Trump Administration Releases Proposed Budget for FY 2020

On March 11, the Trump administration released its proposed budget for Fiscal Year (FY) 2020, and for the third consecutive year, the International Affairs Budget was cut. The budget requests $42.7 billion for the account, a 24% reduction from the $56.1 billion appropriated for FY 2019.

The request for Global Health programs at USAID and the State Department is $6.34 billion, a $2.5 billion (28%) reduction over FY 2019 levels. Almost all of the global health programs receive significant reductions, including PEPFAR (29%), Maternal and Child Health (26%), Tuberculosis (14%), Neglected Tropical Diseases (27%), Nutrition (46%), Family Planning (55%), and Malaria (11%). Funding for Vulnerable Children is eliminated.

U.S. contributions to Gavi, the Vaccine Alliance and The Global Fund to Fight AIDS, Tuberculosis and Malaria are reduced, to $250 million and $1.1 billion respectively. The $1.1 billion contribution falls short of the $1.56 billion needed to meet the Global Fund’s announced target of $14 billion for the upcoming replenishment. In addition, for the upcoming Global Fund replenishment the administration proposes to match $1 for every $3 from other donors, up to a maximum of $3.3 billion. Previously, the United States matched $1 for every $2.

Global Health programs at CDC and NIH did not fare better, with cuts proposed for CDC’s Center of Global Health and National Center for Emerging Zoonotic and Infectious Diseases and NIH’s Fogarty Center and National Institute of Allergy and Infectious Diseases.

In addition the budget mentions the need for other countries to increase their commitments to development and humanitarian assistance, as well as repeatedly calls for reform and transparency at multilateral institutions, including the UN. The budget also reflects the administration’s view that contributions are prioritized for organizations that “most closely align with American interests.”

The past two years, Congress has soundly rejected the President’s budget and even passed a small increase to global health in FY 2019. While Congress still needs to work out a budget deal that lifts spending caps for both defense and non-defense discretionary spending or sequestration returns, we can expect continued bipartisan support for the International Affairs Budget.


GHC Executive Director Provides Testimony to House SFOPs Committee

On March 12, Loyce Pace, GHC’s President and Executive Director, as well as GHC members IntraHealth, PATH, Save the Children, and others, appeared before the House Appropriations State and Foreign Operations (SFOPs) Subcommittee to provide testimony on the FY 2020 budget for global health programs at USAID and the State Department. Ms. Pace highlighted the continued need for U.S. investments in global health, but also how the United States should begin to think more holistically about health funding. Read Ms. Pace’s testimony.

House LHHS Hearing on Department of Health and Human Services Budget Request for Fiscal Year 2020

On March 13, Secretary of the Department of Health and Human Services (HHS), Alex Azar, testified before the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (LHHS).

In opening remarks, Chairwoman Rosa DeLauro (D-CT) stated her opposition of the President’s FY 2020 budget, “I strongly oppose the President’s proposed cuts to the National Institutes of Health’s HIV research portfolio and to PEPFAR and the CDC global AIDS program, which I will note was a priority of Mr. Azar’s former boss President George W. Bush.”

Also critical of the president’s budget, Ranking Member Tom Cole (R-OK) stated that the proposed cut of $1.3 billion is, “literally a risky mistake.” Ranking Member Cole added, “…I consider this every bit as much [important] as the defense budget…we are much more likely to die of pandemics than terrorists attacks. This is really the frontline of defense for the American people, and in an era of Ebola and Zika…I think that this is not a place where we want to be reducing spending.”

Other members of the subcommittee made comments on the Department of Health and Human Services’ role in regards to family detention at the Mexico-U.S. border and how the PEPFAR program will continue to address HIV/AIDS given the proposed funding cut in the president’s budget. View the full hearing.

Senate LHHS Hearing to Review the Ebola outbreak in the DRC and Other Emerging Health Threats

On March 14, Dr. Robert Kadlec, Assistant Secretary for Preparedness and Response at USAID; Dr. Robert Redfield Director of the Centers for Disease Control and Prevention (CDC); Dr. Anthony Fauci, Director of National Institute of Allergy and Infectious Diseases at the National Institutes of Health (NIH); and Rear Admiral Tim Ziemer, Acting Assistant Administrator at the Bureau for Democracy, Conflict, and Humanitarian Assistance at NIH testified before the Senate Appropriations subcommittee on Labor, Health and Human Services, Education, and Related Agencies (LHHS). The subcommittee met to discuss the second largest Ebola outbreak in history in the Democratic Republic of the Congo (DRC), the impending expiration of the Ebola supplemental fund at the end of the year, and the resources needed to address future outbreaks.

In opening remarks, Chairman Roy Blunt (R-MO) offered his strong support of the CDC and its contributions to developing and sustaining crucial biosecurity laboratories, additionally highlighting CDC’s domestic efforts to improve public health preparedness and its link to global health work in disease prevention.

Ranking Member Patty Murray (D-WA) added that US investments helped stop the progression of Ebola in Nigeria and if necessary resources are provided, the same could be possible for other countries in the future.

According to Rear Admiral Ziemer, this outbreak is particularly devastating due to incessant civil unrest, deep distrust of community leaders, and lack of community engagement.

Currently, there are 174 active cases of Ebola in 16 health zones in the DRC. Dr. Redfield reinforced that the outbreak is not under control and therefore not meeting targets to address the suppression of the outbreak. Despite the challenges faced in the DRC, the CDC, in partnership with the World Health Organization, has successfully administered preventive vaccines to 87,000 people.  Additionally, through the CDC’s Field Epidemiology Training Program, nearly 11,000 people have been trained to respond to outbreak scenarios, 196 of them currently working in the DRC. The panel highlighted that security of patients, health workers, and CDC personnel should be a continued priority in U.S. efforts to address the outbreak moving forward. View the hearing.

Global Nutrition House Resolution is Introduced

On March 7, Congressman Roger Marshall (R-KS) and Congressman Jim McGovern (D-MA) introduced H.R.189, recognizing the importance of sustained US leadership to accelerating global progress against maternal and child malnutrition and supporting USAID’s commitment to global nutrition through its multi-sectoral nutrition strategy.


Global Health Council Maternal, Newborn, and Child Health Roundtable Goes to Capitol Hill

On March 7 and 8, the Maternal, Newborn, and Child Health (MNCH) Roundtable met with 15 House and Senate offices to provide updated statistics on maternal and child survival and discuss the importance of sustained funding for global maternal and child health-related programs during the Fiscal Year (FY) 2020 budget cycle.

Upcoming Advocacy Opportunities

In the following months, Global Health Council and members of the global health advocacy community will be on Capitol Hill, educating members of Congress about our work. For more information, please email us at

This post was written by Danielle Heiberg, Senior Manager, Policy & Advocacy, and Victoria Rodriguez, Advocacy Associate.

Leave a Comment