Global Health Budget

Advocacy Update – June 19, 2017

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

FY18 Hearings and USAID Administrator Nomination Hearing Part of Busy Week on Capitol Hill

Last week was a busy one on Capitol Hill. Secretary of State Rex Tillerson testified at four separate hearings on the proposed FY18 budget for the State Department (including USAID’s budget). He appeared before the State and Foreign Operations Appropriations Subcommittee in the House and Senate, as well as the Senate Foreign Relations Committee (SFRC) and the House Foreign Affairs Committee (HFAC). Secretary Price testified before the Senate Labor, Health and Human Services Appropriations Subcommittee to answer questions on the proposed budget for the Department of Health and Human Services.

Later in the week, Mark Green appeared before SFRC regarding his nomination to serve as Administrator of USAID.

Finally, the Africa, Global Health, Global Human Rights and International Organizations subcommittee of HFAC marked up the End Neglected Tropical Diseases Act (H.R.1415).

Tillerson Testifies on FY18 Budget for State and USAID

Secretary of State Rex Tillerson faced four different committees (State and Foreign Operations Appropriations Subcommittee in the House and Senate, as well as the Senate Foreign Relations Committee (SFRC) and the House Foreign Affairs Committee (HFAC)) last week to answer question on the administration’s proposed FY18 budget for the Department of State and USAID.

Republicans and Democrats alike lambasted the proposed cuts, of up to a third, to the foreign affairs budget. Citing multiple humanitarian crises, ISIS, and global health concerns, Chairman Lindsay Graham (R-SC) pointed out that these cuts would put lives at risk. Secretary Tillerson defended the cuts by stating that “Our budget will never determine our ability to be effective. Our people will.” He also stressed the need for other countries to do more.

Since the hearings focused on the entire budget for State and USAID, global health was only a small part of the hearings. Members raised questions about cuts to PEPFAR, maternal and child health programs, as well as the zeroing out of family planning funding. Senator Jeanne Shaheen (D-NH) and Congressman Ami Bera (D-CA) both raised questions about the expansion of the Mexico City Policy to cover all global health funding and the impact the expansion would have. Tillerson stated that the expansion would be minimal and that the State Department would assess in six months.

Price Testifies on FY18 Budget for Department of Health and Human Services

Secretary of Health and Human Services Tom Price testified before the Senate Appropriations Subcommittee on Labor, Health and Human Services on Thursday to answer questions about the FY18 budget for the Department of Health and Human Services, which includes funding for NIH and CDC. While much of the focus was on Republican-led legislation to replace Obamacare, several Senators did voice opposition to cuts to NIH and CDC and expressed support for the two agencies.

Green Nomination to Lead USAID Advances to Full Senate for Vote

Last Thursday, the Honorable Mark Green testified before the Senate Foreign Relations Committee on his nomination to serve as Administrator of USAID. Green is a former Ambassador to Tanzania and a former Congressman representing Wisconsin.

With the Trump administration recommending cuts of up to one-third for the foreign affairs budget, questions regarding the President’s proposed FY18 budget were a critical part of the hearing. Green stated that the organizing principle of foreign assistance should be on ending its need to exist, he assured the Committee that “USAID will not walk away from our commitment to humanitarian assistance, and we will always stand with people everywhere when disaster strikes.”

Senators also raised questions regarding the possible restructuring of USAID and the State Department, including the possibility that the two could be merged. When asked about restructuring, Green responded, “I believe that the State Department and USAID need to be closely aligned, but I believe they have different cultures.”

Green’s nomination was passed by the Committee and now advances to the full Senate.  

NTDs Bill Marked Up

Late last week the Africa, Global Health, Global Human Rights and International Organizations subcommittee of the House Foreign Affairs Committee marked up the End Neglected Tropical Diseases Act (H.R.1415). Introduced by Congressmen Christopher Smith (R-NJ) and Gregory Meeks (D-NY), the legislation would implement R&D and implementation activities to end neglected tropical diseases (NTDs). Overall the Committee was supportive of the bill, recognizing that diseases no know borders, and passed the legislation without amendment. The bill now advances to the full Committee for consideration. Since Title II falls under the jurisdiction of the Energy and Commerce Committee, the bill will also need to be considered and passed by that Committee.

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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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Trump Administration Releases FY18 Budget

On May 23, the Trump administration released its recommended budget for Fiscal Year (FY) 2018. “A New Foundation for American Greatness” includes sharp increases for defense and border security, while drastically cutting nondefense discretionary spending.

Overall Foreign Assistance was cut approximately 32 percent, with a cut of 26 percent to global health programs at USAID and the State Department. Of note, funding for family planning, vulnerable children, and the HIV/AIDS program at USAID were zeroed out.

Also of concern, is the zeroing out of the Development Assistance Account, USAID’s core poverty reduction tool and which includes programs for food security, WASH, and education among others. The administration proposes to roll development assistance into the Economic Support Funds to create a new account: Economic Support and Development Funds. This account would be administered by the State Department, which places more importance on strategic objectives and partnerships and minimizes the importance of development in how the U.S. engages globally.

Global health at the Department of Health and Human Services did not fare any better. The National Institutes of Health is facing a 21 percent cut, with the Fogarty International Center zeroed out. An approximate 20 percent cut was proposed for Global Health at the Centers for Disease Control and Prevention.

As the process moves to Capitol Hill, GHC will follow the appropriations process. From our meetings with Congressional offices, we know that global health and foreign assistance is widely supported, and the initial reaction from Congress to the President’s budget indicates that the final numbers will look much different.

Appropriations Budget Table (as of May 2017)

Key accounts (in thousands):

* Includes $250 million from remaining Ebola response funds
** Funding from remaining Ebola response funds
*** The International Organizations and Programs (IO&Ps) is zeroed out. UNICEF will most likely be funded through Maternal and Child Health.

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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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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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