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President Obama announces new global HIV treatment and prevention goals; Administration statements and resources commemorating World AIDS Day

White House:

President Barack Obama provided remarks at a World AIDS Day event hosted by ONE and (RED) at the George Washington University and issued a presidential proclamation to commemorate World AIDS Day.   During his remarks, President Obama announced new treatment and prevention goals of “providing anti-retroviral drugs to more than 1.5 million HIV-positive pregnant women over the next two years . . . [and] helping 6 million people get treatment by the end of 2013” – an increase of 2 million over the prior target, and called on countries to fulfill their commitments to The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Additional Administration Statements and Resources Commemorating World AIDS Day:

State Department:

Health and Human Services (HHS):

  • Statement from HHS Secretary Kathleen Sebelius on World AIDS Day. Secretary Sebelius also announced the appointment of Nancy Mahon, Executive Director of the MAC AIDS Fund, as the Chair of the Presidential Advisory Council on HIV/AIDS (PACHA).
  • Statement by National Institutes of Health (NIH) Director Dr. Francis Collins, NIH Office of AIDS Research Dr. Jack Whitescarver, and NIAID Director Dr. Anthony Fauci.

U.S. Agency for International Development (USAID):

U.S. Mission to the United Nations:

  • Statement from U.S. Permanent Representative to the United Nations Ambassador Susan E. Rice.

Peace Corps:

  • Peace Corps statement commemorating World AIDS Day.

Department of Defense (DoD):

  • DoD statement titled “World AIDS Day Raises Awareness, Highlights Advances”.

Department of Labor (DoL):

  • DoL Secretary Hilda Solis’ statement titled “Forging Ahead on World AIDS Day”.
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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  • Organization/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.

    Senator Lugar releases report entitled “Fraud and Abuse of Global Fund Investments at Risk Without Greater Transparency”

    Senator Richard Lugar (R-IN), Ranking Member of the Senate Committee on Foreign Relations, released a minority staff report entitled, “Fraud and Abuse of Global Fund Investments at Risk Without Greater Transparency”. The report provides an historical overview of U.S. involvement with the Global Fund to Fight AIDS, Tuberculosis and Malaria though the President’s Emergency Plan for AIDS Relief (PEPFAR) and provides recommendations for improvement to both the U.S. government and the Global Fund.

    H.R. 755 – Investing in Our Future Act of 2011

    The proposed bill would impose a 0.005% tax on the value of the currency (if greater than $10,000 USD) acquired in a currency exchange transaction. The revenue generated by this tax would be directed to three new trust funds established at the Department of the Treasury: 10% would be directed to a “Child Care Assistance Trust Fund,” 25% to a “Multilateral Global Health Trust Fund,” and 25% to a “Global Climate Change Adaptation and Mitigation Trust Fund.” The remainder would be directed to federal budget deficit reduction or reduction of the federal debt.

    The Secretary of State would have authority to provide grants from the Multilateral Global Health Trust Fund to entities such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and other multilateral organizations that meet specific criteria outlined in the bill. The bill also states that funding for the multilateral organizations must be in addition to and not replacing existing funding and should be used for the purposes of “addressing HIV/AIDS, tuberculosis, malaria, maternal mortality, family planning, neglected diseases, and other health issues affecting developing countries.”

    White House releases FY 2012 Budget Request

    The White House released the FY 2012 budget request, which included the following funding totals for the U.S. Global Health Initiative (GHI) and other global health and related activities:

    b>Global Health Initiative (GHI) total: $9.8 billion, including

    - $8.7155 billion from State & Foreign Operations Global Health & Child Survival (GHCS) account, and

    - Over $1.0693 billion from HHS, DoD, and other State & Foreign Operations accounts.

    - PEPFAR: Included in the GHI total is $7.154 billion for PEPFAR of which $1.3 billion is for the Global Fund ($1.0 billion 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 the global health:

    - Global Health & Child Survival (GHCS): $8.7155 billion

    • USAID: $3.0736 billion
      • Maternal & Child Health: $846.0 million
      • Nutrition: $150.0
      • Vulnerable Children: $15.0 million
      • HIV/AIDS: $350.0 million
      • Family Planning/Reproductive Health: $625.6 million
      • Malaria: $691.0 million
      • Tuberculosis: $236.0 million
      • Neglected Tropical Diseases (NTDs): $100.0 million,
      • Pandemic Influenza and Other Emerging Threats: $60 million
    • Department of State: $5.6419 billion
      • HIV/AIDS: $5.6419 billion (includes $1.0 billion for the Global Fund)

    Millennium Challenge Corporation: $1.125 billion

    • Health and Human Services (HHS) funding for global health:
      • National Institutes of Health (NIH):
        • HIV/AIDS Research: $489.4 million
        • Malaria Research: $110.2 million
        • Global Fund: $300.0 million
      • Centers for Disease Control and Prevention (CDC) ($ total): $381.2 million
        • Global AIDS Program: $118.0 million
        • Global Immunization Program: $163.6 million
        • Global Disease Detection & Emergency Response: $44.2 million
        • Parasitic Diseases & Malaria: $19.6 million
          • Malaria: $9.2 million
        • Global Public Health Capacity Development: $35.8 million
    • Fogarty International: $71.3 million
    Congressional letter to Appropriations Committees calls for “robust” funding of FY 2012 global health programs

    Approximately 100 members of Congress signed a letter calling on the Chair and Ranking Member of the Subcommittee on State and Foreign Operations in both the House and Senate Appropriations Committees to support the Senate proposed funding level for FY 2012 global health programs.

    Secretary Clinton gives speech on “Creating an AIDS-Free Generation”

    In a speech titled “Creating an AIDS-Free Generation” given at the National Institutes of Health (NIH), Secretary of State Hillary Clinton highlighted three interventions guiding the U.S. government’s efforts to achieve the goal of an “AIDS-Free Generation”: prevention of mother-to-child transmission, voluntary medical male circumcision, and the use of antiretroviral drugs.   Secretary Clinton also described three U.S. HIV/AIDS policy priorities: using scientifically proven results to inform U.S. policy, an increasing emphasis on country ownership, and “calling on other donor nations to do their part, including by supporting and strengthening the Global Fund.”

    Additional Information:

    Senate Appropriations Committee approves the State and Foreign Operations Appropriations Bill, FY 2012

    The Senate Committee on Appropriations released a summary of the FY 2012 State and Foreign Operations Appropriations bill (S.1601, Committee Report) as approved by the full Committee on September 21, 2011.  The proposed bill includes funding for the U.S. Global Health Initiative (GHI) of approximately $7.9 billion from the Global Health and Child Survival (GHCS) Account, which is $810.5 million below the President’s FY 2012 budget request of $8.7 billion and $75.69 million above FY 2011 levels of $7.8 billion for the GHCS (additional funding for the GHI is provided through other spending bills).  Funding from GHCS for specific areas is as follows:

    • Maternal & Child Health (MCH): $595 million, of which $35 million is for polio eradication
    • Neglected Tropical Diseases (NTDs): $89 million
    • Malaria: $642 million
    • Tuberculosis: $225 million
    • HIV/AIDS: $4,850 million
    • Global Fund: $750 million

    The proposed bill also provides for the following:

    • Family Planning/Reproductive Health: $700 million from all accounts (including the GHCS account), of which $40 million is for the United Nations Population Fund (UNFPA)
    • Millennium Challenge Corporation (MCC): $898.2 million
    • Global Agricultural and Food Security Program: $200 million

    *These funding amounts are preliminary only and will be updated as more information becomes available.