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Senate Appropriations Subcommittee releases summary of FY 2013 State and Foreign Operations Appropriations Bill

The Senate Committee on Appropriations, Subcommittee on the Department of State and Foreign Operations and Related Programs approved the FY 2013 State and Foreign Operations appropriations bill and released a bill summary. The bill includes funding for U.S. global health programs at the U.S. Agency for International Development (USAID) and the State Department comprising a significant portion of funding for the Global Health Initiative (total funding for the GHI is not currently available as some funding provided through USAID, HHS, and DoD are not yet available).

The Senate bill would provide $8.4 billion to the GHI, which is approximately $500 million more than the President’s FY13 request ($7.9 billion) and $400 million more than the House FY13 appropriations bill ($8.0 billion). It is also approximately $200 million above the FY12 amount ($8.2 billion). Of this, the Senate bill would provide the following:

  • HIV/AIDS bilateral: $4.25 billion, which is greater than the President’s Request ($4.0 billion), but below the House bill ($4.6 billion), which maintained the FY12 levels.*
  • Global Fund: $1.65 billion, which is equal to the President’s Request and greater than the House bill ($1.3 billion), which maintained the FY12 levels.*
  • Maternal & Child Health (MCH): $655 million, which is greater than the President’s Request ($578 million) and the House bill ($606 million), which maintained the FY12 levels.
  • Malaria: $650 million, which is greater than the President’s Request ($619 million), but the same as the House bill, which maintained the FY12 levels.
  • Tuberculosis: $265 million, which is greater than the President’s Request ($224 million) and the House bill ($236 million), which maintained the FY12 levels.
  • Pandemic: $75 million, which is greater than the President’s Request ($53 million) and the FY12 amount ($58 million). The House bill did not specify an amount.

In addition, the bill would provide $700 million in funding from all accounts for family planning and reproductive health (FP/RH) including $44.5 million in funding for the United Nations Population Fund (UNFPA). This is greater than the President’s request ($643 million) and the House bill ($461 million). It is also greater than FY12 levels ($661 million).

*The FY 2012 enacted amount for the Global Fund was $1.050 billion. The Administration subsequently moved $250 million from the HIV/AIDS bilateral line to the Global Fund, bringing the Global Fund amount up to $1.3 billion.

White House releases FY 2013 Budget Request

The White House released the FY 2013 budget request, which included funding for the U.S. Global Health Initiative (GHI) and other global health activities.  Overall, funding for the GHI is down in the FY 2013 request, with most of the reduction coming from HIV/AIDS bilateral amounts.  Most other areas saw decreases as well, except for family planning and funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria and GAVI, which increased.

Area

FY12 Estimate (millions)

FY13 Request (millions)

Difference: FY13 – FY12 (millions)

The Global Health Initiative (GHI)

Total GHI

$8,827.6

$8,524.4

$-303.2
 (-3.4%)

     of which PEPFAR

$6,632.3

$6,418.0

$-214.3
 (-3.2%)

           of which HIV*

$5,082.4

$4,536.0

$-546.4
 (-10.8%)

           of which TB

$249.8

$232.0

$-17.8
 (-7.1%)

           of which Global Fund

$1,300.0

$1,650.0

$350
 (26.9%)


*Total USG bilateral funding for HIV/AIDS programs.

Area

Part of the GHI

FY12 Estimate (millions)

FY13 Request (millions)

Difference: FY13 – FY12 (millions)

U.S. Agency for International Development (USAID)

HIV

X

$350.0

$330.0

$-20
 (-5.7%)

Tuberculosis

X

$249.8

$232.0

$-17.8
 (-7.1%)

       GHP account

X

$236.0

$224.0

$-12
 (-5.1%)

       Other accounts

X

$13.8

$8.0

$-5.8
 (-42.2%)

Malaria

X

$650.0

$619.0

$-31
 (-4.8%)

MCH

X

$605.6

$578.0

$-27.6
 (-4.5%)

       of which GAVI

X

$130.0

$145.0

$15
 (11.5%)

Nutrition

X

$95.0

$90.0

$-5
 (-5.3%)

FP/RH

X

$524.0

$530.0

$6
 (1.2%)

NTDs

X

$89.0

$67.0

$-22
 (-24.7%)

Vulnerable Children

X

$17.5

$13.0

$-4.5
 (-25.7%)

Pandemic Influenza

X

$58.0

$53.0

$-5
 (-8.6%)

State Department

HIV

X

$4,242.9

$3,700.0

$-542.9
 (-12.8%)

Global Fund

X

$1,300.0

$1,650.0

$350
 (26.9%)

UNFPA

 

$35.0

$39.0

$4
 (11.4%)

National Institutes for Health (NIH)

HIV

X

$364.5

$388.9

$24.4
 (6.7%)

Malaria

X

$147.0

$147.0

$0
 (0%)

Centers for Disease Control and Prevention (CDC)

HIV

X

$117.1

$117.2

$0
 (0%)

Malaria

X

$9.3

$9.4

$0.1
 (1.1%)

Department of Defense (DoD)

HIV

X

$8.0

$0.0

$-8
 (-100%)

Malaria

X

$0.0

$0.0

-

CRS releases report on U.S. response to global threat of tuberculosis

The Congressional Research Service (CRS) released a report titled “U.S. Response to the Global Threat of Tuberculosis: Basic Facts”. According to the report summary, “[t]his report outlines basic facts related to global TB, including characteristics of the epidemic and U.S. legislation, programs, funding, and partnerships related to the global response to TB.”

GAO releases report on drug quality in global health programs

The U.S. Government Accountability Office (GAO) released a report titled “Ensuring Drug Quality in Global Health Programs”, which “examined (1) the regulatory and policy requirements intended to ensure the quality of drugs procured with U.S. aid funds and (2) the systems in place to monitor drug quality in supply chains used by programs receiving U.S. foreign aid funds.” The GAO did not make any recommendations in this report.

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)