A tough political environment for global health funding
The new Congress brings about a number of important changes to the U.S. House of Representatives’ Appropriations Subcommittee, which determines most of the funding levels for U.S. global health programs through the State and Foreign Operations Subcommittee. Among other programs, this subcommittee plays a major role in determining annual funding levels for the President’s Emergency Plan for AIDS Relief (PEPFAR) program, global tuberculosis, and the Global Fund to Fight AIDS, TB and Malaria. It can also use the appropriations process to effect policy changes by conditioning the use of funds.
The Subcommittee is now led by Rep. Kay Granger (R-TX), while Rep. Nita Lowey (D-NY), who had served as chair, will be the ranking member. A Republican moderate has joined the subcommittee, Rep. Charlie Dent (PA), while a number others who are conservative to varying degrees, depending on the issue, have also been added.
The funding levels decided by the subcommittee will be greatly affected by the extent of spending cuts imposed by the incoming chairs of the Budget Committee and the Appropriations Committee, Rep. Paul Ryan (R-WI) and Rep. Harold Rogers (R-KY), respectively.
Both Ryan and Rogers are staunch fiscal and social conservatives, and in 2008 both voted against the Tom Lantos and Henry J. Hyde U.S. Global Leadership against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act (Lantos-Hyde), which authorized $48 billion for AIDS, TB and malaria programs from 2009 to 2013.
We can expect Ryan to try to impose deep cuts to foreign assistance, according to an analysis by the U.S. Global Leadership Campaign. Rogers has announced he will ask the subcommittee chairs to find cuts in the programs under their jurisdiction that will restore federal discretionary funding to 2008 levels, which would cut international programs by 35 percent and devastate PEPFAR, according to an analysis by amfAR.
Because of the tough funding environment in Congress, advocates have urged that the president’s budget proposal, due February 14, come in as high as possible.
Let’s have a look at each of the Republican members of the subcommittee and their records:
Rep. Kay Granger (R-TX):
Chair of the House Appropriations Subcommittee on State-Foreign Operations, which controls funding levels for global health. She represents the 12th District of Texas, which includes Ft. Worth.
In addition to chairing the State and Foreign Operations Subcommittee, she is serving on the Labor, Health and Human Services Appropriations Subcommittee.
She has recently complimented the aims of the Global Health Initiative yet she has expressed skepticism of the administration’s aid requests in the context of domestic fiscal challenges. She has also expressed concerns about funding for international family planning. Last year she visited Peru with CARE and she has voiced support for maternal health programs.
In 2007 Granger voted in favor of an amendment from Rep. Joe Pitts (R-PA) that aimed to block a provision which allowed the president to waive the requirement to spend at least 33 percent of global HIV prevention funds on abstinence-until-marriage programs. In 2008 Granger did not cast a vote* for the Lantos-Hyde bill.
Rep. Jerry Lewis (R-CA):
Lewis represents the 41st Congressional District of Southern California, including much of San Bernardino County and a portion of Riverside County.
He has been a member of Congress since 1978 and previously served as chairman of the House Appropriations Committee. In addition to joining the State and Foreign Operations Subcommittee, he is serving on the Labor, Health and Human Services Appropriations Subcommittee.
Lewis has helped complete critical projects in Southern California including a cancer treatment center and NASA research at Loma Linda University.
In 2007 he voted in favor of the Pitts amendment and in 2008 he voted for the Lantos-Hyde bill. He is a supporter of global health programs.
In July 2009, Lewis introduced an amendment that would have cut $506 million in multilateral aid from the State-Foreign Operations Appropriations bill. This amendment, which was not approved, would have affected the World Bank’s International Development Association, which supports debt cancellation, health, education, agriculture, microfinance, business development and other programs.
Rep. Frank Wolf (R-VA):
Since 1981 Congressman Wolf has represented the 10th District of Virginia, which stretches from McLean to Winchester in the northern part of the state.
Wolf is the co-chairman of the Tom Lantos Human Rights Commission, a bipartisan organization made up of more than 200 members of Congress who work to raise awareness about international human rights issues. His work in this regard has taken him to Ethiopia, Sudan, Sierra Leone, the Democratic Republic of the Congo, Rwanda and other countries in Africa.
Wolf has supported more federal dollars for basic science research.
In 2007 he spoke on the House floor in favor of the Pitts amendment, to maintain abstinence programming provisions, and in 2008 Wolf voted for the Lantos-Hyde bill.
In 2009 he signed a letter to President Obama urging a robust funding proposal for the international affairs account, which provides most of the funding for global health programs.
Rep. Tom Cole (R-OK):
Since 2002 Tom Cole has served as the representative for Oklahoma’s Fourth Congressional District. Its principal cities include Midwest City, Norman, Moore, Ada, Duncan, Lawton/Ft. Sill, and Ardmore. The district also includes much of southern Oklahoma City.
Cole describes himself as an advocate for a strong national defense, for the interests of small business and taxpayers, a proponent of education at all levels and a leader on issues dealing with Native Americans and tribal governments. Cole is an enrolled member of the Chickasaw Nation, and he is currently the only Native American serving in Congress.
He is a member of the Republican Study Committee, a caucus of more than 100 conservative members of the Republican Party in the House of Representatives.
In addition to joining the State and Foreign Operations Subcommittee, Cole is serving on the Labor, Health and Human Services Appropriations Subcommittee. Cole also serves as a deputy whip in the U.S. House. Cole serves on the GOP Steering Committee and as Republican co-chairman of the Native American Caucus.
A former college instructor in history and politics, Cole holds a BA from Grinnell College, an MA from Yale University, and a PhD from the University of Oklahoma. Cole has been a Thomas Watson Fellow and a Fulbright Fellow at the University of London.
In 2007 he voted in favor of the Pitts amendment, and in 2008 he voted for the Lantos-Hyde bill.
Rep. Mario Diaz-Balart (R-FL):
Mario Diaz-Balart was first elected to the U.S. House of Representatives in 2002. He represents Florida’s 25th Congressional District, which includes part of Miami-Dade, Collier and Monroe Counties.
Diaz-Balart is a new member of the Appropriations Committee. He told The Miami Herald that “during this time of out-of-control government spending” he’s been chosen to “help rein in government spending and waste.” He is also a member of the Budget Committee.
In 2007 he voted in favor of the Pitts amendment, and in 2008 he voted for the Lantos-Hyde bill.
Rep. Charlie Dent (R-PA):
Charlie Dent has served in the House since 2005. He represents Pennsylvania’s 15th District, which includes all or parts of Lehigh, Northampton, Montgomery and Berks counties.
In 2007 he was elected to co-chair the Republican “Tuesday Group,” a centrist organization of congressional Republicans.
Dent describes himself as an advocate on health issues. In 2008, legislation he and his colleague Rep. Mike Doyle (D -PA) introduced to update the Veteran’s Health Administration’s HIV/AIDS testing policy was signed into law. He has been instrumental in providing federal funding for melanoma research, and has been a supporter of medical research through the National Institutes of Health (NIH). He has also been active in advancing legislation aimed at the prevention and elimination of chronic viral hepatitis.
In 2007 Dent voted against the Pitts amendment, and in 2008 he voted for the Lantos-Hyde bill. In 2010 Planned Parenthood Pennsylvania Advocates gave Representative Dent a grade of 100.
Rep. Steve Austria (R-OH):
Congressman Steve Austria has served in the House since 2009 and represents the 7th Congressional District of Ohio. This district includes the cities of Springfield, Circleville, and Lancaster as well as some of the southern suburbs of Columbus and nearby counties.
Austria serves on both the House Budget and Homeland Security Committees.
Austria is a staunch fiscal and social conservative. His campaign stressed Second Amendment rights, tax relief, opposition to abortion, and eliminating waste in government. He is a member of the Republican Study Committee, a caucus of more than 100 conservative members of the Republican Party in the House of Representatives.
Interestingly, in 2009 he signed a letter to President Obama urging a robust funding proposal for the international affairs account.
Our next update — Science Speaks will develop more profiles of key House Republicans who are key players in global health policy and funding. This will include Rep. Denny Rehberg (R-MT), Chair of the House Labor, Health and Human Services Subcommittee, which determines some important global health funding, such as funding for the National Institutes of Health, the Centers for Disease Control and Prevention and its tuberculosis program and clinical trials unit, and a portion of the U.S. contribution to the Global Fund to Fight AIDS, TB and Malaria.
*This post has been corrected to reflect that Rep. Granger did not cast a vote for the 2008 legislation reauthorizing PEPFAR.