Advocacy Update ~ September 30, 2019

September 30, 2019

United Nations Held High-Level Meeting on Universal Health Coverage

On September 23, the United Nations hosted a high-level meeting (HLM) focused on Universal Health Coverage (UHC). The HLM was an opportunity to accelerate countries’ actions towards achieving UHC, which is seen as critical to achieving the Sustainable Development Goals. After months of negotiations over the language to include in the political declaration, the document was approved about 10 days before the HLM. Language on migrant health and sexual and reproductive health and rights continued to remain sticking points even after the document’s approval and several Member States used their statements to speak in favor of or against these paragraphs. Member States also spoke to the need to address the rising burden of noncommunicable diseases (NCDs), as well as the important role health workers in providing health services. While there remain questions around financing and accountability, the political declaration is noteworthy for what is included under UHC from preventative to palliative care, from HIV to NCDs, and the need to build health systems that can provide these services.

Read GHC and the Multilateral Engagement Roundtable’s statement on the HLM.

CR Keeps Government Open Until Nov 21; Senate Marks Up SFOPs Bill

With just a few days to spare before the end of the Fiscal Year (FY), the Senate late last week passed a Continuing Resolution (CR) to keep the government open through November 21. The CR was previously passed by the House in earlier this month, and President Trump is expected to sign the bill. The extra two months gives the Senate time to pass the 12 appropriations bills on the floor and reconcile the differences with the House passed bills. The CR funds federal agencies at FY 2019 levels and includes the transfer of up to $20 million of unobligated funds from the Infectious Diseases Rapid Response Reserve Fund to CDC for “Ebola preparedness and response activities.”

Also last week, the Senate Appropriations Committee marked up and unanimously passed the FY 2020 State and Foreign Operations (SFOPs) spending bill, which includes $55 billion (of which $8 billion is designated for Overseas Contingency Operations) in funding, including $9.1 billion for global health programs at USAID and the State Department. This is an $800 million (1.4%) increase over FY 2019, and $11.7 billion (27%) more than the President’s FY 2020 request.

The bill includes $1.56 billion as part of the U.S. contribution for the sixth replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria. In addition, the Committee states its expectation that the U.S. will continue to donate $1 for every $2 contributed by other donors, rejecting the administration’s proposal to change this to $1 for every $3 contributed. Maternal and Child Health, Malaria, and Tuberculosis all received modest increases over FY 2019 levels.

Notably absent from the bill is language repealing the Mexico City Policy (also known as the global gag rule). Senators Jeanne Shaheen (D-NH) and Patty Murray (D-WA) spoke out against the exclusion at the markup stating that the language has been included in the SFOPs bill for 18 years.

The report text includes strong language on the important role of development alongside defense and diplomacy. In addition, the Committee included report language “limiting the use of funds to implement the recommendations of any foreign assistance review” prior to a review by the General Accounting Office (GAO) and that “programmatic, funding, and organizational changes resulting from such review are subject to prior consultation with, and the regular notification procedures of, the Committee.”

The Committee also addresses the administration’s attempts to rescind foreign assistance funding that would expire before the Committee has an opportunity to act on a rescission bill. Although GAO has ruled that the Budget and Impoundment Control Act of 1974 (ICA) ‘‘does not permit the withholding of funds through their expiration,” the Office of Management and Budget continues to argue that nothing in the ICA limits their ability to do so, underscoring the “urgent need for updating and amending the ICA.”

The Senate Appropriations Committee has yet to act on the Labor, Health and Human Services, and Education (Labor-H), but the bill and report language were released earlier this month. The budget for CDC was increased by just $180 million, of which more than half is appropriated for the Division of Global Public Health Protection within the Center for Global Health. Global Public Health Protection would receive $208.2 million, which is GHC’s recommended funding level. The National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) would receive a $5 million decrease ($615.37 million) over FY 2019 enacted levels.

GHC’s funding chart

Excerpts of report language

Legislative Updates

  • Last week the House Foreign Affairs Committee and Senate Foreign Relations Committee passed Res. 517 and S. Res 318 respectively, resolutions supporting the Global Fund to Fight AIDS, Tuberculosis and Malaria and its upcoming sixth replenishment in October.
  • Also last week, the Senate passed The Ebola Eradication Act (S.1340). Introduced by Senator Robert Menendez (D-NJ), the legislation “immediately provide assistance for global health and certain other actions necessary to respond to the threat posed by Ebola” in the Democratic Republic of the Congo (DRC), South Sudan, and Burundi. The legislation comes in response to the State Department’s annual Trafficking in Persons Report (TIP) which ranks (DRC) as a Tier 3 country. Under the Trafficking Victims Protection Act, a Tier 3 country may be subjected to sanctions for not meeting minimum standards to combat human trafficking. Last year, the Trump administration cut off most assistance to DRC because of its Tier 3 ranking.


This post was written by Danielle Heiberg, Senior Manager, Policy & Advocacy.