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Kaiser Daily Global Health Policy Report

In The News

White House Proposes FY17 Cuts To NIH, PEPFAR In Near-Term Spending Bill; Congress Members Show Little Support

Bloomberg: White House Proposes Large Cuts to NIH Research This Year
“President Donald Trump’s administration has proposed cutting $1.23 billion this fiscal year from research funded by the National Institutes of Health, according to a White House document sent to congressional appropriators. The reduction is part of $18 billion in cuts that the administration wants in fiscal 2017, which ends in October. … A worldwide initiative to help people with HIV and AIDS, known as PEPFAR and heavily focused on patient treatment in Africa, would be slashed by almost $300 million under the plan. The savings would be found by slowing the rate of new patients put on treatment and reducing support to ‘low-performing countries’…” (Edney, 3/28).

The Hill: White House wants to slash billions from grants, foreign aid
“…Congress failed to pass a budget last year and funded the government through April 28 through a continuing resolution. The White House Office of Management and Budget is proposing billions in cuts to programs that make up a small portion of federal spending but are prized by lawmakers from both parties, according to the document. Funding levels are ultimately set by Congress, not the president, and White House spending proposals are routinely ignored by lawmakers. Many of the proposed cuts are unlikely to end up in legislation and mirror similar cuts in Trump’s fiscal 2018 budget proposal, already panned by Congress…” (Lane, 3/28).

STAT: White House proposes new, sweeping budget cuts at NIH
“…In a statement, the American Society for Biochemistry and Molecular Biology harshly criticized the proposed cuts, saying the administration was ‘throwing progress out the window.’ ‘The president continues to put the health and well-being of Americans in danger to move forward a so-called “hard power budget,” even while leaders from his own party view investments in biomedical research as critical to the nation’s security,’ the group said…” (Scott/Kaplan, 3/28).

Washington Post: Trump wants to add wall spending to stopgap budget bill, potentially forcing shutdown showdown
“…Trump’s request, outlined in conversations with White House officials and in a memo from budget director Mick Mulvaney, calls for … new defense and border spending — and $18 billion in cuts to other priorities, such as medical research and jobs programs. But it appeared that few on the Hill shared the White House’s appetite to flirt with a government shutdown over the border wall, which Democrats have pledged to oppose and which even some conservative Republicans object to on fiscal grounds. … Many of the cuts would be aimed at key priorities for Democrats, such as money for global reproductive health education, but they also take aim at more broadly popular agencies including the National Institutes of Health and the Federal Emergency Management Agency…” (Snell et al., 3/28).

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In Testimony To U.S. House Subcommittee, Experts Express Concerns Over Proposed Cuts To Programs Providing East African Food, Humanitarian Assistance; Rep. Smith Pledges Continued Funding

VOA News: Experts Concerned by Potential Cuts to Lifesaving USAID Programs
“A U.S. congressional committee heard complaints Tuesday that USAID programs are at risk of getting ‘slashed’ or ‘eliminated’ under the proposed budget from the White House, during a time when the threat of famine in East Africa is the ‘highest it has been in decades.’ At the hearing of a House Foreign Affairs subcommittee, panelists warned that U.S. budget cuts could undermine efforts to address the consequences of drought and a crisis-driven famine at a time when aid agencies are attempting to scale up efforts to prevent millions from dying…” (Bior, 3/29).

Daily Nation: U.S. food aid to Kenya won’t be cut, Congressman Chris Smith says
“An influential Republican lawmaker pledged on Tuesday that the U.S. will continue providing life-saving food aid to Kenya and neighboring countries despite the Trump administration’s threatened cuts in international assistance. ‘The president proposes; Congress disposes,’ noted Chris Smith, chairman of the House of Representatives’ Africa subcommittee. ‘Congress will make sure we get humanitarian assistance to where we need it most,’ he said. Mr. Smith’s comments were made at a hearing his subcommittee held on the topic of ‘East Africa’s Quiet Famine’…” (Kelley, 3/29).

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Panelists, U.S. Representatives Largely Support Maintaining Foreign Assistance During House Foreign Affairs Committee Hearing

Devex: House Foreign Affairs committee seeks input on budget cuts
“The House Foreign Affairs Committee hearing on Tuesday indicated that the majority of members oppose President Donald Trump’s proposed budget cuts and believe that, while reforms are needed, U.S. foreign assistance should not be slashed. During the hearing, only one member of Congress came out vocally in support of the proposed … budget cuts: Rep. Dana Rohrabacher, a Republican from California, cheered Trump’s proposal. … While several other members questioned the efficacy of certain investments or the way they are made, they mostly spoke in favor of maintaining a robust foreign affairs budget as an instrument of national security…” (Saldinger, 3/29).

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About 22M Children In Nigeria, Somalia, South Sudan, Yemen At Risk Of Starvation Without Aid, UNICEF Warns

U.N. News Centre: Around 22 million children could soon starve without urgent aid, UNICEF warns
“Millions of children are on the brink of starvation in the worst humanitarian crisis in decades, the United Nations Children’s Fund (UNICEF) [Tuesday] warned, urgently calling for nearly $255 million to respond to immediate needs in northeast Nigeria, Somalia, South Sudan, and Yemen. … Some 22 million children are hungry, sick, displaced, and out of school in the four countries, according to the U.N. agency. Nearly 1.4 million are at imminent risk of death this year from severe malnutrition…” (3/28).

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WHO Taking Lead Coordination Role In Bringing Health Care To Frontlines Of Battle For Mosul

Devex: For first time, WHO as implementer in Mosul trauma ‘chain of care’
“…Medical referrals, written and stamped with diagnoses and case details, are usually an anomaly in the frontlines of ongoing conflict. But around the city of Mosul, which government security forces are still fiercely fighting to retake from the Islamic State militant group, they are increasingly becoming the norm — part of a uniquely defined chain of care. Mosul has been the rare humanitarian emergency that everyone could see coming as the Iraqi government telegraphed its intent to retake the city. That has allowed an enormous amount of innovation to happen on the frontlines. One of the most unexpected players close to the battle has been the World Health Organization, a U.N. agency that usually prefers to coordinate from the sidelines…” (Dickinson, 3/29).

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As Yemen War Enters 3rd Year, Access To Health Care Difficult, Child Marriage Rate Rising, U.N. Agencies Report

Thomson Reuters Foundation: Child marriage soars in Yemen as famine looms — U.N.
“Child marriage has soared in Yemen as families struggle to feed their children amid a conflict that has left the country on the brink of famine, the U.N. children’s agency said on Monday. More than two thirds of girls in Yemen are married off before they reach 18, compared to half of girls before the conflict escalated, UNICEF said in a report to mark the second anniversary of the war…” (Batha, 3/27).

U.N. News Centre: Half of all health facilities in war-torn Yemen now closed; medicines urgently needed — U.N.
“More than 14 million people in Yemen have no access to health services, the United Nations health agency [Tuesday] said, warning that transportation of medical personnel and treatment for the injured is getting increasingly difficult as this week the fighting enters its third year…” (3/28).

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Aid Groups, U.N. Respond To Cholera Outbreak, Severe Food Shortages In Somalia; 6M People In Need Of Emergency Assistance

Al Jazeera: Somalia faces major cholera outbreak
“The United Nations has raised alarm over a major outbreak of cholera in southern Somalia. Aid groups are already scrambling to help people suffering from severe drought and mass malnutrition. The U.N. is urging immediate action and aid to avert the crisis. Al Jazeera got access to a hospital in Baidoa in the badly hit southern region…” A video report accompanies the article (Malone, 3/28).

Thomson Reuters Foundation: 3,000 people a day fleeing in cholera-stricken Somalia as famine looms
“More than 3,000 people a day are fleeing their homes in search of food and water due to Somalia’s worst drought in 20 years, the Norwegian Refugee Council (NRC) said, warning of impending famine with children already dying of malnutrition. … More than six million Somalis — half of the population — need emergency aid, including close to one million acutely malnourished children…” (Migiro, 3/29).

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Wall Street Journal Examines Deteriorating Conditions Of Maternal, Newborn Health Care Facilities In Venezuela

Wall Street Journal: Venezuelan Women in Labor Cross to Colombia to Give Birth
“Fearful of having a baby in a grim Venezuelan hospital, Gerlimar Pastrán took a nine-hour bus ride to this border city in Colombia to give birth earlier this month to a healthy boy in a functioning maternity ward. She is one of hundreds of pregnant Venezuelan women who have streamed into Colombia in recent months to have their babies, straining Colombia’s public health network and underscoring the fast-deteriorating conditions of Venezuelan hospitals…” (Muñoz, 3/23).

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Editorials and Opinions

U.S. Congress Should Recognize Fogarty International Center's Impact On Global Health, Protect Its Funding

STAT: This NIH program is crucial to global health. And its future is in danger
Arthur L. Reingold, professor and division head of the Department of Epidemiology and distinguished chair emeritus in global public health and infectious diseases at the University of California, Berkeley, and Madhukar Pai, Canada research chair in epidemiology and global health at McGill University

“…[Eliminating the NIH’s Fogarty International Center] would be a big mistake for the United States and the rest of the world. The center … has initiated and sustained research around the globe aimed at fighting polio, tuberculosis, AIDS, and other infectious diseases, as well as focusing on global environmental health, bioethics, noncommunicable diseases, and more. Through more than 400 research and training projects, the center has trained well over 5,000 scientists worldwide and involved more than 100 American universities. This is an incredible global footprint, by any metric. … The training provided by these programs has supported many of the pivotal studies of HIV/AIDS prevention, control, and treatment strategies that have since become the cornerstone of highly successful interventions that have helped stem the tide of the global pandemics of HIV/AIDS, tuberculosis, and related conditions. … [T]he Fogarty International Center initiated equally successful collaborative research training initiatives focused on emerging infectious diseases, environmental and occupational illnesses, reproductive health, and noncommunicable diseases, among others. … Eliminating the center will not make America great again. On the contrary, it will greatly diminish the tremendous contributions to global health made by America and significantly undermine the global health field. We urge the Congress to recognize this fact and do everything possible to protect the Fogarty Center and the NIH” (3/29).

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Trump Administration Should Streamline, Reorganize U.S. Foreign Policy, Assistance While Ensuring U.S. Continues Global Influence

Forbes: Absolutely Reorganize, But Don’t Break Foreign Assistance
Daniel Runde, William Chreyer chair and director of the Project on U.S. Leadership and Development at the Center for Strategic and International Studies

“…President Trump … announced a potential reorganization of federal agencies, including the State Department and USAID. … Several principles should help guide any reorganization: First, titles and hierarchy matter so provide a real ‘Deputy Secretary of State’ title to the person in charge of development. … Second, recognize development and stabilization as a distinct profession on the same level as diplomacy and defense. … Third, development projects require longer time frames than political or diplomatic efforts and reorganization should reflect this reality. … Fourth, remember the breaking of our public diplomacy capacities with the death of [the U.S. Information Agency (USIA)]. … Fifth, the person who has the development job should control the development budget planning process known as the ‘F’ process. … Sixth, include all 16 agencies ‘doing development’ in this reorganization. … Seventh, the Trump administration should seek to change the mid-1990s OMB rule that gave free reign to independent agencies to freelance on international development with limited or no oversight by U.S. embassies and by USAID. … Eighth, any major reorganization will require congressional cooperation across multiple committees. The Trump administration should work with all of them. … U.S. foreign policy and assistance should be streamlined and organized better, but the Trump administration needs to be careful not to break our ability to exert influence around the globe in the process” (3/23).

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Both Political Will, Foreign Assistance Critical To Address Underlying Causes Of Conflict, Humanitarian Crises

IRIN: Famine in Somalia: Twice in six years?
Daniel Maxwell, Henry J. Leir professor in food security at the Friedman School of Nutrition Science and Policy and acting director of the Feinstein International Center at Tufts University, and colleagues

“…Humanitarian budgets have grown in recent years, but have not kept pace with the level of assessed need. The popular sentiment this year in the U.S. and some other countries appears to be ‘me first’ (‘and the rest of the world can take care of itself’). But people are moved to support others in extreme times, and such solidarity is sorely needed today. Without popular support, international humanitarian assistance will not be able to keep up with demand. Beyond the need for financial assistance in the short term, the longer-term need is the political will to address the underlying causes of the conflicts and other drivers of crisis. We know the magnitude and severity of the crisis facing Somalia and its likely consequences — as we do for South Sudan, Yemen, Nigeria, and other countries. But we also know how to prevent these crises. The time for action is now, and the timeframe for preventing widespread mortality is rapidly closing. Political solutions are required, but the need for resources is clear, as is the need for all parties to respect International Humanitarian Law and ensure that people have access to life-protecting assistance” (3/28).

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From the Global Health Policy Community

MFAN Releases Statement On Expansion Of Congressional Caucus For Effective Foreign Assistance

Modernizing Foreign Assistance Network: Sens. Isakson and Coons Lead Senate Expansion of Congressional Caucus for Effective Foreign Assistance
This statement, delivered on behalf of MFAN by co-chairs George Ingram and Connie Veillette, discusses the expansion of the Congressional Caucus for Effective Foreign Assistance to the Senate. “MFAN looks forward to deepening our work with the Caucus to make U.S. foreign assistance more accountable and impactful,” according to the statement (3/28).

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