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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

  • Area: ,
  • Organization/Initiative: , , , , , , ,
  • Issue/Condition: , , , , , , , ,
  • 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.

    Senate Appropriations Committee introduces Continuing Resolution for the remainder of FY 2011; includes overall increase in global health funding

    The Senate Committee on Appropriations introduced a Continuing Resolution (CR) that would authorize appropriations for the remaining seven months of FY 2011 (the first 5 months of FY 2011 were funded under FY 2010 levels). This legislation would replace the full-year appropriations bill (H.R. 1) that was recently passed by the House on February 19, 2011. Unlike H.R. 1, which proposes to cut global health funding, the Senate CR proposes an overall increase in global health funding (see table below). Additionally, the summary of the CR provided by the Senate Committee on Appropriations categorizes State and Foreign Operations funding as part of National Security.

    Summary of the FY11 Full-Year Continuing Appropriations Act (H.R. 1473)

    Representative Harold Rogers (R-KY, 5th) introduced the “Department of Defense and Full-Year Continuing Appropriations Act, 2011” (H.R. 1473) authorizing appropriations for the remaining six months of FY 2011 (the first 6 months of FY 2011 were funded under FY 2010 levels). The proposed funding totals for global health (as compared to FY 2010 totals) included in this appropriations bill are provided in the table below.

    Note: The appropriations bill (H.R. 1473) includes an across-the-board rescission of 0.2 percent to all discretionary spending; the global health funding totals for FY 11 (H.R. 1473) listed below include this rescission.

    Timeline of the bill:

    - Introduced and referred to the House Committee on the Budget and the House Committee on Ways and Means on April 11, 2011.

    - Passed by the House (260-167) and the Senate (81-19) on April 14, 2011.

    - Signed by the President (Public Law No: 112-10) on April 15, 2011.

    FY 2011 full-year Continuing Appropriations Act (H.R. 1) introduced in the House includes reductions in global health funding compared to FY 2010 totals

    Representative Harold Rogers (R-KY, 5th) introduced the “Full-Year Continuing Appropriations Act, 2011” (H.R. 1) authorizing appropriations for the remaining seven months of FY 2011 (the first 5 months of FY 2011 were funded under FY 2010 level). The proposed reductions in global health funding (when compared to FY 2010 totals) included in this appropriations bill are provided in the table below.

    Timeline of the bill:

    - Introduced and referred to the House Committee on Appropriations and the House Committee on the Budget on February 11, 2011.

    - Passed by the House (235-189) on February 19, 2011.

    - The Senate Committee on Appropriations introduced an amended full-year Continuing Appropriations Act on March 4, 2011. Learn more about the Senate version here.

    - The Congressional Budget Office (CBO) released a cost estimate of the Senate version on March 8, 2011.

    Senate Appropriations Subcommittee approves FY 2012 Labor, HHS, Education Appropriations Bill

    The Senate Committee on Appropriations, Subcommittee on Labor, Health and Human Services (HHS), and Education approved, during a markup hearing, the FY 2012 Labor, HHS, and Education appropriations bill (S.1599). Among other things, the bill provides funding for global health programs through appropriations to the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and the Fogarty International Center. The Committee Report outlines funding amounts provided in the bill including $350.3 million for global health activities through the CDC and $299 million for the Global Fund to Fight AIDS, Tuberculosis and Malaria.

    Additional Information:

    • Access a summary of the bill released by the Senate Committee on Appropriations.
    • The full Senate Committee on Appropriations is scheduled to markup the bill September 21, 2011.
    • Learn more about the status of FY 2012 appropriations using the Kaiser Family Foundation’s Budget Tracker.
    House Appropriations Committee releases FY 2012 Labor, HHS, & Education Appropriations Bill

    The House Committee on Appropriations released the draft FY 2012 Labor, Health and Human Services (HHS), and Education appropriations bill (H.R. 3070), which provides funding for global health programs through appropriations to the National Institutes of Health (NIH), including the Fogarty International Center, and the Centers for Disease Control and Prevention (CDC). The proposed bill and an accompanying funding table highlight the following amounts for global health:

    • $324.2 million for global health programs at the CDC, of which $118.0 million is for HIV/AIDS programs;
    • $71.3 million for the Fogarty International Center; and
    • The proposed bill eliminates HHS funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria.

    Learn more about the U.S. global health budget using the Kaiser Family Foundation’s Budget Tracker.

    GAO releases report on PEPFAR program planning and reporting

    In a report titled “President’s Emergency Plan for AIDS Relief: Program Planning and Reporting”, the U.S. Government Accountability Office (GAO), in response to legislative directives, “(1) described key procedures for planning and reporting on PEPFAR performance and (2) examined published PEPFAR performance plans and reports.”