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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.

House Appropriations Subcommittee completes markup of State and Foreign Operations Appropriations Bill

The House Committee on Appropriations, Subcommittee on State and Foreign Operations completed its markup of the FY 2011 State and Foreign Operations appropriations bill with the following recommendations:

Total Funding for State & Foreign Operations: $52.656 billion ($4 billion below the President’s FY11 request; $3.89 billion above the FY10 enacted level)

Global Health and Child Survival Account (GHCS): $8.25 billion ($263 million below the President’s request; $471 million above the FY10 enacted level) which includes $2.725 billion for USAID and $5.525 billion for the State Department. Funding for specific areas is as follows:
– HIV/AIDS activities and the Global Fund to Fight AIDS, Tuberculosis and Malaria: $5.875 billion
– HIV/AIDS: $5.05 billion

- Global Fund to Fight AIDS, Tuberculosis and Malaria contribution: $825 million
– Malaria: $615 million

- Family Planning and Reproductive Health: $735 million which includes funding from multiple accounts and provides $60 million to the United Nations Population Fund (UNFPA)

Millennium Challenge Corporation: $1.105 billion ($174.7 million below the President’s FY11 request; equal to the FY10 enacted level)

Administrator Shah discusses the Global Health Initiative

At an event hosted by the Center for Strategic and International Studies (CSIS), U.S. Agency for International Development (USAID) Administrator Dr. Rajiv Shah, provided remarks on the “vision” and “defining features” of the Global Health Initiative (GHI) including “doing more of what works” by improving monitoring and evaluation, “expanding service platforms,” prioritizing innovation, focusing on country ownership, and using a women- and girls-centered approach. During a question and answer session at the conclusion of his remarks, Administrator Shah also discussed, among other things, the President’s Emergency Plan for AIDS Relief (PEPFAR), the Feed the Future Initiative, and procurement reform at USAID.

Congressional letter expresses concern and requests clarification on PEPFAR policies, funding and strategy in Africa

In a letter to the U.S. Global AIDS Coordinator Ambassador Eric Goosby, twenty-five members of Congress expressed “concern about several reported policy and funding decisions that have impacted treatment programs supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) in certain countries in African” and requested clarification on the Administration’s “strategy for reaching the goal of providing AIDS treatment to 4 million people.”

Congressional letter urges President Obama to support the Global Fund

In a letter to President Obama, 100 members of Congress joined Representative Barbara Lee (D-CA, 9th) to urge the Obama Administration “to make a three-year commitment to the Global Fund to Fight AIDS, Tuberculosis, and Malaria of no less than $6 billion for fiscal years 2012, 2013, and 2014, in addition to any proposed bilateral funding.”

S. 3676 – Department of State, Foreign Operations, and Related Programs Appropriations Bill, 2011

The Senate Committee on Appropriations approved by a vote of 18-12 the FY 2011 State and Foreign Operations appropriations bill with the following recommendations:

Total Funding for State & Foreign Operations: $54.06 billion ($2.6 billion below the President’s FY11 request; $5.3 billion above the FY10 enacted level)

Global Health and Child Survival Account (GHCS): $8.239 billion ($274 million below the President’s request; $460 million above the FY10 enacted level) with funding for specific areas is as follows:
– HIV/AIDS activities and the Global Fund to Fight AIDS, Tuberculosis and Malaria: $5.85 billion
– HIV/AIDS: $5.05 billion

- Global Fund to Fight AIDS, Tuberculosis and Malaria contribution: $800 million
– Malaria: $635.5 million

- Tuberculosis: $230 million

- Neglected Tropical Diseases (NTDs): $100 million

- Child Survival and Maternal Health: $641 million

- Nutrition: $100 million

- Family Planning and Reproductive Health: $700 million which includes funding from multiple accounts and provides $55 million to the United Nations Population Fund (UNFPA)

Millennium Challenge Corporation: $1.105 billion ($174.7 million below the President’s FY11 request; equal to the FY10 enacted level)

Feed the Future: $1.3 billion ($344 million below the President’s FY11 request)

“Global Gag” Rule Amendment:The Committee approved by a vote of 19-11 an amendment to the appropriations bill introduced by Senator Frank Lautenberg (D-NJ) that would codify into law President Obama’s decision to rescind the “global gag” rule (otherwise known as the Mexico City Policy), which prevented the U.S. from providing foreign assistance for family planning purposes to any organization that performed or promoted legal abortion.

Ambassador Goosby provides an update on PEPFAR programs in Uganda

In a State Department blog post titled “PEPFAR Programs in Uganda: An Update,” U.S. Global AIDS Coordinator Ambassador Eric Goosby summarized recent challenges surrounding HIV treatment in Uganda and outlined some of the actions PEPFAR will take to address these challenges including:
– Strengthen PEPFAR’s linkages, through the Global Health Initiative (GHI), with other U.S.-supported health programs;

- Support treatment scale-up and expansion of access to HIV prevention and care services;

- Provide an immediate infusion of antiretroviral drugs;

- Provide increased short- and medium-term financial assistance;

- Promote best practices and innovations in service delivery;

- Conduct an analysis of treatment expenditures in order to develop a plan that expands access to treatment;

- Accelerate the full functioning of grants from the Global Fund to Fight AIDS, TB and Malaria; and

- “Pursue a new approach to purposeful engagement with the Government of Uganda and civil society” in order to coordination and collaboration.

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