

PEPFAR Reauthorization Passes Out of Committees

In late September, the Senate Foreign Relations Committee and the House Foreign Affairs Committee (HFAC) passed the President’s Emergency Plan for AIDS Relief (PEPFAR) Reauthorization bill (S. 3476/H.R. 6651), which will extend programmatic funding until 2023. During markup, HFAC amended its bill to address the omission of the set aside for orphans and vulnerable children (OVC) impacted by HIV/AIDS, which had been included in PEPFAR law since 2003. Floor votes on the bill are anticipated to occur after midterm elections in November.

On September 27, during the United Nations General Assembly, Secretary Pompeo announced the release of 2018 Progress Report on the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020).

Administration Transferred Crucial HHS Funds

In September, Health and Human Services Secretary Alex Azar sent a letter to Congress detailing his intention to transfer up to $266 million from the Department of Health and Human Services (HHS) accounts that support health, education, and research programs—some of which include programs led by the CDC and NIH—to the Office of Refugee Resettlement to cover costs associated with caring for unaccompanied children crossing the border.

Accounts that we know are affected include:

1.) $16.7 million from CDC overall

 a. )$1.9 million from NCEZID
b.) $1.286 million from CDC Global Health

i. $436,000 Global HIV/AIDS
ii. $597,000 polio
iii. $170,000 measles
iv. $83,000 parasitic diseases and malaria

2.) $87.269 million from NIH overall

a.) $12.123 million from NIAID, incl. $235,000 universal flu vaccine
b.) $178,000 from Fogarty
c.) $1.744 million from NCATS

While the transfer is fait accompli, GHC is circulating an organizational sign on letter to Secretary Azar expressing our concerns about the precedent set by these transfers, and the impacts they have on global health long term.

If you are interested in signing on, please email advocacy@globalhealth.org for a copy of the letter. Deadline is Wednesday, October 10.

 

 

Advocacy Update ~ September 24, 2018

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

Appropriations Update

FY 2019 and the end of the fiscal year

In the last few days of the fiscal year (FY), which ends on September 30, Congress is working to pass remaining FY 2019 spending bills packaged as “minibuses” – several spending bills packaged together.

The Senate passed a minibus that includes the Labor, Health and Human Services, and Education and the Defense spending bills (H.R. 6157), which contains funding for programs at NIH and CDC. The minibus is now in the House, with a vote expected this week. The minibus includes increases or sustained funding for global health programs.

NIH is funded at $39 billion (increase of $2 billion), and includes:

  • $78.1 million for the Fogarty International Center (increase of $2 million)
  • $5.5 billion for NIAID (increase of $263 million)

CDC is funded at $7.89 billion (increase of $127 million), and includes:

  • $488.6 million for the Center for Global Health (maintained from FY 2018), including an addition of $50 million for the Infectious Disease Rapid Response Reserve Fund
  • $620.3 million for Center for Emerging Zoonotic and Infectious Diseases (increase of $6 million)

The minibus also contains a Continuing Resolution (CR) that will fund the remaining appropriations bills, including the State and Foreign Operations bill, until December 7. Despite President Trump sending mixed signals on whether he will sign the minibus, House Republican Leadership believe they can avert a government shutdown.

GHC Meets with OMB to Discuss FY 2020

While Congress is in the midst of solidifying appropriations for FY 2019, Global Health Council and the global health community completed funding recommendations for FY 2020 for review by the Office of Management and Budget (OMB). Recently, GHC and a small group of GHC members met with OMB to provide the recommendations and to discuss the critical importance of continued commitment to cost-effective global health programs by the United States.

View GHC’s FY 2020 letter to OMB.

PEPFAR Reauthorization Introduced in the Senate

On September 18, Senators Bob Corker (R-TN) and Bob Menendez (D-NJ) introduced legislation to reauthorize PEPFAR (S.3476) through 2023. The Senate Foreign Relations Committee has placed the bill on the agenda of its next business meeting on Wednesday, September 26; the bill is expected to move quickly through the Senate. The text of the bill may be reviewed here once available to the public.

In late summer, Representatives Chris Smith (R-NJ) and Barbara Lee (D-CA) introduced similar legislation (H.R. 6651) in the House.

Advocacy Update ~ September 10, 2018

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

OMB Rescinds Prospective Rescissions Package

After considerable push-back, the administration did not send a newly proposed rescissions package to Congress. The package was expected to target appropriated but unobligated funding from the International Affairs budget. Although global health programs were not expected to be targeted, the proposed cuts to other development areas, including UN programs, would have had an impact across the development community. If the rescissions package had been sent to Congress, it was unclear if the administration had legal authority to do so, as it would have been released with fewer than 45 days remaining in the fiscal year. While it seems that there will not be another push to rescind funding in the remaining days of this fiscal year, we should expect the administration to continue to target the International Affairs budget.

 

Appropriations Update

Last week, the House returned from August recess and in the short time remaining before the end of the fiscal year (FY), Congress will continue work on FY 2019 appropriation bills. Congress hopes to pass nine of the 12 spending bills as “minibuses” – several spending bills packaged together – this month. It will need to pass a Continuing Resolution (CR) to keep the remaining agencies open. A CR is expected to last until after the midterm elections, but could go until December. . While President Trump has threatened to shut down the government over funding for a border wall, he has backed off on carrying out this threat until after the elections. The State and Foreign Operations (SFOPs) appropriations bill, which funds global health programs at USAID and the State Department, is not expected to pass this month.

In late August, the Senate passed a minibus that includes the Labor, Health and Human Services, and Education spending bill – which contains funding for programs at NIH and CDC– and Defense. The bill is now in the House of Representatives for a vote, and GOP conferees who will participate in the conference committee to negotiate any differences have recently been announced.

 

Community sign on letter to Congress supporting FY 2019 funding levels

While FY 2019 appropriations are being finalized, GHC is working with the global health advocacy community to complete funding recommendations for FY 2020 for review by the Office of Management and Budget (OMB). The global health advocacy community is urging the U.S. to remain committed to investing in and supporting critical, cost-effective global health programs.

 

Looking Ahead to the 116th Congress

With the midterm elections just around the corner, GHC has started preparations for the 116th Congress and the new members and staff expected to arrive on Capitol Hill in January. GHC, in coordination with the global health advocacy community, is working on the next version of the Global Health Briefing Book, which will launch at an event on Capitol Hill early next year. More details will be forthcoming, and we hope you will join us for the Hill Day and global health expo planned for the launch. For more information: advocacy@globalhealth.org.

Advocacy Update ~ August 20, 2018

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

President’s Emergency Plan for AIDS Relief (PEPFAR) Reauthorization Bill

On August 3, Representatives Chris Smith (R-NJ) and Barbara Lee (D-CA), with Ed Royce (R-CA), Eliot Engel (D-NY), Ileana Ros-Lehtinen (R-FL), and Karen Bass (D-CA) as additional cosponsors, introduced the PEPFAR Extension Act of 2018 (H.R. 6651). The bill reauthorizes the President’s Emergency Plan for AIDS Relief (PEPFAR) through 2023 and upholds the United States’ commitment to address the HIV/AIDS epidemic.

In a press release, Representative Lee stated, “For the last 15 years, PEPFAR has been a testament to the bipartisan cooperation on U.S. leadership in global public health. Thanks to PEPFAR, millions of lives have been saved through HIV/AIDS treatment, care, and education. But our work is far from over – we are at a tipping point and Congress must recommit to this fight…I am so proud of our work across the aisle, ensuring that PEPFAR can continue to save lives for decades to come.”

GHC Executive Director Loyce Pace welcomed the legislation, stating, “Over the past 15 years, PEPFAR has had an impact on the lives of those living with HIV/AIDS, as well as building health systems to address malaria, TB, and maternal and child health. By renewing our commitment to this groundbreaking initiative, we emphasize its value and pave the way for even more global health progress worldwide.”

Read GHC’s full statement here.

 

OMB Expected to Send Rescissions Package to Capitol Hill

It is expected that the Office of Management and Budget (OMB) will send a new rescissions proposal to Capitol Hill sometime between now and the end of the fiscal year (FY), on September 30. The rescissions package is expected to target unobligated funds from FY 2017 and FY 2018, and which expire at the end of FY 2018, and could disproportionately impact the International Affairs Budget.

The timing of a new rescissions package is a bit of political maneuver on the part of the administration. The Congressional Budget and Impoundment Control Act states that Congress has 45 legislative days to act on a rescissions proposal, and during this time funding targeted for rescission is impounded, meaning it cannot be spent. If Congress fails to act within the 45 days, impounded funds are released. By timing a rescissions package with fewer than 45 days remaining in the fiscal year and by targeting expiring funds, the administration is essentially forcing Congress to take action to prevent the funds from expiring and returning them to the U.S. Treasury. It is unclear if Congress will take up the rescissions package with a busy schedule planned for September, including the FY 2019 appropriation bills in both chambers and the Supreme Court nomination in the Senate.

GHC will continue to monitor any proposed rescissions and will provide updates as needed.

For more information on the rescission process, please refer to our Rescission FAQ.

 

Appropriations Update

Both House and Senate State and Foreign Operations (SFOPS) and Labor, Health and Human Services (LHHS) Appropriations subcommittees have marked up their bills for FY 2019.

The Senate returned from a short recess on August 15 to resume work on the appropriation bills. The Senate is debating a “minibus”–several appropriation bills packaged together–which could contain the LHHS bill. Senate leadership believes a majority of the appropriation bills will be passed by the end of August, but could still leave other bills, like SFOPS, on the table. The House returns from August recess on September 4 and will have a little under two weeks to come to a decision on the bills prior to the end of FY 2018. If Congress has not enacted the bills in time, a continuing resolution will be needed to keep the government open.

As FY 2019 appropriations are being decided, GHC is also working with the greater global health community to complete funding recommendations for FY 2020 which will be delivered to OMB in the next few weeks.

Please refer to our previous Advocacy Update for highlights on each appropriations bill.

 

Global Health Security Simulation on Capitol Hill

In July, GHC in collaboration with the Johns Hopkins Center for Health Security, NTI | bio, and PATH hosted Clade X: A Global Health Security Simulation for Congressional staff to demonstrate the need for continued support to prevent serious infectious disease threats. The simulation—an abridged, modified version of the original day-long Clade X pandemic exercise designed and hosted by the Center for Health Security—was conducted to highlight the necessity for effective preventive interventions and the importance of accountability of government agencies during global health crises. The exercise gave Congressional staff a window into the choices government leaders must make during a pandemic and highlighted the need for the U.S. to play a leadership role in the global health security community. Read more.

Advocacy Update ~ July 16, 2018

This post was written by the GHC Advocacy Team.

Senate and House Appropriations Committees Release LHHS Bills
Both the Senate and House Appropriations committees marked up their respective Labor, Health and Human Services and Education bills (LHHS) for Fiscal Year (FY) 2019, which includes funding for global health programs at the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). It is possible that the LHHS bill will be rolled into a minibus, several appropriations bills bundled into one bill, although the timing of this is unknown.

Download the funding chart.

Highlights of the House LHHS bill
The House provided $178.9 billion overall for the bill. The CDC’s Center for Global Health received flat funding at $488.6 million, with Global Health Protection receiving $108.2 million. The National Center for Emerging Zoonotic and Infectious Disease (NCEZID), also within CDC, received a $52 million decrease ($562.6 million in comparison to $614.6 million in FY 2018). The Fogarty International Center at NIH received a slight increase of $634,000 ($76.6 million in comparison to $75.7 million in FY 2018). The National Institute of Allergy and Infectious Diseases (NIAID) also received a slight increase ($5.4 billion in comparison to $5.3 billion in FY 2018).

Highlights of the Senate LHHS bill
The Senate provided $1.1 trillion overall for the bill. In the Senate bill, CDC’s Center for Global Health is flat funded at $488.6 million, of which $108.2 million is for the Global Public Health Protection. NCEZID received a $3 million increase ($617.5 million in comparison to $614.5 million in FY 2018). The Fogarty International Center received a little over $2 million increase ($78.2 million in comparison to $75.7 million in FY 2018). NIAID received an increase of about $200 million ($5.5 billion in comparison to $5.3 billion in FY 2018).

House Foreign Affairs Committee Holds Hearing on TB
Last week, the Centers for Disease Control and Prevention (CDC), U.S. Agency for International Development (USAID), and the State Department testified in front of the House Foreign Affairs Committee on Tuberculosis (TB) in Southern Africa. Agency representatives provided updates on current TB programs and progress on interagency collaboration on the U.S. Global TB Strategy. Witnesses included: Ambassador Deborah L. Birx, U.S. Global AIDS Coordinator at the Department of State; Irene Koek, Senior Deputy Assistant Administrator of the Global Health Bureau at USAID; and Dr. Rebecca Martin, Director of the Center for Global Health at CDC.

The hearing focused on the importance of collaboration among the three agencies and across other global health sectors, specifically in regards to TB/HIV coinfection. Dr. Martin discussed how CDC collaborates with the State Department through the President’s Emergency Plan for AIDS Relief (PEPFAR) to test TB patients for HIV, and provide treatment for people living with HIV/TB coinfections. Ambassador Birx emphasized the need to improve the scale of TB preventive therapy to help lower TB prevalence and reduce HIV coinfection. Both Dr. Martin and Ms. Koek stated that having U.S. government leadership present at the upcoming UN High-Level Meeting on TB provides opportunities for new political commitments to end TB and accelerate progress where it is needed the most.

Congressmen Tom Garrett (R-VA) and Joaquin Castro (D-TX) spoke about their families’ experiences with TB and the importance of this work both in the U.S. and abroad. Chairman Christopher Smith (R-NJ) expressed interest in TB funding and the return on investment (ROI) TB-related programs yield. Congressman Garrett pushed further on the issue of funding, asking what he should tell his constituents regarding the ROI of TB-related programs. Dr. Martin responded, “Investments in TB are smart, as every U.S. dollar invested in TB yields $43 in return.”