Budget Deal Reached on Global Health Programs and Needle Exchange Ban

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Lawmakers have finalized the fiscal year 2010 budget for foreign assistance, setting funding for key programs to fight global HIV and TB and reaching a landmark deal to revise the needle-exchange ban.

The agreement—expected to pass the House before the end of this week and the Senate before the end of next week—includes some modest increases for bilateral HIV and TB, as well as for the Global Fund to Fight AIDS, Tuberculosis and Malaria. But the funding levels still fall far short of what’s needed to combat these twin epidemics and of what was authorized in the Lantos-Hyde Act passed by Congress last summer.

The deal, for example, would allocate $5.359 billion for global AIDS, $1.05 billion for the Global Fund, and $225 million for TB. It also includes a slight boost for NIH. The gloal AIDS figure does not include bilateral HIV/AIDS funds for USAID or the CDC’s Global AIDS Program; with those pots of money tallied, the total US bilateral AIDS funding for 2010 stands at $5.828 billion. (See chart below for more details on how this comparies to last year, etc.)

The real headline, though, is this: Key congressional negotiators agreed to ease the ban on federal funding for needle exchange programs. This is a long-overdue move that will remove an unnecessary and harmful barrier to effective HIV prevention efforts. It’s also a big surprise.

Earlier this year, the House approved lifting the ban, but included so many restrictions as to make federal funding for such programs essentially unfeasible (i.e., not near any schools, parks, arcades, etc.). The Senate voted to keep the ban in place.

The new agreement revises the ban so it would only prohibit the use of federal funds for needle exchange programs in a location “that local public health or law enforcement agencies determine to be inappropriate.”

Here’s the chart, which lays out the approved spending levels for FY2009, the funding levels authorized in the PEPFAR II, the President’s request for FY2010, and last night’s Congressional agreement.

Dollars in millions

  FY09 PEPFAR II Obama FY 10 Final
Global AIDS $5.159bil $6.5bil $5.259bil $5.359bil
Global Fund $600 $2bil $600 $1.05 bil
Tuberculosis $163 $650 $173 $225
NIH $30.566 N/A $30.758 $31.008

 

Notes:  The reauthorization bill did not contain specified year by year funding levels with the exception of the Global Fund which was authorized at $2 billion.   The amounts listed under PEPFAR II for bilateral Global AIDS and TB are extrapolated from the overall five-year funding levels authorized in the bill. In addition, as noted above, the global AIDS figure does not include money directed to USAID or CDC for their bilateral HIV programs.

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