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UPDATED: House-Senate Conference Committee releases FY 2012 Appropriations Agreement

UPDATE: The President signed the bill into law (Public Law #112-74) on December 23, 2011 after the Conference Agreement passed the House (296-121) on December 16, 2011 and the Senate (67-32) on December 17, 2011. Additionally, the Senate voted against (43-56) a resolution (H.Con.Res. 94) that would have applied a 1.83% across-the-board rescission to all FY 2012 appropriations except the Department of Defense (DoD), Military Construction, and Veterans Affairs.
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Representative Hal Rogers (R-KY, 5th; Chairman House Committee on Appropriations) released a statement announcing that a joint House-Senate Conference Committee had reached agreement on final FY 2012 Appropriations legislation (H.R. 2055), which includes funding for global health programs through the State Department, U.S. Agency for International Development (USAID), the Department of Health and Human Services (HHS), and the Department of Defense (DoD). While total funding for the Global Health Initiative (GHI) is not yet available, the appropriations detailed in this agreement totaled $8.3 billion.

According to the Conference Report and the Joint Statement of Managers, the legislation also:

  • Directs that no FY 2012 global health funds may be used for needle exchange programs;
  • Includes additional Congressional oversight before the Administration makes a multi-year funding pledge;
  • Requires the Administration to report back to Congress with an analysis of the potential costs/savings of transitioning the Office of the Global AIDS Coordinator (OGAC) into USAID; and
  • Requires the Administration to 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 as provided in the Conference Report (House Report 112-331) and Joint Statement of Managers are summarized as follows:

Area

Part of the GHI*

FY11 Enacted (millions)

FY12 Request (millions)

FY12 Conference Agreement
(millions)**

Difference
(millions)

Conference – FY11

Conference – Request

State & Foreign Operations

Maternal & Child Health (MCH)

X

$548.9

$846.0

$605.6

$56.7
 (10.3%)

$-240.5
 (-28.4%)

        GAVI (non-add)

X

$90.0

$115.0

$100.0

$10
 (11.1%)

$-15
 (-13%)

Nutrition

X

$89.8

$150.0

$95.0

$5.2
 (5.8%)

$-55
 (-36.7%)

Vulnerable Children

X

$15.0

$15.0

$17.5

$2.5
 (16.9%)

$2.5
 (16.7%)

HIV/AIDS

X

$4,935.1

$4,991.9

$4,842.9

$-92.3
 (-1.9%)

$-149
 (-3%)

        USAID

X

$349.3

$350.0

$350.0

$0.7
 (0.2%)

$0
 (0%)

        State Department

X

$4,585.8

$4,641.9

$4,492.9

$-93
 (-2%)

$-149
 (-3.2%)

Global Fund

X

$748.5

$1,000.0

$1,050.0

$301.5
 (40.3%)

$50
 (5%)

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

 

$615.0

$769.1

$610.0

$-5
 (-0.8%)

$-159.1
 (-20.7%)

        GHCS Account

X

$524.0

$625.6

$524.0

$0
 (0%)

$-101.7
 (-16.2%)

        Other Bilateral Accounts

 

$51.1

$96.0

$51.1

$0
 (0%)

$-45
 (-46.8%)

        UNFPA

 

$40.0

$47.5

$35.0

$-5
 (-12.5%)

$-12.5
 (-26.3%)

Tuberculosis

X

$224.6

$236.0

$236.0

$11.5
 (5.1%)

$0
 (0%)

Malaria

X

$618.8

$691.0

$650.0

$31.2
 (5%)

$-41
 (-5.9%)

Neglected Tropical Diseases (NTDs)

X

$76.8

$100.0

$89.0

$12.2
 (15.8%)

$-11
 (-11%)

Pandemic Preparedness

X

$47.9

$60.0

$58.0

$10.1
 (21.1%)

$-2
 (-3.3%)

MCC

 

$898.2

$1,125.1

$898.2

$0
 (0%)

$-226.9
 (-20.2%)

Water

 

-

-

$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

Administration releases “The United States Global Health Initiative: Strategy Document”

The Administration released “The United States Global Health Initiative: Strategy Document,” which includes information on the operational plan, targets, and implementation of the Global Health Initiative (GHI).

Foreign assistance reform bill introduced in House

Representative Howard Berman (D-CA, 28th) introduced the “Global Partnership Act of 2012” (H.R. 6644). According to a press release from Representative Berman, the bill would reform the U.S. foreign aid system and replace “both the Foreign Assistance Act of 1961, which covers economic, and development assistance, and the Arms Export Control Act, which deals with arms sales and military aid” The proposed bill includes specific sections addressing maternal and child health, HIV/AIDS, tuberculosis, malaria, neglected tropical diseases, family planning and reproductive health, noncommunicable diseases, water, and food security.

Administration official discusses U.S. efforts to assist Least Developed Countries through the GHI and Feed the Future

In a statement before the Economic and Financial Committee (Second Committee) of the General Assembly of the United Nations, U.S. Deputy Representative to ECOSOC John Sammis summarized U.S. efforts to help reduce poverty and achieve the Millennium Development Goals (MDGs) through initiatives such as the Global Health Initiative (GHI) and Feed the Future (FtF).

White House releases FY 2011 Budget

The White House released the FY 2011 budget request, which included the following funding totals for the U.S. Global Health Initiative (GHI) and other global health and related activities:

Global Health Initiative (GHI) total: $9.572 billion, including

- $8.513 billion from State & Foreign Operations Global Health & Child Survival (GHCS) account, and

- $1.059 billion from HHS, DoD, and other State & Foreign Operations accounts.

- PEPFAR: Included in the GHI total is $6.990 billion for PEPFAR of which $1 billion is for the Global Fund ($700 million from the State Department and $300 million from HHS).

Additional funding details on the GHI and other global health related accounts:

State and Foreign Operations funding for global health:

- Global Health & Child Survival (GHCS): $8.513 billion
– USAID: $3.013 billion
– Maternal Health & Child Health/Nutrition: $900.0 million
– Maternal & Child Health: $700.0 million

- Nutrition: $200.0
– Vulnerable Children: $15.0 million

- HIV/AIDS: $350.0 million

- Family Planning/Reproductive Health: $590.0 million

- Other Infectious Diseases: $1,158.0 million, which includes
– Malaria: $680.0 million,

- Tuberculosis: $230.0 million ,

- Neglected Tropical Diseases (NTDs): $155.0 million,

- Pandemic Influenza and Other Emerging Threats: $75 million, and

- Other Public Health Threats: $18 million.
– Department of State: $5.500 billion
– HIV/AIDS: $5.500 billion (includes $700 million for the Global Fund)
– Millennium Challenge Corporation: $1.280 billion

Health and Human Services funding for global health:

- CDC ($351.9 total):
– Global AIDS Program: $118.1 million

- Global Immunization Program: $152.8 million

- Global Disease Detection: $37.8 million

- Global Malaria Program: $9.2 million

- Other Global Health: $35.1 million
– Global Fund: $300.0 million

- Fogarty International: $73.0 million

Administration releases Global Health Initiative (GHI) Consultation Document

The Administration released “Implementation of the Global Health Initiative: Consultation Document,” which includes specific goals and targets, core principles, and an operational plan for the Global Health Initiative (GHI).

USAID reports NTD treatment results

The U.S. Agency for International Development (USAID) released treatment results for the Neglected Tropical Disease (NTD) Control Program stating “that USAID funds for NTD control have enabled countries to provide more than 162 million treatments to more than 69 million people in Year 4 of the Program.”

Administration official discusses “Global Health and Foreign Policy”

In a speech titled “Global Health and Foreign Policy,” U.S. Representative to the Economic and Social Council of the United Nations Ambassador Rick Barton discussed the core principles of the Global Health Initiative (GHI) and stated “health is at the heart of the Millennium Development Goals [MDGs], and is essential to progress on poverty eradication, socio-economic development, primary education for all, gender equality, and partnering for development.”

CRS Report – Centers for Disease Control and Prevention Global Health Programs: FY2001-FY2011

From the report summary: “This report explains the role CDC plays in U.S. global health assistance, highlights how much the agency has spent on global health efforts from FY2001 to FY2010, and discusses how funding to each of its programs has changed during this period.”

Congressional letter urges USAID to provide funding for Research and Development (R&D) of new treatments for NTDs

In a letter to the United States Agency for International Development (USAID) Administrator Dr. Rajiv Shah, thirteen members of Congress expressed the need to expand U.S. government Neglected Tropical Diseases (NTD) initiatives to include all fifteen NTDs as designated by the World Health Organization (WHO), and urges “USAID to determine the best funding strategy to allow for proper resources to be devoted specifically to R&D for all NTDs.”