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 Presidentâ€™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 Presidentâ€™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 Presidentâ€™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.
In a State Department blog post titled â€œPEPFAR Programs in Uganda: An Update,â€ 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.
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.
The White House also released a fact sheet titled “The Beginning of the End of AIDS” summarizing efforts to combat HIV/AIDS through the President’s Emergency Plan for AIDS Relief (PEPFAR).
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):
USAID Administrator Shah writes USAID Impact Blog post titled “World AIDS Day: New Advances Are Critical to Achieving the Vision of an AIDS-free Generation”.
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.
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:
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.
“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)**
House – FY11
House – Request
State & Foreign Operations
of which GF
of which UNFPA
Water (all acounts)
Health and Human Services (HHS)
CDC Global Health
of which HIV
NIH – Global Fund
NIH – Fogarty International Center
Department of Defense (DoD)
The Global Health Initiative
Total GHI (known amounts)****
*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.
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 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.
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.”
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.