Approps

Advocacy Update ~ August 7, 2017

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

FY18 Appropriations: House Appropriations Committee Approves Bills
In mid-July, the House Appropriations committee approved the Fiscal Year (FY) 2018 State and Foreign Operations bill, which includes funding for USAID, State Department and other international activities. The House rejected the deep cuts proposed by President Trump earlier this year, signaling continued bipartisan support for foreign assistance. (Funding chart.)

On the surface, overall funding for global health programs at both USAID and State appears relatively flat ($8.32 billion for FY18 compared to $8.72 billion in FY17). However, the House recommended that approximately $322.5 million of unspent Ebola response funds be repurposed for Malaria and the Emergency Reserve Fund (which was also cut from $70 million to $10 million), so new funding for global health is actually down. This is also worrisome as this is bolstering accounts with funding that will not be available beyond FY19.

Most programs are at level funding, with the exception of Family Planning/Reproductive Health, which was recommended at a ceiling of not more than $461 million, a cut of 25%. With the ban on contributions to UNFPA (instituted by the Trump administration earlier this year), all funds would be available for bilateral activities. The bill also includes language expanding the Mexico City Policy to include all global health assistance and restricting voluntary contributions to UNFPA; if the language remains in the final bill, it will legislatively impose these two policies for the fiscal year. During the markup, amendments were offered to remove this language, but were defeated along party lines.

The House recommended the full commitment to Gavi, the Vaccine Alliance at $290 million (a $15 million increase); however, because the increase to Maternal and Child Health (MCH) is minimal, overall base funding for MCH is decreased ($814.5 million for FY18 compared to $814 million in FY17).

Also of note was included language of “extraordinary measures” that would allow the Secretary of State to take funding from other accounts, including ‘‘Global Health Programs,’’ ‘‘Development Assistance,’’ ‘‘International Disaster Assistance,’’ ‘‘Economic Support Fund,’’ ‘‘Democracy Fund,’’ ‘‘Assistance for Europe, Eurasia and Central Asia,’’ ‘‘Migration and Refugee Assistance,” “Millennium Challenge Corporation,” if an “international infectious disease outbreak is sustained, severe, and is spreading internationally, or that it is in the national interest to respond to a Public Health Emergency of International Concern.” This language could be a mechanism to move money from other accounts during an outbreak and avoid passing emergency appropriations.

The Appropriations committee also approved the Labor, Health and Human Services, and Education bill, which includes funding for NIH and CDC, and again the committee signaled its support for these programs. Topline NIH funding was increased by $1.1 billion, with Fogarty International Center and the National Institute of Allergy and Infectious Diseases receiving small increases. The Center for Global Health and Global HIV/AIDS, both in CDC, were flat funded, while recommended funding for the National Center for Emerging Zoonotic and Infectious Diseases was decreased by 14.5%.

Meanwhile, on the other side of Capitol Hill, the Senate has allocated $51.2 billion as the top-line spending for its version of the State and Foreign Operations bill. This is a 1.7% cut if you exclude the ISIS supplemental and famine relief funding that was included in the FY17 omnibus (or 10.8% if you include it). The Senate will not markup this appropriations bill until it returns from August recess.

In addition to following the FY18 process, GHC and the global health advocacy community have also begun work on the FY19 budget. The global health community will be submitting FY19 recommendations to the Office of Management and Budget (OMB) later this month.

Resouces:

Reach Act Reintroduced in Senate
Senators Susan Collins (R-ME) and Chris Coons (D-DE), led a bipartisan group of 10 Senators – Jerry Moran (R-KS), Jeanne Shaheen (D-NH), Marco Rubio (R-FL), Richard Blumenthal (D-CT), Mike Enzi (R-WY), Johnny Isakson (R-GA), Richard Durbin(D-IL), and Chris Murphy (D-CT) – in reintroducing the Reach Every Mother and Child Act (S.1730) on August 2. The Reach Act aims to accelerate the reduction of preventable maternal and child deaths, keeping USAID on track to end these deaths within a generation. The legislation is supported by more than 50 diverse non-profit and faith-based organizations working to end preventable maternal, newborn, and child mortality at home and overseas. Click here for GHC’s statement on the Reach Act.

Senate Confirmed Ambassador Mark Green to Lead USAID
Ambassador Mark Green’s nomination to lead USAID was unanimously approved by the Senate confirmation on August 3. Ambassador Green has previously served as the U.S. Ambassador to Tanzania, as a U.S. Congressman, and as the President of the International Republican Institute. Read GHC’s statement on Ambassador Green’s confirmation.

Statement on Global Health Security Agenda
The current endpoint for the Global Health Security Agenda (GHSA) is 2019. GHC’s Global Health Security Roundtable, Global Health Security Agenda Consortium, Global Health Security Agenda Private Sector Roundtable, and Next Generation Global Health Network released a statement in support of extending the GHSA beyond 2019 for a minimum of five years. In addition to building upon the successes of the GHSA, the statement emphasizes that GHSA “2.0” must focus on meaningful action, political will, and financing strategies to enact national roadmaps and fill existing gaps. Read the joint statement.

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Advocacy Update ~ July 10, 2017

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

FY18 Appropriations
Capitol Hill was quiet last week because of the July 4th holiday. There is talk that the House State and Foreign Operations Subcommittee will hold a hearing to markup the FY18 appropriations bill in mid-July, with the full committee markup to shortly follow. There are also rumors that the Senate may delay its August recess by a week to address appropriations. Congress has few working days left to finish up the appropriations process before the start of the new fiscal year on October 1.

CDC Director Nominated
On Friday, Health and Human Services Secretary Tom Price, named Dr. Brenda Fitzgerald as Director of the Centers for Disease Control and Prevention (CDC) and Administrator of the Agency for Toxic Substances and Disease Registry (ATSDR). Dr. Fitzgerald is currently the Commissioner of the Georgia Department of Public Health. Read the official announcement.

Mark Green Nomination
After postponing the meeting to vote on Ambassador Mark Green’s nomination to serve as Administrator of USAID, the Senate Foreign Relations Committee has scheduled the vote for Wednesday, July 12. View the committee schedule.

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Gutting Global Health Programs Serves No One

Washington, DC (May 23, 2017) — Today the Trump administration released its proposed budget for Fiscal Year (FY) 2018 that contains a 26 percent decrease in global health funding at the U.S. Agency for International Development (USAID) and Department of State, as well as the elimination of development assistance. In addition, cuts 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. Of note, is the zeroing out of USAID’s family planning programs and critical partnerships through Fogarty International Center at the National Institutes of Health (NIH). These cuts will have a significant impact on current global health programs, and will have a devastating effect on the world’s poor as well as ripple effects for Americans.

Global Health Council is deeply concerned that these drastic budget cuts would impede efforts to fight 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.

These cuts, coupled with the Trump’s administration proposal to reorganize and possibly eliminate federal agencies and programs, signal a shift away from the leadership role the United States has played in development. Gutting global health and development programs and drastically reducing the workforce will not balance the budget and will end up putting Americans at risk for the consequences of U.S. disengagement.

“What we’re dealing with is a public relations campaign, not sound policy. Declaring war on global health and development serves no one. It doesn’t balance the budget or generate jobs or benefit Americans in any meaningful way. These cuts the administration has proposed for agencies and programs only roll back progress we’ve made on making Americans safer from epidemics and instability or more prosperous from innovation and strong economies. We can either invest in what works today or pay many times over for the consequences tomorrow,” stated Loyce Pace, MPH, President and Executive Director of Global Health Council.

Foreign assistance, including global health, 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. What’s more: U.S. investments in global health work. 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.

Global Health Council calls on Congress to continue to support global health programs, by supporting at a minimum, funding at the FY17 levels for FY2018, but for the greatest impact at least $10.5 billion, and $60 billion overall for the Foreign Affairs account. 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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Media Contacts

Liz Kohlway, Communications & Member Engagement Manager
Global Health Council
ekohlway@globalhealth.org
(703) 717-5251

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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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Fiscal Year 2018 Budget Process Is Underway

Although the timeline for the budget process for Fiscal Year 2018 (FY18) is pushed back due to the elections, GHC, in coordination with the global health advocacy community, this week submitted its recommendations for key global health accounts to the Office of Management and Budget (OMB). In a non-election year, OMB would begin crafting the President’s budget in the early fall, but this year the process will not begin until after the election, and it is expected that the President’s budget will not be released until April.

Overall, GHC recommends relative flat funding or modest increases for most of the global health accounts – $10.421 billion, an increase of around $2 billion over FY16 enacted levels. However, increases were recommended for nutrition ($250 million), tuberculosis ($500 million) and malaria ($874 million). Other recommendations include: $1.2 billion for family planning and reproductive health (including $78 million for UNFPA); $900 million for maternal and child health (including $290 million to meet the U.S.’ pledge to Gavi, the Vaccine Alliance); and $132.5 million for UNICEF.  In addition, GHC recommends that NCD-related objectives are integrated in existing U.S. global health programs.

Recommendations for key global health accounts contained in the budgets for National Institutes for Health (NIH) and the Centers for Disease Control and Prevention (CDC) were also put forward, but GHC will continue to refine these recommendations based on community input.

FY17 Appropriations Update (July 29, 2016)

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