Global Health Budget

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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Cuts to UN Funding Would Cost Millions of Lives

This blog was written by GHC Board Member Kate Dodson, Vice President of Global Health for the United Nations Foundation.

On March 16, the White House released an FY18 budget proposal that calls for drastic cuts to the State Department, US Agency for International Development (USAID) and other non-defense discretionary spending. This means a huge reduction in funding for the United Nations (UN), including its specialized agencies that play a central role in promoting and protecting the health of populations around the world – such as the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), UN Women, the Joint UN Program on HIV/AIDS (UNAIDS), and the World Food Program (WFP), among others. If adopted by Congress, such cuts would cripple vital humanitarian programs that contribute to global stability and economic growth, and would severely jeopardize the health and security of Americans at home and abroad.

Strong support for the UN is crucial to achieving many strategic goals that matter to people around the world and is essential to achieving U.S. objectives. While the U.S. President’s initial budget proposal acknowledges the importance of multilateral platforms such as Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis, and Malaria as well as bilateral initiatives like the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI), the proposed cuts to the UN and foreign assistance in general will severely undermine the effectiveness of these programs.

The UN system is well positioned with the international credibility, convening power, and organizational mechanisms to facilitate and coordinate health work on a global scale in a way that the U.S. cannot do alone. A strong and fully-funded UN is essential for U.S. health agencies like the Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) to fulfill their mandate of protecting Americans from health threats both foreign and in the U.S. These organizations rely on the extensive networks of UN agencies, including staff on the front lines, to access remote or unstable areas, and to leverage local infrastructure and resources. They also rely on the convening power of the UN system to provide a platform for multilateral collaboration on health – including the sharing of pathogen samples and timely reporting of outbreaks – and to harness the commitment of other countries toward mitigating and responding to shared health threats.

Funding for the UN amounts to only 0.1% of the overall federal budget but yields an enormous return on investment. For less than a penny per dollar, the U.S. government can play a key role in helping the UN vaccinate 45% of the world’s children, protect 376 million people from contracting malaria each year, and work with countries to prevent, detect, and respond to infectious disease outbreaks, potentially averting the next global pandemic. Republican Representative Ed Royce recently said that cuts to these programs “could damage efforts to combat terrorism, save lives, and create opportunities for American workers.” Even more, withholding full support to the UN could destabilize the international humanitarian order.

This is a make or break moment for global health progress. Due in large part to the efforts of the UN – with support from the U.S. – we are within sight of an AIDS-free generation, on the brink of eradicating polio and guinea worm, and getting closer each day to ending preventable child and maternal deaths. The UN’s work in these areas promotes fundamental American values and advances our nation’s core foreign policy, national security, global health, and economic objectives. A cut in funding to the UN would not make America stronger, safer, or healthier – it would do just the opposite.

Help us take a stand for the United Nations by sharing the following resources from the UN Foundation’s Better World Campaign:

Social Media Toolkit

Press Release

News Articles

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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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Congress Returns After Summer Recess

Congress returned to Capitol Hill this week to deal with Fiscal Year 2017 (FY17) appropriations and funding the domestic response to Zika. With fewer than 20 days remaining in the Congressional schedule before the election and FY16 ending on September 30, little time remains for Congress to address these issues. Earlier this week, Senate Democrats rejected by a procedural vote to advance legislation that would have provided additional funding for the domestic Zika response. The$1.1 billion bill was rejected due to GOP riders, including one to defund Planned Parenthood, attached to the legislation. Congress could potentially attach Zika response funding to the FY17 legislative package. In regards to FY17, Congress is expected to pass a Continuing Resolution (CR) to keep the federal government open beyond September 30. However, it still remains unclear if the CR will expire in December, in which case Congress will return for a lame duck session to complete the federal budget, or if a longer CR will last until March and the new Congress will finish up the FY17 budget.

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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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