A crucial milestone was passed this week in the effort to get increased funding levels approved for global health programs, including PEPFAR, USAID and the Global Fund. The State and Foreign Operations Subcommittee of the House Appropriations Committee, led by Rep. Nita Lowey (D-NY), approved some increases for these programs relative to FY 2010, despite having less money overall to work with.
The Subcommittee divides up an overall amount of money that is only about 1.4% of the total US budget. But, this total was $4 billion less than what President Obama requested, due to a cut imposed by the Chair of the Appropriations Committee, Rep. David Obey. In fact, it was the international affairs account that bore the brunt of the cuts to the President’s budget proposal.
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. Advocates had requested specific, higher levels and have sent a letter to both the House and Senate raising concern about HIV/AIDS funding.
These are the amounts approved for a few areas of interest, drawing on info from the Global Health Council:
The Global Fund — the Subcommittee rejected the Obama proposal to cut the US contribution below the FY 2010 level. Instead, the Subcommittee approved $825 m, a boost of $75 million for the Fund above FY 2010. (President’s Request: $700 m; FY10: $750 m). However, it remains to be seen whether the portion of the US contribution that comes through the Labor Health and Human Services budget will be provided in full.
Bilateral HIV/AIDS — the Subcommittee provided a boost of $91 million over the FY 2010 level, approving $5.050 b (President’s Request: $5.150 b; FY 10: $4.959b). This is about half of what President Obama had requested. Obama had proposed using half of his requested increase for PEPFAR to help finance technical and management assistance for the GHI Plus Countries, and we hear that the report language accompanying allows this. That means that about $50 m of the boost for PEPFAR will go to this purpose and only $41 m will be available to expand access to direct services, such as prevention, care and treatment.
USAID’s TB program — The Subcommittee gave this program a boost of $15 m over the FY 2010 level, approving a total of $240 m (President’s request was $230 m; FY 10: $225 m)
In other decisions, the Subcommittee provided the full amount requested for the Peace Corps, giving it a boost of $46 m over 2010. And it approved a $71 m increase for Embassy Security, Construction and Maintenance, $114m above the Obama request.
The panel considered an amendment offered by Rep. Rehberg that would have reduced most of the bill’s spending levels by 7.27 percent and reduced multilateral assistance by 31.85 percent. But, this was voted down along party lines.
There are still many hurdles yet before the funding levels are finalized. The Senate’s State and Foreign Operations Subcommittee is expected to consider the International Affairs budget sometime in July. Then a conference committee would have to iron out any differences. Finally, the bill would have to be approved by the full Congress, which could be significantly delayed by the fall elections.