Advocacy Update

Advocacy Update ~ November 20, 2017

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


Update on FY18 Appropriations

Congress is working against the clock to pass a final Fiscal Year (FY) 2018 spending bill before the Continuing Resolution (CR) ends on December 8. The final push will not be easy, as the current spending levels are higher than the budget caps for FY18. Unless Congress can pass a deal to raise the budget caps, across the board spending cuts, or sequester, will be triggered. It is expected that a short-term CR will be needed for the remainder of December, but it is unclear what a final spending bill will look like.  For the House and Senate proposed FY18 numbers click here.

End Tropical Diseases Act Marked up by House Foreign Affairs Committee

On November 15, Congressman Chris Smith’s (R-NJ) bill, The End Tropical Diseases Act (H.R. 1415), was marked up and passed out of the House Foreign Affairs Committee. The bill aims to expand programs to address neglected tropical diseases (NTDs) which disproportionately impact individuals living in extreme poverty, especially in developing countries. Moreover, the bill calls for USAID and other federal agencies to not only respond to these diseases but also develop and distribute medicines to treat NTDs with an emphasis for field research on the impact of these treatments for future application. As Title II of the bill is under the jurisdiction of the House Energy and Commerce Committee, the bill must be marked up by that committee before moving to the House floor for a vote. Read the press release statement from Congressman Smith here.

Roundtable Round-Up

1) In mid-November, the NCD Roundtable organized a Hill day and met with 12 Congressional offices to discuss the importance of NCDs in the global health agenda.
2) The Global Health Security Roundtable met with the Office of Global Health at CDC to receive a debrief on the Global Health Security Agenda (GHSA) ministerial meeting and the extension of GHSA.

If you are interested in joining these roundtables please email

Advocacy Update ~ November 6, 2017

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

Introduction of Congressional Resolutions to End AIDS in Children
The bipartisan, bicameral resolutions “Recognizing the importance of a continued commitment to ending pediatric AIDS worldwide,” were introduced late last month by Senators Marco Rubio (R-FL) and Bob Casey (D-PA) and Congresswomen Ileana Ros-Lehtinen (R-FL), and Barbara Lee (D-CA). These four members of Congress were joined by 27 bipartisan peers as original co-sponsors of the resolutions. In a press release statement, Charles Lyon, President and CEO of Elizabeth Glaser Pediatric AIDS Foundation, said, “The introduction of these resolutions puts a spotlight on children and the global AIDS response, but also the important role Congress plays in ensuring that the burden of AIDS is ended in children once and for all.” Read EGPAF’s statement.

Redesign Consensus: A Plan for U.S. Assistance
As uncertainty surrounding proposed foreign aid cuts and redesign, or reorganization, of federal agencies still remains in the air, a number of development and foreign policy experts devised separate proposals on more effective organizational structures primarily focused on  USAID and the State Department and the efficient use of foreign assistance. Authors of six of these plans came together to create a unified approach to achieve an empowered U.S. development function. The “Redesign Consensus: A Plan for U.S. Assistance” is a unified set of practical recommendations and steps that the administration and Congress can take to strengthen effectiveness and coherence to the U.S. aid architecture. Read Redesign Consensus proposal.

USAID Administrator Testifies on Accountable Soft Power in the National Interest
In early November, USAID Administrator Mark Green testified before the House State, Foreign Operations, and Related Programs subcommittee in an oversight hearing on the role of soft power in national interests. With the President’s proposal of 30 percent budget cuts to foreign aid, the hiring freeze at USAID, and lack of focus and engagement in potential conflict zones, the committee reviewed the recent accountability of U.S. foreign affairs. A range of issues were covered, with only a few questions specifically on global health. Congresswoman Nita Lowey (D-NY) questioned the justification for the expansion of the Mexico City Policy to all global health programs, and asked Administrator Green for the data on the impact of the expansion. He indicated that USAID is currently working on a review of the first six months of the expanded policy, and would share the final report with Congress.

Global Health Security Agenda extended to 2024
In late October, during the Global Health Security Agenda (GHSA) Ministerial meeting, partner countries, including the United States, agreed to extend the GHSA to 2024. The GHSA is a growing partnership of 50 nations, international organizations, and non-government stakeholders focused on building countries’ capacity to combat infectious diseases and to elevate global health security as a national and international priority. Learn more about GHSA.

Advocacy Update ~ October 23, 2017

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

Senate Passes Budget Resolution

Late last week the Senate passed a Budget Resolution, setting topline funding amounts for the appropriations bills for Fiscal Year (FY) 2018, but similar to the House, the chamber really set up the vehicle for tax reform. The bill maintains spending at 2017 levels, but over the next ten years would cut nondefense spending, ending in 2027 with a $106 billion cut. For the International Affairs Budget, the bill contains $39.5 billion in base funding (the funding breakdown for Overseas Contingency Operations (OCO) between defense and international affairs was not specified).

Although the vote was along party lines (with all Democrats and Independents, along with Senator Rand Paul (R-KY), voting no), some Republicans downplayed its importance. Senator John McCain (R-AZ) stated, “At the end of the day, we all know that the Senate budget resolution will not impact final appropriations.”

Congress has until December 8, when the Continuing Resolution (CR) expires, to work out a final spending bill for the eight remaining appropriations bills for the fiscal year.

Reach Act Introduced in the U.S. House of Representatives

In early October amidst the hustle and bustle of the budget resolution debates, U.S. Representatives David Reichert (R-WA), Betty McCollum (D-MN), Barbara Lee (D-CA), and Daniel Donovan (R-NY) reintroduced the Reach Every Mother and Child Act (H.R. 4022) in the House of Representatives. This bipartisan legislation aims to accelerate the reduction of preventable child, newborn, and maternal deaths, putting us within reach of the global commitment to end these deaths within a generation. The Senate reintroduced the Reach Act in August, which now has 14 cosponsors. Read GHC’s statement.


Advocacy Update – October 10, 2017

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


Deputy Secretary of State John Sullivan Testifies on the Department of State Redesign

In late September, Deputy Secretary of State John Sullivan testified at a House Foreign Affairs Committee hearing on the Department of State Redesign (Redesign). Redesign is a broad effort under the Trump administration to increase efficiency at federal agencies, including USAID and the State Department. The need for this hearing came after speculation of a possible merger of State and USAID and uncertainty on how efficiency at State would increase with the President’s proposed one-third cut to the State and USAID budget.

During the nearly three hour long hearing, committee members probed Sullivan on a broad range of issues such as increasing diversity in State hiring, how diplomacy commitments would continue despite major cuts to funding, and the number of vacant positions for political appointees and ambassadorships in several countries. Sullivan put one concern to rest: under the plan, the State Department submitted to the Office of Management and Budget (OMB) State and USAID will not be merged (OMB is managing the Redesign process and will make final decisions on any restructuring). On cuts to State and USAID funds, Sullivan said that these “budget parameters” are only one part of the process. Further, Congressman David Cicilline (D-RI) cited Secretary Tillerson’s memorandum to the Office of Management and Budget (OMB) that stated Redesign will generate $5 billion over the next five years in efficiencies and asked if this meant further cuts to the State Department. Sullivan emphasized that these are projected efficiencies from restructuring certain functions and offices at State and not a direct cut from the beginning. In regards to a timeline, Sullivan said that the hope is that all major reforms will be completed by the end of the calendar year.

With all of the uncertainty surrounding upcoming changes, Deputy Secretary Sullivan did admit that morale is low at the State Department and having this hearing is part of the process of reducing uncertainty.

The global health community, as well as the broader development community, continues to monitor the Redesign process and the impact future steps will have on global health and development programs.  Read GHC’s statement on Redesign.

Final FY18 Appropriations Sign-on Letter

GHC is circulating a sign on letter urging appropriators to use the highest numbers from each chamber for global health, nutrition and WASH accounts as they negotiate the final FY18 appropriations bill.

In addition, we express concerns with the language allowing:

1) the transfer of unspent Ebola funds to fund USAID global health security activities and support increases for certain infectious diseases, and
2) the broad transfer authority in the House SFOPs bill, which allows funds to be drawn from a broad range of State Department and USAID accounts in order to respond to international infectious disease outbreaks.

U.S-based NGOs are encouraged to sign on. To receive the draft letter and sign on, please email We will accept signatures until COB, Friday, October 13.

Mexico City Policy Six-Month Review

The State Department is committed to conducting a six-month review of the impact of the expansion of the Mexico City Policy (renamed to Protecting Life in Global Health Assistance). In response to the recommendations for the review provided by our community, the State Department has reached out to request additional comments and suggestions from our community.

Organizations, especially implementing organizations, should provide constructive and detailed comments and suggestions on the expanded policy and its impact, both from the programmatic and administrative perspective. We encourage you to provide feedback on how to mitigate and minimize harm, unintended consequences, impacts on the ground, and/or concerns about implementation. It is our understanding that general statements requesting a rollback of the policy will be disregarded. The State Department has indicated that there will be future opportunities to provide input as they continue to review the implementation of the policy.

These guidelines and topline themes, drafted by a few NGOs, may be useful in crafting your comments.

The period to submit comments is short: all suggestions and comments must be submitted by Sunday, October 15 to

Advocacy Update – September 25, 2017

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

House passes Mini Omnibus for FY18

In mid-September, the House made unexpected progress in the annual appropriations process, and passed a mini Omnibus bill, made up of eight spending bills, for Fiscal Year (FY) 2018. The Omnibus included funding for global health in the State and Foreign Operations and the Labor, Health and Human Services, and Education sections of the bill. To put this in perspective, the last time the House completed the appropriations process before the end of the fiscal year was in 2009.

Overall in State and Foreign Operations, which funds USAID and the State Department, funding for global health programs decreased slightly ($8.3 billion for FY18 compared to $8.7 billion for FY17). While most global health programs were flat funded, Family Planning had a 25% cut at $461 million. In the Labor, Health, and Human Services section, top-line funding for NIH increased by $1.1 billion to $35.2 billion. For the CDC, the Center for Global Health was flat funded and funding for the Center for Emerging Zoonotic and Infectious Diseases slightly decreased.

Global health also received some attention in the amendment process. Representative David Engel (D-NY) introduced an amendment to increase funding for TB at USAID from $241 million to $450 million. Although the amendment failed, it was an opportunity to highlight the need for additional funding for TB. Representative Claudia Tenney (R-NY) proposed an amendment to increase funding for community block grants by offsetting funding for CDC global health by $14 million, which could have had an impact on the Center for Global Health’s ability to respond during an outbreak. After a floor debate on the need for increased funding for CDC community block grants, the amendment was withdrawn.

The Senate, while not as far along as the House, has made gradual progress on appropriations. Earlier this month, Congress passed a Continuing Resolution to keep the government funded through December 8, giving the two chambers time to negotiate the differences between their respective spending bills. For the latest on appropriations in the Senate read the Advocacy update from September 11.

View the full Funding Chart.

FY19 Budget Recommendations

Although we are still waiting to see how the FY18 budget process will play out, work has already begun on the FY19 budget. It is our understanding that the Office of Management and Budget (OMB) instructed federal agencies to use the FY18 President’s budget as the starting point for coming up with their requests for the coming fiscal year. The President’s budget cut foreign assistance, which includes the global health accounts, approximately 30%, so we can expect to see similar recommendations in the FY19 budget.

In late August, GHC sent to the Office of Management and Budget (OMB) recommendations for FY19 for the global health accounts at USAID, State Department, as well as the Center for Global Health at CDC, and a few key accounts at NIH. Recognizing the limitations placed on the agencies, GHC recommended at a minimum funding levels that match FY17 levels (for a few accounts, GHC used the House FY18 number if it was higher. At the time, the Senate numbers were not available), but also included higher funding recommendations to demonstrate what is needed to have the greatest impact.

GHC met with OMB in early September to discuss our recommendations and why investing in global health and development is critical.

To compare the FY19 recommendations with the President’s FY18 budget, please refer to the full funding chart above.

Civil Society Recommendations for Six-Month Review of Mexico City Policy

Global Health Council released a statement of principles, endorsed by over 100 civil society organizations, on the upcoming six-month review of the impact of the expanded Mexico City Policy. The State Department proposed a six-month review of the policy’s impact on U.S. global health programs, which have saved and improved the lives of millions around the world. As the timeline approaches for the six-month review, the statement of principles provides recommendations for a review that is meaningful and comprehensive, and proposes an annual review to understand how the policy affects U.S. programs and their outcomes long-term. Read GHC’s press release.

GHC has shared and discussed the statement with State Department, USAID, and others.

Redesign Process: GHC Releases Statement on Importance of Global Health

Earlier this month, federal agencies submitted to OMB their proposals for a “redesign” or restructuring of their respective internal structures, including offices, programs, etc. The foreign assistance community has been closely following the process as it relates to the State Department and USAID, and the role that foreign assistance will have in U.S. engagement globally.

While the process has not been entirely transparent, civil society was invited to several stakeholder listening sessions to provide comments and ask questions of the “Redesign” team at State and USAID. These sessions were not entirely productive as the community was not provided detailed information on the team’s specific plans for restructuring, making it difficult to provide meaningful comments.

GHC released a statement, endorsed by a number of organizations, to USAID and State emphasizing the importance of global health in development. As we did not have details on how, or even if, global health programming would be restructured, the statement is purposely broad. The statement was also shared with OMB, which will make any final decisions on restructuring.

It is unclear at this time, if any of the proposals will be shared publicly, but watch this space for updates as the process moves forward.