Infographic: The Significant Impact of Budget Cuts on Global Health


Infographic courtesy: Friends of the Global Fight



GHC member Friends of the Global Fight published a press release voicing deep concern about proposed cuts to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. According to Friends’ analysis of President Trump’s proposed FY19 budget released on February 12th, the “budget request, which proposes cutting $425 million from the U.S. commitment to the Global Fund, would risk resurgence of disease, potentially squandering major progress that the U.S. has led in the fight against AIDS, tuberculosis, and malaria.” They also released a new infographic (above), detailing the serious impact that the proposed $425 million (31 percent) cut to the Global Fund would have on its lifesaving work. Additionally, watch Friends’ video calling on Congress to support the Global Fund, and support them by spreading the word with the aid of their social media toolkit.


Advocacy Update ~ February 12, 2018

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

6 More Weeks of FY18 Appropriations Discussions

On Friday morning, President Trump signed into law a budget deal that includes a six-week stopgap spending bill, the fifth Continuing Resolution (CR) for this fiscal year (FY). This CR will keep the government open through March 23. This latest activity came about after extensive debates on lifting the spending caps and a push by House Democrats for a floor vote on the Deferred Action for Childhood Arrivals program. The budget deal and CR was temporarily threatened by Senator Rand Paul, who blocked a vote until after midnight on Thursday night, resulting in a brief government shutdown – the second one of the fiscal year.

The budget deal resolves the challenge Congress was facing on spending caps and sequestration. The legislation a $320 billion package that raises discretionary and non-defense discretionary spending over the next two years. Breaking this down, defense spending will rise by $80 billion and non-defense discretionary (NDD) spending will rise by $63 billion for FY18, with $21 billion in NDD targeted for domestic priorities. For FY19, defense spending will increase an additional $85 billion and NDD spending will go up an additional $68 billion.

While the increase in NDD spending allows leeway for appropriators to maintain level funding in the International Affairs account (150 account), final allocations, known as 302(b), for each spending bill, still need to be determined. With about one-third of the increase in NDD spending already targeted for specific programs, it doesn’t leave much left to be allocated to other accounts. Moreover, the budget deal includes a cut to the Overseas Contingency Operations (OCO) in the 150 account, meaning that our best hope for level funding for this account is to increase base spending. The 302(b) levels are expected tonight or Tuesday morning. Then appropriators will spend the next six weeks finalizing FY2018 spending bills, most likely wrapping all spending bills into an omnibus bill.

View GHC Appropriations Chart.

President’s FY19 Budget

The President’s FY19 Budget is expected to be released today. It’s unclear if a full budget or a “skinny” budget, with just topline numbers, will be made available. Justifications for the recommendations are not expected until spring. Similar to last year, we expect to see around a one-third cut to the International Affairs budget. GHC will release an analysis of the budget when it is available.

State Department Releases 6-month Review of Mexico City Policy

Last week the State Department released a review of the first six months of the implementation of the expansion of the Mexico City Policy (renamed to the Protecting Life in Global Health Assistance). With the review covering May-September 2016, and many awards, particularly within PEPFAR, not yet subjected to the policy, it wasn’t expected that anything more than a superficial analysis could be provided. The review cites that only four NGOs declined to comply with the policy, but over 500 prime recipients of U.S. funding have not yet had to determine compliance. The review primarily acknowledged the need for clarification on parts of the language dealing with financial support, training, and termination due to non-compliance.

The State Department committed to another review to be completed by December 15, 2018. GHC will continue to advocate with the State Department and other agencies for a thorough and transparent review in order to fully understand the impact of and how to mitigate harm from this expanded policy.

Read the Six Month Review.

Read GHC’s statement.

CDC Plans to Pull Back from 39 of 49 Country Posts

In January, the Wall Street Journal reported that CDC would downsize its programs in 39 of the 49 countries where CDC maintains an overseas presence to support global health security activities. The downsizing is in anticipation of the expiring five year Ebola supplemental package at the end of FY19. The remaining ten countries that the CDC plans to focus on are India, Thailand, Vietnam, Jordan, Kenya, Uganda, Liberia, Nigeria, Senegal and Guatemala. In response to this potential scale back, Global Health Council, the Global Health Security Consortium, Next Generation Global Health Security Network, and the Global Health Technologies Coalition sent a letter to HHS Secretary Alex Azar, and others in the administration, to share the concerns on the pending funding cliff and asked for an open dialogue with HHS to discuss how to move forward. Read the letter here. The letter was circulated on news platforms such as the Washington Post and CNN.

Dr. Anne Schuchat Assumes Acting Director Role at CDC

Dr. Anne Schuchat will serve as acting director of CDC following the resignation of Dr. Brenda Fitzgerald at the end of January. Dr. Fitzgerald’s resignation came shortly after Politico published reports that exposed her investments in a tobacco company after she accepted the director’s position.

More Than Words – The Case for Cultural Sensitivity in Translation

This blog was written by Sandra Alboum, founder and CEO of Alboum Translation Services as part of Global Health Council’s Member Spotlight Series. Alboum Translation Services is a translation agency that serves nonprofits worldwide. Their clients include the World Health Organization, Elizabeth Glaser Pediatric AIDS Foundation, American Cancer Society, Johns Hopkins Bloomberg School of Public Health, Pathfinder International, and Planned Parenthood, as well as other organizations working in public health, education, the environment, human services, and arts and culture. For more information, visit or contact Sandra at Alboum Translation Services is a Global Health Council 2018 member.

Tibetan nomadic women attend a maternal and child health education session © 2005 Aleksandr Dye, Courtesy of Photoshare

“Your auntie’s aunt.” Roughly translated from Mandarin to English, that’s how Chinese women refer to getting their period each month. Your auntie’s aunt arrives and then when she longer comes because of menopause, she goes on holiday. More than slang, this is how physicians also refer to women’s monthly cycles in conversations with patients.

Understanding this cultural nuance was critical to the success of one nonprofit’s recent global patient education campaign. The organization had embarked on an effort to educate women worldwide about early signs of ovarian cancer. US-based program managers felt strongly that all materials should use accurate medical terminology rather than colloquialisms, as the program sought to provide women with appropriate language to use when speaking with their doctors. Brochures and fact sheets were translated from English into six languages. When, as part of the quality control process, translations were back-translated into English, the less formal language of “your auntie’s aunt” and “holiday” were found. Program managers insisted these be changed – calling into question the overall quality of the translation. Translators and editors pushed back, however, citing the program’s goals as the reason for the non-medical terminology.

In the end, the translation team’s recommendations prevailed and the educational materials were published utilizing language that was truly understood by the intended audience. While not the terminology we’d use in the United States in English, it was the terminology that made the campaign the most effective and impactful in China.

Had translators used medical terminology in the ovarian cancer prevention campaign described, the materials would have been rendered useless before they were placed in a single patient’s hand. Terms like menstruation, menstrual cycle, and menopause would have not been understood as relevant to them – they would have been glossed over as something they’d never heard of and therefore never experienced. With this story in mind, and as you consider your own organization’s global campaigns, here are a few ways to ensure effective communications and materials.

1) Skip Google Translate (and other automated tools). You get what you pay for with a free tool. Professional translators bring the human element of communication – the understanding of context and cultural nuance that is essential to a quality translation. While fluency in both the original and target language is essential, translators who are familiar with the subject matter of the material being translated bring additional value to delivering an accurate, effective translation.

2) Know Your Audience. Spanish isn’t Spanish worldwide and even in the United States. Start by defining your audience – where will the material be used or where is your audience from? If you’re targeting European Spanish speakers, their dialect will be notably different from those hailing from Mexico or Ecuador. Also consider the reading level of your audience. If you’re talking to a population with lower (or no) education, their ability to understand complex material may be limited.

3) Consider Cultural Nuances. How one culture refers to a health condition is often notably different from another. Be flexible with both words and graphics to most effectively convey your message in another language or geography. In addition, review images to ensure they reflect the audience as well. There’s little value in a photograph of a white woman in shorts and a short-sleeved t-shirt on a tree-lined street in a communication being used in the Middle East where women traditionally cover their bodies and communities look markedly different that those in suburban America.

As with any marketing, advocacy, fundraising, or communications program, global campaigns and domestic programs targeting non-English speaking populations must consider the program goals, audience, materials, and budget for them to have maximum effectiveness.

A Check Up on U.S. Global Health Policy, After One Year of the Trump Administration

Image credit: Kaiser Family Foundation


On January 29, 2018, Jennifer Kates, Josh Michaud, Ashley Kirzinger, and Cailey Muñana of the Kaiser Family Foundation issued a brief, where the authors took “stock of the U.S. global health response on the occasion of one year of the Trump Presidency and look ahead to the global health policy issues that are likely to be front and center in the coming months and years.” The brief shows a range of problems facing the global health community, both pre-dating the presidency and after, but indicate that half of the public still believes the United States should maintain its leadership in global health and that global health programs still enjoy strong bipartisan support.

Four Ways Global Health Organizations Can Correct the Gender Imbalance in Their Own Leadership—and Beyond

This blog post was originally posted on the IntraHealth International website. The post is written by Constance Newman, senior team leader on gender equality and health at IntraHealth International; P.K. Chama of the Catholic Medical Mission Board in Lusaka, Zambia; M. Mugisha of QD Consult Ltd. in Kampala, Uganda; C.W. Matsiko of MATSLINE Consult Ltd. in Kampala, Uganda; and Vincent Oketcho, Uganda country director at IntraHealth.

Image credit: IntraHealth International

Women make up the vast majority of the workforce in healthcare worldwide and in the field of global health, but relatively few fill senior leadership roles in these sectors. A new article published in Global Health, Epidemiology, and Genomics offers guidance on how global health organizations can help change this.

Gender stereotyping, discrimination and cultural roles often prevent women from reaching positions of highest authority, according to the authors of “Reasons behind Current Gender Imbalances in Senior Global Health Roles and the Practice and Policy Changes that Can Catalyze Organizational Change”.

For instance, women make up 75% of the health workforce in many countries, but only 25% of leadership roles. Only 31% of the world’s ministers of health are women. And at the 2015 World Health Assembly, only 23% of chief delegates of member state delegations were led by women.

Global health organizations face the same imbalances. While women make up the vast majority of global health students (up to 84%), they hold only 24% of global health faculty positions among the top 50 US universities and a quarter of directorships in global health centers.

But global health organizations can become beacons of analysis and change. They can also play a key role in helping us reach Sustainable Development Goal 5: to achieve gender equality and empower all women and girls.

The authors offer several key steps organizations can take to correct these imbalances, including:

Conduct participatory organizational gender analyses: These can help pinpoint the processes, mechanisms, and structures—such as glass ceilings and gender stereotypes related to reproductive roles—that keep women from rising to leadership roles. Governance leaders, human resources (HR) managers, and employees should all be involved and should share their findings widely.

Identify the harms of gender stereotyping and implement strategies to eradicate them. One example comes from a focus group response the authors received during a gender analysis in Zambia: “Men have a biological make-up that makes them vulnerable to appearance…” the male respondent said. “I think there are some cases where women are really suggestively dressed, and it is difficult because it creates an environment which is very hard…because men mostly, we go for what we see.”

Societal stereotypes like these make their way into the workplace and keep women from reaching leadership roles. Of course, changing such conceptions in society is a task beyond any one organization, the authors say, but the first step to organizational change is to challenge them. Organizations can raise awareness of the harmful effects of stereotypes at work and help build their employees’ capacity to challenge such stereotypes.

Use substantive equality principles in organizational governance and HR management. Setting targets, establishing quotas, taking steps toward affirmative mobilization and fairness can all mitigate the impact of discrimination and help correct gender imbalances.

Put special measures and enabling conditions in place. Consider the issue of paid family leave. Taking paternity leave, the authors write, “can put male employees who might opt for it at as much risk of being stigmatized as the female employees who, in leaving work early to work the ‘second shift’ at home, may be stigmatized as less productive and reliable. There are therefore built-in (organizational) cultural disincentives for both women and men to use these arrangements which must be addressed in communications and incentives for their use.”

Organizations should not design family leave on an individual basis, the authors say. Instead, they should create family-friendly policies for the long-term—and with a firm understanding of the gender dynamics at play.

Read the full article to learn more.