Advocacy Update

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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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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Proposed White House Budget Cuts Risk Stalling Global Health Progress
Global Health Council Statement on President Trump’s Proposed Budget

Washington, DC (March 16, 2017)  Today President Donald Trump released a proposed budget that contains close to a one-third reduction in federal funding for the State Department and U.S. Agency for International Development (USAID). These cuts will have a significant impact on foreign assistance, which includes development and humanitarian assistance and funding to the UN, and will have a devastating effect on the world’s poor and have ripple effects for Americans.

Global Health Council is deeply concerned that these cuts to foreign assistance will include global health programs, which would roll back years of progress made in fighting diseases such as HIV/AIDS, malaria, and polio; improving maternal and child health; and strengthening global responses to disease outbreaks such as Zika and Ebola.

Foreign assistance accounts for just 1% of the overall federal budget, but this low cost of life-saving programs yields a significant return on U.S. investments. Surveys continually show many Americans support our leadership role in the world. With support from the United States, we are within sight of an AIDS-free generation; ending preventable child and maternal deaths; and eradicating polio, measles, and guinea worm. These investments in global health contribute to broader foreign policy goals, including stabilizing volatile areas, supporting overseas disaster response, and accelerating trade and development.

“The United States has helped millions of people transition out of poverty and live longer and healthier lives, which creates more stable and economically thriving countries. Along with defense and diplomacy, development is a critical part of our role in the global arena, and the proposed cuts jeopardize that role,” stated Loyce Pace, President and Executive Director of Global Health Council.

Global Health Council calls on Congress to continue to support foreign assistance, including global health programs, by supporting funding of $60 billion for Fiscal Year 2018. Funding these critical accounts that support health, WASH, education, nutrition, and gender programs, as well as humanitarian responses, ultimately strengthens U.S. leadership around the world and fosters a safer, more prosperous America.

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About Global Health Council
Established in 1972, Global Health Council (GHC) is the leading membership organization supporting and connecting advocates, implementers, and stakeholders around global health priorities worldwide. GHC represents the collaborative voice of the community on key issues; we convene stakeholders around key priorities and actively engage with decision makers to influence global health policy. Learn more at www.globalhealth.org. Global Health Council published “Global Health Works: Maximizing U.S. Investments for Healthier and Stronger Communities,” comprehensive consensus recommendations and impact stories available at www.ghbb.globalhealth.org.

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Advocacy Update – March 6, 2017

By Danielle Heiberg, GHC Advocacy Manager

Budget Update

Ahead of President Trump’s speech to Congress last week, it was reported in the media that the administration was sending budget guidance to federal agencies that includes a $54 billion increase to defense and decreasing by the same amount funding to nondefense discretionary accounts.

While exact figures are not known, it was reported that most discretionary accounts would see a 15% cut, while State Department could be facing a 37% cut, reducing its funding to pre-9/11 levels. Such a drastic cut to the State Department account, which also funds USAID, would most likely mean reducing staff levels and drastic cuts to development assistance. While the global health account is separate from development assistance, a cut to these programs will have an effect on the work of our community.

The President is expected to release a “skinny budget” on March 14, but it is doubtful that this budget will contain detailed funding levels for individual accounts. A fuller budget is expected in May.

Congress, which holds the power of the purse, did not react favorably to the initial reports regarding the President’s Budget; Senator Lindsay Graham declaring it “dead on arrival.” Other Republicans also spoke in support of foreign assistance and not balancing the budget through cuts to discretionary programs.

While this is hopeful, it remains critical that we continue to advocate on Capitol Hill on the importance of foreign assistance and on maintaining funding levels. Last week, GHC sent a letter, signed by 70 global health organizations, to the Chairs of the House and Senate Budget Committees supporting the foreign assistance account and highlighting successes due to U.S. investments in global health, nutrition, food security, and other areas.

Update on Mexico City Policy

GHC understands that field guidance was issued outlining the implementation of the Mexico City Policy as it relates to family planning assistance at USAID. The Mexico City policy (also known as the global gag rule) was reinstated by President Trump in the first few days of his administration, however, President Trump expanded the policy to include all global health assistance, not just family planning assistance.

As expected, and consistent with the previous implementation in 2001, that as a condition of receiving family planning assistance from USAID, foreign NGOs will need to agree that they do not provide or promote abortion services or referrals. U.S. NGOs will need to certify that none of their foreign NGO subgrantees provide such services. This will be applied to all new USAID grants and cooperative agreements, as well as existing grants and cooperative agreements when they are amended, that provide family planning assistance.

USAID will release further guidance on how the global gag rule will be applied to global health assistance.

In mid-February, GHC held a community discussion on the global gag rule and how the reinstatement and expansion will affect our community. For more information on the discussion and next steps, email advocacy@globalhealth.org.

For more information:

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