Administration details deep cuts to CDC domestic and global health programs, steep drops in National Institutes of Health funding, and a retreat from efforts to find and control outbreaks where they start . . . and calls it “Putting America’s Health First”
Work led by the United States to prevent, detect, treat and control diseases, to develop new diagnostic devices, medicines and vaccines, and to make those innovations available where they are needed, would do so with resources diminished by double digit percentages, under the terms of a budget proposal titled “A New Foundation for American Greatness.”
It is a foundation that would be built on limited resources for science, which would be slashed by nearly 20 percent — or more than $7 billion — of the funding presently allocated to the U.S. National Institutes of Health, which sets agendas for scientific disease-fighting discoveries worldwide, as what the document itself describes as “the largest public funder of biomedical research in the world.” Included in that cut would be the elimination of the $70 million budget for the Fogarty International Center, which for the last 50 years has led and funded medical training and research partnerships throughout the world, while supporting work at American universities with 80 percent of its grant dollars. With the smallest investment of budget dollars of the institutes and centers that make up NIH — but rates of return in health advances and capacities, as well as economic investment benefiting academic institutions around the country that have earned the center support from a bilpartisan Congress, the Fogarty center would close under the Trump proposal. The Office of the NIH director, in turn would receive new responsibilities, to coordinate global activities including workforce development.
More proposals that run counter to stated aims follow. The proposal promises to “continue to support ongoing commitments to global health programs, including completing our commitment to Gavi, the Vaccine Alliance, maintaining funding for malaria programs, and continuing treatment for all current HIV/AIDS patients under the U.S. President’s Emergency Plan for Aids Relief.” But that assertion is contradicted by numbers that include an 11 percent drop in funding for PEPFAR, funded at $4.32 billion in 2017, with a proposed cut to $3.85 billion. The proposal would drop the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria by $225 million. That Global Fund money will be in greater demand; the proposal also recommends an additional $62.6 million, or more than 25 percent drop from 2017 support levels for tuberculosis programs. At the same time the plan proposes cutting the overall global health allocation for USAID by 51 percent, bringing it down to $1.51 billion. That funding, in turn, will face greater demand, with the cut including the complete elimination of support for family planning programs.
Under a heading titled “Putting America’s Health First,” the administration proposes cutting $76 million from global health programs managed by the U.S. Centers for Disease Control and Prevention. Overseas AIDS responses take the biggest cut of $59 million — or nearly half of the CDC global AIDS budget. But the proposal also requests a cut of more than twice that — $183 million — to domestic programs to control HIV, tuberculosis, and sexually transmitted diseases.
The budget proposal was introduced this morning by Office of Management and Budget Director Mike Mulvaney, who differentiating “taxpayers” from “recipients,” called for “compassion on both sides of the equation,” articulating a perceived dichotomy that may explain how neither narrative nor the numbers in the document acknowledge the potential of cuts to funding for public health, research and preparedness to leave Americans more vulnerable to diseases at home or abroad.