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Senate Appropriations Subcommittee releases summary of FY 2013 State and Foreign Operations Appropriations Bill

The Senate Committee on Appropriations, Subcommittee on the Department of State and Foreign Operations and Related Programs approved the FY 2013 State and Foreign Operations appropriations bill and released a bill summary. The bill includes funding for U.S. global health programs at the U.S. Agency for International Development (USAID) and the State Department comprising a significant portion of funding for the Global Health Initiative (total funding for the GHI is not currently available as some funding provided through USAID, HHS, and DoD are not yet available).

The Senate bill would provide $8.4 billion to the GHI, which is approximately $500 million more than the President’s FY13 request ($7.9 billion) and $400 million more than the House FY13 appropriations bill ($8.0 billion). It is also approximately $200 million above the FY12 amount ($8.2 billion). Of this, the Senate bill would provide the following:

  • HIV/AIDS bilateral: $4.25 billion, which is greater than the President’s Request ($4.0 billion), but below the House bill ($4.6 billion), which maintained the FY12 levels.*
  • Global Fund: $1.65 billion, which is equal to the President’s Request and greater than the House bill ($1.3 billion), which maintained the FY12 levels.*
  • Maternal & Child Health (MCH): $655 million, which is greater than the President’s Request ($578 million) and the House bill ($606 million), which maintained the FY12 levels.
  • Malaria: $650 million, which is greater than the President’s Request ($619 million), but the same as the House bill, which maintained the FY12 levels.
  • Tuberculosis: $265 million, which is greater than the President’s Request ($224 million) and the House bill ($236 million), which maintained the FY12 levels.
  • Pandemic: $75 million, which is greater than the President’s Request ($53 million) and the FY12 amount ($58 million). The House bill did not specify an amount.

In addition, the bill would provide $700 million in funding from all accounts for family planning and reproductive health (FP/RH) including $44.5 million in funding for the United Nations Population Fund (UNFPA). This is greater than the President’s request ($643 million) and the House bill ($461 million). It is also greater than FY12 levels ($661 million).

*The FY 2012 enacted amount for the Global Fund was $1.050 billion. The Administration subsequently moved $250 million from the HIV/AIDS bilateral line to the Global Fund, bringing the Global Fund amount up to $1.3 billion.

House Appropriations Committee releases FY 2013 State and Foreign Operations Draft Committee Report

The House Committee on Appropriations released the FY 2013 State and Foreign Operations Draft Committee Report, which provides additional information on funding through the State and Foreign Operations appropriations bill (released May 8, 2012) for U.S. global health programs at the U.S. Agency for International Development (USAID) and the State Department. This funding comprises a significant portion of the Global Health Initiative budget (total funding for the GHI is not currently available as some funding provided through USAID, HHS, and DoD are not yet available).

The report also included the following policy provisions:

  • Reinstates the Mexico City Policy (also known as the “Global Gag Rule”)
  • Prohibits funding for the United Nations Population Fund (UNFPA)
  • No funding provided for needle exchange programs

Area

FY12 Estimated (millions)

FY13 Request (millions)

FY13 House Report (millions)

Difference (millions)

Report – FY12

Report – Request

State Department - Global Health Programs (GHP)

HIV/AIDS Bilateral

$4,242.9

$3,700.0

$4,242.9

$0
 (0%)

$542.9
 (14.7%)

Global Fund*

$1,300.0

$1,650.0

$1,300.0

$0
 (0%)

$-350
 (-21.2%)

Total State-GHP

$5,542.9

$5,350.0

$5,542.9

$0
 (0%)

$192.9
 (3.6%)

USAID – Global Health Programs (GHP)

Maternal & Child Health (MCH)

$605.6

$578.0

$605.6

$0
 (0%)

$27.6
 (4.8%)

Nutrition

$95.0

$90.0

$95.0

$0
 (0%)

$5
 (5.6%)

Vulnerable Children

$17.5

$13.0

$17.5

$0
 (0%)

$4.5
 (34.6%)

HIV/AIDS

$350.0

$330.0

$350.0

$0
 (0%)

$20
 (6.1%)

Tuberculosis

$236.0

$224.0

$236.0

$0
 (0%)

$12
 (5.4%)

Malaria

$650.0

$619.0

$650.0

$0
 (0%)

$31
 (5%)

Neglected Tropical Diseases (NTDs)

$89.0

$67.0

Not Yet Available

-

-

Pandemic Preparedness

$58.0

$53.0

Not Yet Available

-

-

Family Planning & Reproductive Health (FP/RH)**

$524.0

$530.0

Not Yet Available

-

-

Total USAID-GHP:

$2,625.0

$2,504.0

$2,474.9

$-150.1
 (-5.7%)

$-29.1
 (-1.2%)

The Global Health Initiative (GHP Account)

Total GHI (known amounts)***

$8,167.9

$7,854.0

$8,017.7

$-150.1
 (-1.8%)

$163.7
 (2.1%)

Total Family Planning & Reproductive Health (FP/RH) – All Accounts**

Total FP/RH**

$661.0

$642.7

$461.0

$-200
 (-30.3%)

$-181.7
 (-28.3%)

       of which GHP Account

$524.0

$530.0

Not Yet Available

-

-

       of which UNFPA

$35.0

$39.0

$0.0

$-35
 (-100%)

$-39
 (-100%)

       of which Other Accounts

$102.0

$73.7

Not Yet Available

-

-

*The FY 2012 enacted amount for the Global Fund was $1.050 billion. The Administration subsequently moved $250 million from the HIV/AIDS bilateral line to the Global Fund, bringing the Global Fund amount up to $1.3 billion.
**The Committee Report “limit[s] the level of funds provided in this Act for family planning to not more than $461,000,000”, but does not delineate this funding by account. FY 2012 FP/RH funding was enacted at “not less than” $610 million; according to ForeignAssistance.gov (accessed 5/16/12), the Administration has planned to provide $661 million for FP/RH in FY 2012.
***Total funding for the GHI is not currently available as some funding provided through USAID, HHS, and DoD are not yet available.

USAID releases “Global Health and Child Survival: Progress Report to Congress 2010-2011″

The U.S. Agency for International Development (USAID) released the “Global Health and Child Survival: Progress Report to Congress 2010-2011” summarizing the agency’s health development efforts for 2010-2011.

House Appropriations Committee releases FY 2013 State and Foreign Operations Appropriations Bill

The House Committee on Appropriations released the FY 2013 State and Foreign Operations Appropriations bill, which included funding for U.S. global health programs at the U.S. Agency for International Development (USAID) and the State Department (see table below) comprising a significant portion of funding for the Global Health Initiative (total funding for the GHI is not currently available as some funding provided through USAID, HHS, and DoD are not yet available). Funding through the appropriations bill for the GHI at USAID and State would be $164 million (2%) greater than the President’s request.

With the exception of family planning and reproductive health (FP/RH) funding, and funding for PEPFAR at the State Department, the bill did not delineate specific amounts for other programmatic areas (e.g. TB, malaria, etc.).

The bill also included the following policy provisions:

  • Reinstates the Mexico City Policy (also known as the “Global Gag Rule”)
  • Prohibits funding for the United Nations Population Fund (UNFPA)
  • No funding provided for needle exchange programs (according to a press release accompanying the bill)

Department / Agency

FY12 Estimated (millions)

FY13 Request (millions)

FY13 House Bill 
(millions)

Difference (millions)

House – FY12

House – Request

State & Foreign Operations – Global Health Programs (GHP)

USAID

$2,625.0

$2,504.0

$2,474.9

$-150.1
 (-5.7%)

$-29.1
 (-1.2%)

State*

$5,542.9

$5,350.0

$5,542.9

$0
 (0%)

$192.9
 (3.6%)

Total GHI (known amounts)**

$8,167.9

$7,854.0

$8,017.7

$-150.1
 (-1.8%)

$163.7
 (2.1%)

Family Planning & Reproductive Health (FP/RH)

FP/RH***

$661.0

$642.7

$461.0

$-200
 (-30.3%)

$-181.7
 (-28.3%)

       of which UNFPA

$35.0

$39.0

$0.0

$-35
 (-100%)

$-39
 (-100%)

*Represents combined PEPFAR funding (HIV bilateral and Global Fund) at the State Department.
**Total funding for the GHI is not currently available as some funding provided through USAID, HHS, and DoD are not yet available.
***The House FY 2013 State and Foreign Operations bill states that “Of the funds appropriated by this Act, not more than $461,000,000 may be made available for family planning/reproductive health.” FY 2012 FP/RH funding was enacted at “not less than” $610 million; according to ForeignAssistance.gov (accessed 5/16/12), the Administration has planned to provide $661 million for FP/RH in FY 2012.

USAID releases “USAID’s Global Health Strategic Framework: Better Health for Development”

The U.S. Agency for International Development (USAID) released “USAID’S Global Health Strategic Framework: Better Health for Development” for fiscal years 2012-2016.  The framework states that it incorporates the principles of the Global Health Initiative (GHI), and outlines, among other things, USAID’s core health priorities, which include saving mothers and children, fostering an AIDS-free generation, combating infectious disease, increasing the availability and use of voluntary family planning, and strengthening health systems. The framework also summarizes the agency’s strategic approaches guiding its global health efforts: technical leadership; partnerships; science, technology, and development; scaling up of proven interventions; and strengthening local health system capacity.

USAID Administrator Shah testifies before House Committee on Foreign Affairs on FY13 budget request

U.S. Agency for International Development (USAID) Administrator Dr. Rajiv Shah testified before the House Committee on Foreign Affairs and provided a summary of the FY13 budget request for USAID highlighting efforts through the Feed the Future Initiative and the Global Health Initiative (GHI) including the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI).

Additional Information:

  • Opening remarks by Representative Ileana Ros-Lehtinen (R-FL, 18th; Committee Chair) expressing, among other things, her opposition to a proposed increase in FY13 funding for family planning and reproductive health (FP/RH).
  • Opening remarks by Representative Howard Berman (D-CA, 28th; Ranking Member) calling for, among other things, a revision and updating of the Foreign Assistance Act of 1961.
White House releases FY 2013 Budget Request

The White House released the FY 2013 budget request, which included funding for the U.S. Global Health Initiative (GHI) and other global health activities.  Overall, funding for the GHI is down in the FY 2013 request, with most of the reduction coming from HIV/AIDS bilateral amounts.  Most other areas saw decreases as well, except for family planning and funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria and GAVI, which increased.

Area

FY12 Estimate (millions)

FY13 Request (millions)

Difference: FY13 – FY12 (millions)

The Global Health Initiative (GHI)

Total GHI

$8,827.6

$8,524.4

$-303.2
 (-3.4%)

     of which PEPFAR

$6,632.3

$6,418.0

$-214.3
 (-3.2%)

           of which HIV*

$5,082.4

$4,536.0

$-546.4
 (-10.8%)

           of which TB

$249.8

$232.0

$-17.8
 (-7.1%)

           of which Global Fund

$1,300.0

$1,650.0

$350
 (26.9%)


*Total USG bilateral funding for HIV/AIDS programs.

Area

Part of the GHI

FY12 Estimate (millions)

FY13 Request (millions)

Difference: FY13 – FY12 (millions)

U.S. Agency for International Development (USAID)

HIV

X

$350.0

$330.0

$-20
 (-5.7%)

Tuberculosis

X

$249.8

$232.0

$-17.8
 (-7.1%)

       GHP account

X

$236.0

$224.0

$-12
 (-5.1%)

       Other accounts

X

$13.8

$8.0

$-5.8
 (-42.2%)

Malaria

X

$650.0

$619.0

$-31
 (-4.8%)

MCH

X

$605.6

$578.0

$-27.6
 (-4.5%)

       of which GAVI

X

$130.0

$145.0

$15
 (11.5%)

Nutrition

X

$95.0

$90.0

$-5
 (-5.3%)

FP/RH

X

$524.0

$530.0

$6
 (1.2%)

NTDs

X

$89.0

$67.0

$-22
 (-24.7%)

Vulnerable Children

X

$17.5

$13.0

$-4.5
 (-25.7%)

Pandemic Influenza

X

$58.0

$53.0

$-5
 (-8.6%)

State Department

HIV

X

$4,242.9

$3,700.0

$-542.9
 (-12.8%)

Global Fund

X

$1,300.0

$1,650.0

$350
 (26.9%)

UNFPA

 

$35.0

$39.0

$4
 (11.4%)

National Institutes for Health (NIH)

HIV

X

$364.5

$388.9

$24.4
 (6.7%)

Malaria

X

$147.0

$147.0

$0
 (0%)

Centers for Disease Control and Prevention (CDC)

HIV

X

$117.1

$117.2

$0
 (0%)

Malaria

X

$9.3

$9.4

$0.1
 (1.1%)

Department of Defense (DoD)

HIV

X

$8.0

$0.0

$-8
 (-100%)

Malaria

X

$0.0

$0.0

-

Administration officials release statements commemorating the International Day of Zero Tolerance to Female Genital Mutilation/Cutting

Secretary of State Hillary Clinton released a statement commemorating the International Day of Zero Tolerance to Female Genital Mutilation/Cutting (FGM/C) and reaffirming the U.S. commitment to abolishing the practice of FGM/C.

Additional Information:

CRS releases report on FY2012 State and Foreign Operations appropriations

The Congressional Research Service (CRS) released a report titled “State, Foreign Operations, and Related Programs: FY2012 Budget and Appropriations”. According to the summary, “[t]his report analyzes the FY2012 request and congressional action related to FY2012 State-Foreign Operations legislation.”

FY2012 Consolidated Appropriations Act introduced in the House

Representative Hal Rogers (R-KY, 5th; Chairman House Committee on Appropriations) introduced the “Consolidated Appropriations Act, 2012” (H.R. 3671), which includes funding for global health programs through the State Department, U.S. Agency for International Development (USAID), and the Department of Health and Human Services (HHS). Chairman Rogers also introduced a resolution (H.Con.Res. 94) that would apply a 1.83% across the board rescission to all FY 2012 appropriations except the Department of Defense (DoD), Military Construction, and Veterans Affairs.

According to the bill and the Chair’s summary, the bill also:

  • “Directs that no HIV/AIDS funding be provided for needle exchange programs”;
  • “Requires additional congressional oversight before the Administration makes public announcements of multi-year funding pledges”;
  • Requires that the Administration report back to Congress with an analysis of the potential costs (including savings and increases) of transitioning the Office of the Global AIDS Coordinator (OGAC) into USAID; and
  • Requires that the Administration report back to Congress with an analysis of transitioning the leadership of the Global Health Initiative (GHI) to USAID as outlined in the Quadrennial Diplomacy and Development Review (QDDR).

Global health appropriations included in the bill are as follows:

Department / Agency

Part of the GHI*

FY11 Enacted (millions)

FY12 Request (millions)

FY12 House Bill (H.R. 3671) (millions)**

Difference
(millions)

House – FY11

House – Request

State & Foreign Operations

USAID-GHCS

X

$2,495.0

$3,073.6

$2,625.0

$130
 (5.2%)

$-448.6
 (-14.6%)

State GHCS

X

$5,334.3

$5,641.9

$5,542.9

$208.5
 (3.9%)

$-99
 (-1.8%)

        of which GF

X

$748.5

$1,000.0

$1,050.0

$301.5
 (40.3%)

$50
 (5%)

FP/RH***

 

$615.0

$769.1

$610.0

$-5
 (-0.8%)

$-159.1
 (-20.7%)

        of which UNFPA

 

$40.0

$47.5

$35.0

$-5
 (-12.5%)

$-12.5
 (-26.3%)

MCC

 

$898.2

$1,125.1

$898.2

$0
 (0%)

$-226.9
 (-20.2%)

Water (all acounts)

 

-

-

$315.0

-

-

Health and Human Services (HHS)

CDC Global Health

 

$340.3

$381.2

$348.9

$8.6
 (2.5%)

$-32.4
 (-8.5%)

        of which HIV

X

$118.7

$118.0

$117.8

$-0.9
 (-0.8%)

$-0.2
 (-0.2%)

NIH – Global Fund

X

$297.3

$300.0

$0.0

$-297.3
 (-100%)

$-300
 (-100%)

NIH – Fogarty International Center

 

$69.4

$71.3

$69.6

$0.2
 (0.3%)

$-1.7
 (-2.4%)

Department of Defense (DoD)

HIV

X

$10.0

$0.0

$8.0

$-2
 (-20%)

-

The Global Health Initiative

Total GHI (known amounts)****

 

$8,255.4

$9,133.5

$8,293.7

$38.3
 (0.5%)

$-839.9
 (-9.2%)

*GHI: U.S. Global Health Initiative.
**The FY 2012 Consolidated Appropriations Act included an across-the-board 0.189% rescission to all funding provided through the Labor-HHS portion of the bill.
***The FY 2012 Consolidated Appropriations Act states that “not less than $575,000,000 should be made available for family planning/reproductive health” through all bilateral accounts, but does not delineate this amount by account. UNFPA funding is in addition to the bilateral funding and is provided through the International Organizations and Programs (IO&P) account.
****Total funding for the GHI is not currently available as some funding provided through SFOPS, HHS, and DoD were not delineated in the FY 2012 appropriations bills.