“Throughout my career, I have never believed, nor have I ever experienced, that the level of funding devoted to a goal is the most important factor in achieving it . . .” U.S. Secretary of State Rex Tillerson
Secretary of State Rex Tillerson shared that philosophy with skeptical U.S. Senators Tuesday, on the same day a new analysis counted numbers of illnesses and lives lost that would accompany Trump administration budget proposals to slash more than $2.5 billion directly from global health responses, while compromising those responses on additional fronts as well.
The Trump plan, which the administration titled “A New Foundation for American Greatness,” which Sen. Lindsay Graham (R-SC) called “radical and reckless,” and which Sen. Bob Corker (R-TN) called “a complete waste of time,” would eliminate nearly a third of the current State Department budget, including a billion dollar cut to the flagship U.S. global President’s Emergency Plan for AIDS Relief. Intensifying the impact of that, the proposal also includes a $225 million cut to the U.S. contribution to the Global Fund to Fight AIDS Tuberculosis and Malaria, a more than $62 million cut to tuberculosis programs and an overall cut of more than half the global health budget of USAID. Adding to the impacts, on global health, and the cost effectiveness of efforts, Sen. Jeanne Shaheen pointed out, is the complete elimination of U.S. support for all overseas health services that include counseling, information, referrals or services to terminate pregnancies, under the new sweeping Trump version of the Global Gag Rule.
She questioned the Secretary during his testimony before the Senate Appropriations State and Foreign Operations Subcommittee Tuesday.
In addition to compromising the effectiveness and cost-savings of global HIV prevention and treatment programs, she noted the impacts of the expanded Global Gag Rule would include at least an additional two million unsafe abortions, an additional 12,000 maternal deaths, and an additional six million unintended pregnancies.
“So, you’re comfortable impacting women’s health in the way I’ve just defined?” she asked, filling the silence that followed with: “That’s a question.”
Tillerson did not answer that question.
“I’m certainly not comfortable with that kind of impact on women’s health worldwide,” Sen. Shaheen added.
“Duly noted,” Subcommittee Chair Sen. Graham said.
By then Sen. Graham already had questioned Sec. Tillerson on the Trump administration’s proposed cut to PEPFAR funding: “Why are you cutting it by a billion dollars?” and received not much more of an answer.
“The program moneys that are available,” Sec. Tillerson said, “are to sustain the HIV AIDS treatments in 11 countries to continue to take those to conclusion. As patients roll off those rolls, new treatments can be available.”
Currently, fewer than half of the estimated more than 38 million people with HIV worldwide receive the antiretroviral treatment that averts illnesses, allows them to live near normal life spans, and prevents transmission of the virus to others. The treatment, of course, is lifelong.
As Tillerson was grappling with these questions, the Kaiser Family Foundation released an analysis of the impacts of the Trump proposal, which included:
- The number of people on antiretroviral treatment could decline by almost 1 million;
- Additional new HIV infections would range from 69,200 to 280,000;
- Additional cases of tuberculosis, the leading killer of people with HIV would range from 7,600 to 31,100;
- and an additional7,000 and 31,300 to maternal, infant and child deaths would occur.
The entire paper can be found here.