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S. 3686 – An original bill making appropriations for the Department of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2011, and for other purposes.

The Senate Committee on Appropriations approved by a vote of 17-12 the FY 2011 Labor, Health and Human Services, and Education, and related agencies bill with the following recommendations:

Health and Human Services funding for global health:

- CDC (total): $353.3 million
– Global AIDS Program: $118.1 million

- Global Immunization Program: $153.2 million

- Global Disease Detection: $37.8 million

- Global Malaria Program: $9.2 million

- Other Global Health: $35.1 million
– Fogarty International Center (FIC): $72.9 million

- The Global Fund: $300 million

Secretary Clinton delivers speech titled “The Global Health Initiative: The Next Phase of American Leadership in Health Around the World”

In a speech titled “The Global Health Initiative [GHI]: The Next Phase of American Leadership in Health Around the World,” Secretary of State Hillary Clinton discussed the reasons why the U.S. is investing in global health including: to strengthen fragile or failing states; to promote social and economic progress; to protect U.S. security; as a tool of public diplomacy; and as a demonstration of U.S. compassion. Secretary Clinton also outlined how the GHI would work towards achieving its goal “to save the greatest possible number of lives, both by increasing our existing health programs and by building upon them to help countries develop their own capacity to improve the health of their own people.”

Secretary Clinton announces the “Global Alliance for Clean Cookstoves”

During remarks at the Clinton Global Initiative Secretary of State Hillary Clinton announced “the Global Alliance for Clean Cookstoves, a new public-private partnership led by the United Nations Foundation (UNF) to create a thriving global market for clean and efficient household cooking solutions that will save lives, improve livelihoods, empower women, and combat climate change. The Alliance will work to tackle the severe health, economic, and environmental consequences associated with smoke from traditional cook stoves and open fires used by over half the world’s population.” The U.S. has committed $50.82 million over the next five years to ensure that the Global Alliance for Clean Cookstoves reaches its “goal of 100 million homes adopting new clean stoves and fuels by 2020.”

Administration officials testify at a Congressional hearing titled “PEPFAR: From Emergency to Sustainability and Advances Against HIV/AIDS”

During a House Committee on Foreign Affairs hearing titled “PEPFAR: From Emergency to Sustainability and Advances Against HIV/AIDS,” U.S. Global AIDS Coordinator Ambassador Eric Goosby discussed the successes of the President’s Emergency Plan for AIDS Relief (PEPFAR) and outlined core principles moving forward including PEPFAR’s role in the Global Health Initiative (GHI), addressing gender issues, country ownership and building local capacity, and stronger engagement with multilateral partners such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH) Dr. Anthony Fauci summarized how NIH contributes to the PEPFAR mission through HIV/AIDS research that provides “the tools necessary to diagnose, prevent, and treat HIV.” Center for Disease Control and Prevention (CDC) Director Thomas Frieden discussed the successes of PEPFAR and outlined the guiding principles of CDC’s global health work which include: “strengthen public health capacity; better use data to improve program performance and policy; and maximize sustainable health impact through the use of existing and new systems, cost-efficiencies, partner investments, and scale-up of the highest impact interventions with a focus on populations with the greatest need.”

Prior to testimony from the Administration officials, the hearing was opened with remarks from the Committee Chair, Representative Howard Berman (D-CA, 28th), and Ranking Member, Representative Ileana Ros-Lehtinen (R-FL, 18th).

Representatives Berman and Ros-Lehtinen provide opening remarks at a Congressional hearing on PEPFAR

Representatives Howard Berman (D-CA, 28th – Chair) and Ileana Ros-Lehtinen (R-FL, 18th – Ranking Member) provided opening remarks during a hearing of the House Committee on Foreign Affairs titled “PEPFAR: From Emergency to Sustainability and Advances Against HIV/AIDS.” Representatives Berman and Ros-Lehtinen described the successes of the President’s Emergency Plan for AIDS Relief (PEPFAR) to date, the need to continue to focus on treatment as well as prevention, and emphasized the U.S. commitment to combating HIV/AIDS.

After opening remarks, the Committee took testimony from U.S. Global AIDS Coordinator Ambassador Eric Goosby, Director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH) Dr. Anthony Fauci, and Center for Disease Control and Prevention (CDC) Director Thomas Frieden.

State Department joins partnership to combat sexual violence against girls

The U.S. Department of State, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and in collaboration with the Office of Global Women’s Issues, joined the Together for Girls partnership which aims to end sexual violence against girls by “conducting national surveys, using these new data to base country-specific interventions tailored to address sexual violence, and launching public awareness campaigns to motivate changes in social norms and behaviors.”

Administration statements in response to results from the CAPRISA 004 Microbicide HIV Prevention Study

In response to the results from the Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004 Microbicide HIV Prevention Study, U.S. Agency for International Development (USAID) Administrator Dr. Rajiv Shah released a statement congratulating the researchers, summarizing USAID’s involvement in the study, and outlining the next steps required in order to begin integrating the microbicide into U.S. government programs such as the President’s Emergency Plan for AIDS Relief (PEPFAR). Director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, Dr. Anthony Fauci also released a statement congratulating researchers on the findings from the CAPRISA 004 microbicide study and highlighted NIAID’s ongoing HIV/AIDS prevention research.

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.
————-

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

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  • 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.