This primer provides an overview of congressional engagement in global health. It examines the structure of Congress and its role and key activities in global health. It then illustrates these by examining two global health examples: the creation and evolution of PEPFAR and the 2014/2015 Ebola outbreak in West Africa.
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While global health has enjoyed significant bipartisan support among US policymakers over the past 15 years, the potential for changes in the political landscape in 2016 makes this an opportune time to assess the USG’s position relative to global health needs and funding. With this in mind, the Kaiser Family Foundation’s Global Health Policy Program asked Hart Research Associates and Public Opinion Strategies to solicit the views of specialists in foreign policy and global health.
The Kaiser Family Foundation has tracked public opinion on global health issues in-depth since 2009. This most recent survey examines views on U.S. spending on health in developing countries and perceptions of barriers and challenges to making progress on the issue. Two-thirds of Americans (65 percent) overall and majorities of Democrats, independents and Republicans alike, say that the United States should play at least a major role in world affairs, including roughly one in five overall (18 percent) who say the U.S. should take the leading role. The survey also finds a general skepticism on the part of the American people when it comes to the effectiveness of global health spending, with seven in ten saying the “bang for the buck” of U.S. spending in this area is only fair or poor, and more than half believing that spending more on global health efforts won’t lead to meaningful progress (a share that has grown since 2012). Although many Americans have concerns about the value of global health spending, six in ten say the U.S. spends too little (26 percent) or about the right amount (34 percent) on global health, and three in ten say it spends too much. Most also recognize benefits to such spending, both for Americans at home as well as for people and communities in developing countries.
After Congress provided an unprecedented level of emergency funding for Ebola in FY15 in response to the West African outbreak, beyond regular appropriations for global health programs, FY16 returned to business as usual. There was no additional emergency funding and global health amounts remained essentially flat funding compared to prior years. The FY16 Omnibus Appropriations bill, which was signed into law by the President on December 18, 2015, included an estimated $10.2 billion in funding for global health programs continuing a trend of essentially flat funding since FY10.
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As the U.S. enters a Presidential election year and the larger global health and development landscape changes, U.S. global health programs face a key moment of transition. The prior decade saw unprecedented attention to and funding for global health by the U.S. government. Although funding has flattened in recent years,…
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