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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

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.

President Obama highlights U.S.-UK commitments to maternal and child health and the Global Fund

During a joint press conference with United Kingdom Prime Minister David Cameron, President Obama highlighted, among other things, U.S.-UK commitments to improve maternal and child health and support the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund).

Additional Information:

 

PEPFAR releases FY 2013 Country Operational Plan Guidance

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) released the “PEPFAR FY 2013 Country Operational Plan (COP) Guidance” outlining the U.S. Government’s (USG) “annual investments and anticipated results in HIV/AIDS and [is] the basis for approval of annual USG bilateral HIV/AIDS funding in most countries.”

Obama Administration announces 3-year, $4 billion pledge and calls for reforms to the Global Fund

As part of the Third Replenishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria the Obama Administration announced a 3-year, $4 billion (FY11-FY13) pledge and a “Call to Action” to the Global Fund aimed at “develop[ing] and implement[ing] a set of reforms to maximize the impact of Global Fund grants.” Additionally, a press release from the President’s Emergency Plan for AIDS Relief (PEPFAR) on the new commitment and “Call to Action” states that future U.S. contributions to the Global Fund would be based on a “review of: 1) measurable progress in delivering on an action agenda for improved grant impact, 2) maintaining the Global Fund’s focus on combating the three diseases, and 3) continued financial support from other donors.”

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).

Senate Appropriations Committee releases FY11 Omnibus Appropriations Act

The Senate Committee on Appropriations released the text of the FY 2011 Omnibus Act with the following funding levels:

Total Funding for State & Foreign Operations: $53.5 billion ($3.1 billion below the President’s FY11 request; $4.7 billion above the FY10 enacted level)

Global Health and Child Survival Account (GHCS): $8.22 billion ($291 million below the President’s request; $443 million above the FY10 enacted level) with funding for specific areas is as follows:
Maternal and Child Health: $761 million

- Family Planning and Reproductive Health: $710 million which includes funding from multiple accounts and provides $57.5 million to the United Nations Population Fund (UNFPA)

- HIV/AIDS activities and the Global Fund to Fight AIDS, Tuberculosis and Malaria: $5.85 billion:
HIV/AIDS: $5.025 billion

- Global Fund to Fight AIDS, Tuberculosis and Malaria contribution: $825 million (Note: An additional $300 million is appropriated for the Global Fund through the Department of Health and Human Services bringing total FY11 contribution to $1.125 billion.)

Millennium Challenge Corporation: $1.10 billion ($174.7 million below the President’s FY11 request; equal to the FY10 enacted level)

Food Security and Agricultural Development: $1.4 billion ($244 million below the President’s FY11 request)