Global health programs took a huge financial hit last week when the Senate failed to pass an omnibus spending bill for fiscal year (FY) 2011, mainly because of united Republican opposition and the need for a 60-vote supermajority. The bill contained $442 million in additional funding for global health programs.
Instead of increasing funds, the Senate is expected to approve a “continuing resolution” Tuesday that will fund programs at FY10 levels (with the exception of about $1 billion in additional funding, mainly for veterans and defense-related programs). This measure expires March 4, 2011, when Congress will reopen the funding issue with a Republican-controlled House of Representatives.
When the omnibus spending bill failed, urgently needed funding increases went down the drain, along with some important reporting requirements on global health and development:
- $91 million for bilateral AIDS programs through the State Department
- $75 million for the Global Fund to Fight AIDS, TB and Malaria
- $10 million for the U.S. Agency for International Development’s TB program
- $6 million for microbicides research through the Office of the Global AIDS Coordinator
- $61.5 million for bilateral and multilateral family planning/reproductive health assistance
- Funding for the Global Health Initiative Strategic Reserve Fund
- Important increases for malaria, maternal and child health, nutrition, Feed the Future and other programs
- Numerous reporting and consultation requirements for the administration, for instance: on administrative costs, including overhead; Global Health Initiative-plus country plans; global health program effectiveness; harmonization of bilateral and multilateral assistance programs to reduce duplication; and support for TB vaccines and drugs
- Plus, increases for domestic health, including HIV/AIDS programs in the U.S. and $750 million in new health research dollars for the National Institutes of Health
Secretary of State Hillary Clinton appealed for passage of the omnibus, but the administration seemed to have other priorities, such as the approval of the START treaty with Russia.
Much of the discussion and media coverage of the bill centered on the controversial inclusion of $8 billion in “earmarks,” which are special funding proposals included at the request of an individual senator. Senators from both parties included earmarks, yet Republicans in the end (joined by two Democrats) opposed the bill because of their inclusion.
Sen. Patrick Leahy (D-VT), was scathing in his criticism of opposition to the bill:
“As Chairman of the Department of State and Foreign Operations Subcommittee, I can say unequivocally that freezing spending for global security programs—as we are about to do—will shortchange the American people—this generation and future generations, compromise the security of this country, and cost the lives of countless people in the world’s poorest countries.
“Fifty years from now I suspect our grandchildren or great-grandchildren will look back and wonder why we were so penny wise and pound foolish, when so much was at stake.
“At a time when there are more than 7,000 new HIV infections each day, a continuing resolution will reduce the U.S. contribution to the Global HIV/AIDS fund by $75 million. That will almost certainly cause other donors to reduce their contributions too. Millions of people who need drugs to stay alive won’t get them.”
The funding outlook in Congress certainly seems dismal for next year, especially in the House of Representatives, which initiates funding measures, and this means advocates need to redouble efforts to reach out to legislators from both parties.
Last week, Rep. Ileana Ros-Lehtinen (R-FL), the incoming chair of the House Foreign Affairs Committee, successfully killed a bill to help combat child marriage because it would require additional funds ($67 million in additional outlays, 2011-2015). The incoming Appropriations Chairman, Harold Rogers (R-KY), has said that in January he will propose cuts in already-agreed-to FY11 funding.