With Congress adjourned until after Labor Day and not a single funding bill for the federal fiscal year beginning October signed into law before the recess even began, the virtual standstill of legislative action could have a mixed impact on global health funding.
It appears that House and Senate leaders have reached a tentative agreement to fund most government programs under a so-called “continuing resolution” that would essentially continue funding for most programs at current levels through March 30, 2013. PEPFAR is likely to see at least a modest cut from current funding so that resolution could delay or potentially reduce the overall hit to the program. A continuing funding resolution is not good news for the Global Fund to Fight AIDS, TB and Malaria. The Senate funding subcommittee proposed $1.65 billion for the Fund—in line with the President’s budget request and in fulfillment of the US 3-year pledge of $4 billion. The Global Fund urgently needs these US dollars to jump start a new round of funding to countries that are still reeling from the cancellation of funding Round 11, which has stalled scale-up of HIV, TB and malaria programs in many developing countries. Global TB funding was also slated for an increase in the Senate funding bill while the House funding subcommittee flat-funded both the Global Fund and global TB programs. While there is no guarantee that the higher Senate funding levels would prevail, advocates will continue to press for them. Congress will consider and presumably vote on a continuing resolution in September.
There appears to be little appetite for much other legislating when the Congress returns. Most members of Congress will be anxious to return home to campaign while party leaders wait for the voters to have their say in November. Congress does plan to reconvene after the election for a so-called “lame duck session”. How much work will be accomplished during this period is hard to predict and will have everything to do with the election results and what they mean for the balance of power in Washington.
Meanwhile, a serious threat to virtually all programs in the federal budget looms in January when the provisions of the Budget Control Act take effect. Since Congress has failed to come up own package of spending reductions and revenue increases, automatic across-the-board cuts will kick in starting January 2, 2013. These cuts are supposed to be at a level of roughly 8.5 percent. Congress can act to delay or eliminate these cuts, but act they must or the cuts will be automatic. Advocates are hoping that the prospect of draconian cuts in defense, as well as in domestic and global health programs, will inspire some rare bipartisan and bicameral action by the Congress.