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Public Policy Update: News from Washington, D.C. |
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July, 2010
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Senate Full Committee Approves FY 2011 State, Foreign Operations Appropriations Bill
July 29, 2010
On July 29, 2010 the Senate Appropriations Committee marked up the FY 2011 State/Foreign Operations Appropriations bill. The Senate Appropriations Committee passed the bill out of committee with an 18-12 vote. The Senate marked level of the Department of State, Foreign Operations and Related Programs Appropriations Bill is $54.06 billion; $2.6 billion below the President’s request and $5.29 billion above the FY 10 enacted levels.
The FY 11 President's request for total global health funding was $8.513 billion. After House Subcommittee mark-up, total global health funding stands at $8.25 billion; a $263 million decrease from the President's request. Senate mark-up of the bill left global health funding at $8.239 billion. This includes:
- Maternal and Child Health: $641 million including $33.1 million for programs to eradicate Polio and an additional $100 million allocated for nutrition (House Mark: $750 million including up to $100 million for nutrition; FY10: $549 m including $75 m for nutrition).
- Family Planning: $700 million for all family planning and reproductive health accounts, including and $55 million in contributions to the United Nations Population Fund (House mark: $735 million total. $675 m for USAID family planning and $60 m in contributions to the United Nations Population Fund; FY10: $648.5 m including contributions to UNFPA).
- Malaria: $635.5 million (House mark: $615 million; FY 10: $585m).
- Tuberculosis: $230 million (House mark $240 million; FY 10: $225 m).
- Neglected Tropical Diseases: $100 million; President’s request $155 million (House mark $80 m; FY 10: $65m).
- HIV/AIDS funding under the State GHCS account is broken down as follows:
- HIV/AIDS Bilateral: $5.85 billion, which is equal to the President’s request (House mark: $5.050 billion; FY 10: $4.959 billion).
- Global Fund (foreign operations only): $800 million, which is $100 million above the President’s request (House mark: $825 million; FY10: $750 million).
During this full committee mark up, Senator Lautenberg (D-NJ) introduced an amendment on the floor to permanently overturn the “global gag” rule. The Global Gag Rule denied funding from the United States to organizations providing family planning and contraception that also provides or promotes legal abortions. The amendment prevailed on a 19-11 vote. The prospects of the Lautenberg amendment are uncertain in the companion House appropriations bill, which does not currently contain a similar amendment. Additionally, the timeline for passing the FY 2011 Appropriations Bill into public law remains uncertain. Final action on appropriations bills may not occur until a lame duck session after the November election.
Written by Kimberly Sutton, Global Health Council
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House Appropriations Subcommittee on State and Foreign Operations Marks-Up FY 2011 Appropriations Bill
July 2, 2010
On June 30, 2010 the House Appropriations Subcommittee on State and Foreign Operations marked up the FY 2011 budget request submitted by the White House in February. House Appropriations Chairman Obey announced that all FY 2011 spending bills will be funded at levels below the President's request, placing the $58.8 billion International Affairs Budget, which received a 12% increase, under stiff scrutiny.
The FY 11 President's request for total global health funding was $8.513 billion. After House Subcommittee mark-up, total global health funding stands at $8.25 billion; a $263 million decrease from the President's request. All of the global health programs in this bill were increased over FY 10 enacted levels. Tuberculosis, family planning, and the Global Fund received increases above the President's request. The President's request for the Global Health and Child Survival USAID Account (USAID-GHCS) was $3.013 billion, or 24.5% above FY2010 enacted levels. After House Subcommittee mark-up, the USAID-GHCS accounts stands at $2.725 billion, a $288 million decrease from the FY 11 Presidential request. This includes:
- Maternal and Child Health: $750 million including up to $100 million for nutrition. (President's request: $900 m including $200 m for nutrition; FY10: $549 m including $75 m for nutriton). The other $100 m for nutrition is said to be earmarked under the funding for HIV/AIDS.
- Family Planning: $735 m total. $675 m for USAID family planning and $60 m in contributions to the United Nations Population Fund (President's request: $715.7 m including contributions to UNFPA; FY10: $648.5 m including contributions to UNFPA)
- Malaria: $615 m (President's request: $680 m; FY 10: $585m)
- Tuberculosis: $240 m (President's request was $230 m; FY 10: $225 m)
- Neglected Tropical Diseases: $80 m (President's request: $155 m; FY 10: $65m)
- HIV/AIDS funding under the State GHCS account is broken down as follows:
- HIV/AIDS Bilateral: $5.050 b (President's Request: $5.150 b; FY 10: $4.959b)
- Global Fund (foreign operations only): $825 m (President's Request: $700 m; FY10: $750 m)
The Senate is expected to act on the State and Foreign Operations Appropriations Bill after the 4th of July recess, and any differences resulting from House and Senate mark-ups are likely to be settled by an appropriations conference committee.
Written by Kimberly Sutton, Global Health Council
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June, 2010
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Advocacy and Policy at the 37th Annual Global Health Conference
June 22, 2010
 In conjunction with its 37th Annual Global Health Conference from June 14-18, the Global Health Council accompanied eighty of its member attendees to Capitol Hill on Tuesday, June 15 for Advocacy Day. Attendees met with Senate and House offices on both sides of the aisle and discussed priorities for 2010, current pending global health legislation, the Global Health Initiative, funding levels for fiscal year 2011, and more. Many staffers and even some Members of Congress had the opportunity to hear directly from in county members who shared their insights on what policies are working, what interventions are successful and what funding requirements are necessary for sustained progress in these difficult economic times.
The Advocacy Day culminated with a special reception in the Capitol Building where Global Health Council President and CEO Dr. Jeffrey L. Sturchio presented Congressional Leadership Awards to four Members of Congress for their outstanding leadership on global health issues. Senator Russell Feingold (D-WI), Representative John Boozman (R-AR), Representative Betty McCollum (D-MN) and Representative Donald Payne (D-NJ) all attended the reception, further showing their dedication to global health issues.
Serendipitously the Council's last plenary session of the 37th annual conference addressed the Global Health Initiative (GHI), this just hours after the U.S. government had released the names of the eight "GHI Plus" countries. Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, Nepal and Rwanda will receive "technical assistance and other resources" as learning labs for the future of the GHI. The closing plenary gave conference attendees a prime opportunity to articulate their questions about the $ 63 billion plan directly to U.S. government officials in charge. Visit the Council's Global Health Initiative and Annual Conference webpages for more information.
Written by Duncan Rollason, Global Health Council
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April, 2010
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Global Health Council 2010 Advocacy Week in Washington, D.C.
April 1, 2010
Last week (March 22-24) the Global Health Council held its annual advocacy week and held more than 25 meetings with members of Congress and their staff. Approximately 50 representatives from GHC member organizations, about one-half of whom represented organizations based outside of Washington, D.C. attended meetings during the week. Meetings were very productive and conversations addressed such issues as the Global Health Initiative, Foreign Assistance Reform and global health, the global health budget, and policy priorities in AIDS, TB, malaria, MNCH/RH and other global health areas.
View Council's Advocacy Week Priorities.
As a global health community we outlined the following top line asks for members of Congress and their staff:- Support increases to the International Affairs 150 account proposed in President Obama's FY 2011 Funding Request.
- Support for the overall 9% increase to global health accounts.
- A global health coordinator in the White House.
- A mechanism must be put in place to ensure that country's needs are balanced and allow for effective U.S. contributions to the global health and development agenda. Accountability mechanisms must also be put in place.
- A coordinated U.S. health systems approach that is aligned with the common framework being developed by GAVI, World Bank, and the World Health Organization.
- Investments and focus on new research an innovation is a critical component for improving global health programs and saving lives. We strongly support the increased focus on implementation/operations research.
- We welcome the Global Health Initiative as a comprehensive global health strategy however; we urge Congress and the Administration to continue work towards the commitments set forth in Lantos/Hyde US Leadership Against HIV/AIDS, TB and Malaria.
To see a full list of talking points and policy priorities visit the advocacy section of the Council's website.
Written by Duncan Rollason, Global Health Council
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March, 2010
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Secretary Clinton Testifies in Support of the FY 2011 International Affairs Budget
March 11, 2010
The first step of the 2011 budget and appropriations process began February 24, 2010 as U.S. Secretary of State Hillary Clinton testified in front of congress in support of the Fiscal Year 2011 International Affairs Budget. For the Council's policy update on the FY11 International Affairs Budget, please click here. Secretary Clinton testified on February 24 and 25 to four key committees: Senate Appropriations Subcommittee on State and Foreign Operations, Senate Foreign Relations Committee, House Foreign Affairs Committee and the House Appropriations Subcommittee on State and Foreign Operations.
To begin the hearings, Secretary Clinton testified to the Appropriations Subcommittee on State, Foreign Operations and the Senate Foreign Relations Committee on February 24, 2010. In her testimony to both committees, Secretary Clinton laid out the administration's priorities for the International Affairs Account, U.S. foreign policy, and reinforced the US government's dedication to remaining a solid leader in foreign policy, national security and foreign aid. She also highlighted the priorities of the Department of State which include security, manpower and tools and development. According to Secretary Clinton, investing in security primarily involves funding U.S. foreign policy and defense agendas in the "frontline states" of Afghanistan, Pakistan and Iraq. This constitutes $10.8 billion of the FY 2011 request. Investing in manpower includes a plan to expand jobs at United States Agency for International Development (USAID) and the State Department and minimize the number of costly independent consultants.
In regards to global health, Secretary Clinton highlighted the important role that global health plays in achieving the budget's third priority of development. She explained that the goal of U.S. investments in global health is to build on the progress made in treating HIV, malaria and tuberculosis through additional investments and implementation of the Global Health Initiative (GHI).
During both hearings, the majority of questions posed to Secretary Clinton by members of the congressional committees centered on investing in security, specifically relating to Iran, Afghanistan, Pakistan and Iraq. Other recurring themes included sanctions against Cuba and humanitarian aid to Haiti. Overall, the global health related questions posed to Secretary Clinton during the Senate hearing, centered on orphans, global food security, and the GHI. The rights of vulnerable children and orphans were addressed as Sen. Landrieu (D-LA) referenced H.R. 3070 "Families for Orphans Act of 2009" and expressed her belief that children belong in families. Secretary Clinton reiterated that she shares Sen. Landrieu's convictions and outlined the cultural, technological, financial and educational barriers that make absorbing orphans difficult.
Next, Secretary Clinton testified in front of the House Foreign Affairs Committee and the House Appropriations Subcommittee on State and Foreign Operations on February 25, 2010. After reading her opening statement and reiterating the important role that global health plays in advancing the budget's development priorities, the secretary fielded questions. Similar to the hearings in the Senate, the questions that Secretary Clinton received regarding global health in the House centered on orphans, global food security, and the GHI.
During the House Appropriations Subcommittee on State and Foreign Operations hearing, Rep. Denny Rehberg (R-MT) expressed his belief that UNICEF has often become an impediment or barrier to inter-country adoption and asked if there is a policy in place to address expedited adoption for the safety of children. Secretary Clinton responded by acknowledging the barriers common to adoption, highlighting difficulties in expedited adoption, especially the need to be certain there are no capable surviving relatives and the difficulties in obtaining this certainty posed by poor infrastructure in many developing countries. She concluded by stating that the Department of State is actively examining what can be done to address the problem of orphans.
The GHI was another common topic of discussion during the House hearings. Rep. Christopher H. Smith (R-NJ) expressed his concern for language in GHI which he believes will allow for government funding for abortions, stating that GHI language must ensure that each unplanned and unintended unborn child is welcomed and cared for in GHI. Rep. Jeff Fortenberry (R-NE) continued on the same theme, stating that abortion is not health care and is often the result of abandonment, and as such, tax payers should not be put in the position of paying for abortion domestically or abroad. To this, Secretary Clinton responded that the U.S. government does not fund abortions, explaining that funding through GHI will provide for family planning, maternal health and an expansion of life saving measures to reduce maternal mortality. Secretary Clinton expressed her support for the funding of family planning and reproductive health because so many of the issues faced by women in developing countries, including abortion, occur because they cannot control their reproductive health. She further explained that there should not be a "gag rule" and that women should not be deprived of any information integral to their health, any information that will allow them to plan for their family or allow them to pursue what is in their own best interest.
Rep. Barbara Lee (D-CA) asked Secretary Clinton how existing initiatives, such as PEPFAR, will fit within GHI, and if the goals and targets of PEPFAR will be upheld in GHI. Secretary Clinton reiterated the administration's commitment to PEPFAR, explaining that they will focus on helping countries currently receiving funding for treatment to build sustainable health funds and infrastructure. She highlighted that the GHI intends to increase the number of people on treatment while transition towards interventions that are institutional and sustainable.
The Global Health Council submitted a list of questions in advance of the hearings and is pleased that some of them were asked. For copies of Secretary Clinton's opening statement, please click here.
For copies of hearing transcripts or archived webcasts, please see the following websites:
Written by Kimberly Sutton, Global Health Council
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February, 2010
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White House Releases FY2011 President's Budget Request
February 1, 2010
On February 1, 2010, President Obama submitted the Fiscal Year 2011 (FY 11) budget request to Congress outlining the administration's budget priorities including proposed funding for the International Affairs Account (150). According to the president, the budget request endeavors to accommodate the current fiscal challenges while laying a foundation for the future with an emphasis on resilience, transparency and accountability. Within the 150 account, international affairs funding priorities for FY 11 focus on four key areas that are integral to a country's prosperity and stability: food security, health, climate change and global engagement.
For FY 11, President Obama requested a total of $56.77 billion for the International Affairs Budget, which represents a $5.87 billion, or 12% increase above the Fiscal Year 2010 (FY 10) enacted level. Within the International Affairs Account, various development accounts saw substantial increases including an overall increase of 9% to the global health budget and a $460.8 million or 18% increase to the Development Assistance account. The Transition Initiatives, Migration/Refugee Assistance and the International Organizations and Programs accounts received decreases of 13%, 5% and 11% respectively.
In total, global health programs received $8.50 billion with this amount split between the U.S. Agency for International Development (USAID) Global Health and Child Survival Account (USAID-GHCS) and the Department of State's Global Health and Child Survival Account (State- GHCS). The largest increase was seen in USAID's GHCS account which received $3.013 billion, or 24.5% above the FY2010 enacted level. Among the largest recipients under USAID were Neglected Tropical Diseases (NTDs) programs which received $155 million, or a 138.5% increase and Maternal & Child Health (MCH) programs which received a $700 million, or 27.5% increase above the FY2010 enacted levels. Family planning and reproductive health along with malaria saw moderate increases with a total of $590 million, or 12.4% increase and $680 million, or 16.2% increase, respectively. USAID tuberculosis funding saw a slight increase, with proposed funding at $230 million, or 2.2% above enacted FY 10 levels. Additionally, $200 million was proposed for nutrition activities linked with the Global Hunger and Food Security Initiative, and $100 million to the Global Health Initiative Partner Plus Strategic Fund (more details below).
USAID global HIV/AIDS, vulnerable children, and other public health threats were allocated the same amounts as in FY2010. The only decrease within USAID's GHCS account was seen in pandemic influenza preparedness account with proposed FY11 funding of $75 million, which represents a $31 million, or 29.2% decrease.
In addition to the $3.013 billion awarded to the USAID GHCS account, $5.5 billion was given to the State-GHCS account. This is a modest increase of 2.6% above the enacted FY10 level. Recipients under the State-GHCS account include UNAIDS, which received $45 million, a slight increase of 4.7%, and the Global Fund to Fight AIDS, TB and Malaria, for which funding decreased 6.7% from $750 million to $700 million. The President's Emergency Plan for AIDS Relief (PEPFAR), which supports integrated HIV/AIDS programs and health systems strengthening received funding totaling $4.35 billion. Funding for oversight and management costs was allocated to the State-GHCS account totaling $164 million. Additionally, $237 million was awarded for technical support, strategic information and evaluation costs.
The World Health Organization (WHO), which leads international efforts to prevent, control, and eradicate disease, was appropriated $109.40 million, a 1.87% increase over FY 10 enacted levels. The WHO continues to utilize funds allocated by the U.S. in order to "invest in people" by advancing health care, promoting worldwide education and providing humanitarian assistance.
Federal funding for global health is also provided to the Department of Health and Human Services through the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). Total requested global health funding to the CDC is $352 million which was a $19 million or 5.77% increase above FY 10 enacted levels. Of these funds, $118 million is allocated to the Global AIDS Program, $151.7 million to the Global Immunization Program, and $9.2 million to the Global Malaria Program. An additional $37.8 million was awarded for Global Disease Detection and $35 million was allocated for "Other Global Health." In addition, in FY 11 the CDC introduced new global health funding including $11.7 million for global health: Field Epidemiology and Laboratory Training and Sustainable Management Development Program, which aims to build sustainable public health capacity in developing countries. Other new items include $2 million for global integrated maternal and child health and $10 million for global safe water, to improve global access to clean water.
Within the NIH budget, global health programs received $116 million for research on malaria, which was $25 million below FY10 enacted levels. Consistent with previous years, NIH was also awarded $300 million to support the Global Fund.
Written by Kimberly Sutton, Global Health Council
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Questions?
If you have any questions regarding these articles or would like more information, please contact Smita Baruah at sbaruah@globalhealth.org.
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