KFF Daily Global Health Policy Report

In The News

U.S. President Trump's 2018 Budget Outline Includes Significant Cuts For State, USAID, NIH, Other Agencies

Devex: Trump’s ‘America first’ budget slashes foreign aid, multilateral funding
“President Donald Trump’s first budget proposes … cuts to the United States Agency for International Development and the State Department and recommends slashing funding to the United Nations. The draft budget, which was released Thursday morning, reveals plans to stop U.S. funding for U.N. climate change deals, but will preserve support for the President’s Emergency Plan for AIDS Relief and meet commitments made to the Global Fund for AIDS, Tuberculosis, and Malaria, and to Gavi, the Vaccine Alliance…” (Edwards, 3/16).

New York Times: Pentagon Grows, While EPA and State Dept. Shrink in Trump’s Budget
“President Trump will send a budget to Congress on Thursday that sharply reorders the nation’s priorities by spending billions of dollars on defending the southern border and bolstering the Pentagon while severely cutting funds for foreign aid, poverty programs, and the environment…” (Rappeport/Thrush, 3/16).

New York Times: Who Wins and Loses in Trump’s Proposed Budget
“President Trump released a partial outline of his 2018 budget on Thursday, proposing billions of dollars in spending cuts to most government agencies to pay for large increases in military and homeland security spending, resulting in a 1.2 percent cut in discretionary spending over all” (Parlapiano/Aisch, 3/16).

Reuters: Military wins in first Trump budget; environment, aid lose big
“…Trump’s budget outline is a bare-bones plan covering just ‘discretionary’ spending for the 2018 fiscal year starting on Oct. 1. It is the first volley in what is expected to be an intense battle over spending in coming months in Congress, which holds the federal purse strings and seldom approves presidents’ budget plans…” (Rampton, 3/16).

Reuters: Trump plans 28 percent cut in budget for State Department, USAID
“… ‘It is time to prioritize the security and wellbeing of Americans, and to ask the rest of the world to step up and pay its fair share,’ Trump said in a letter introducing his budget, which calls for large increases in U.S. defense spending. ‘This is a “hard power” budget. It is not a “soft power” budget,’ Mick Mulvaney, Trump’s budget director, told reporters, referring to the president’s desire to prioritize military power over the influence that can flow from development aid…” (Mohammed et al., 3/16).

ScienceInsider: NIH, DOE Office of Science face deep cuts in Trump’s first budget
“President Donald Trump’s first budget request to Congress, to be released at 7 a.m. Thursday, will call for cutting the 2018 budget of the National Institutes of Health (NIH) by $6 billion, or nearly 20 percent, according to sources familiar with the proposal. … The NIH proposal is drawing deep concern from biomedical research advocates…” (3/16).

Wall Street Journal: Trump Budget Seeks Big Cuts to Environment, Arts, Foreign Aid
“…The budget proposal is certain to run into stiff opposition in Congress, where lawmakers on both sides of the aisle have already signaled they are unlikely to enact Mr. Trump’s deep cuts when they pass spending bills that actually fund the government. … The budget proposal is the administration’s opening salvo for the 2018 budget process. Congress, however, still has not finished appropriations for fiscal 2017 — current spending legislation only funds the government through April 28…” (Sparshott et al., 3/16).

Washington Post: Trump federal budget 2018: Massive cuts to the arts, science and the poor
“…Republicans have objected, for example, to the large cuts in foreign aid and diplomacy that Trump has foreshadowed, and his budget whacks foreign aid programs run by the Education, State, and Treasury departments, among others. ‘The administration’s budget isn’t going to be the budget,’ said Sen. Marco Rubio (R-Fla.). ‘We do the budget here. The administration makes recommendations, but Congress does budgets’…” (Paletta et al., 3/16).

Washington Post: NIH would see huge budget cut under president’s proposal
“…The plan ‘includes a major reorganization’ of NIH’s 27 institutes and centers and would eliminate the Fogarty International Center, a [$69.2] million program dedicated to building partnerships between health research institutions in the United States and abroad…” (Bernstein, 3/16).

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U.S. Secretary Of State Tillerson Says State Department's Current Budget 'Not Sustainable,' Accepts 'Challenge' To Reduce Spending Under Trump's Proposed Budget

Reuters: Tillerson says State Department spending ‘simply not sustainable’
“U.S. Secretary of State Rex Tillerson said on Thursday the State Department’s current spending was ‘not sustainable,’ and he willingly accepted the ‘challenge’ President Donald Trump had given in proposing to cut more than a quarter of his agency’s budget. … Speaking in Tokyo at the start of a trip to Asia focused on the threat from North Korea, Tillerson defended the cuts as a necessary correction to a ‘historically high’ budget that had grown to address conflicts abroad in which the United States was engaged, as well as disaster aid…” (Lies, 3/16).

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Foreign Policy Examines Dutch Minister Ploumen's 'She Decides' Initiative, European Uncertainty About Trump Administration

Foreign Policy: If Trump Wants to End Legal Abortion, He’s Going to Have to Go Through Holland First
“Lilianne Ploumen didn’t intend to be the face of the European resistance to Donald Trump. But the headlines she triggered by her efforts to counter one of Trump’s first decisions in the White House have thrust her into that role. … The energetic [Dutch minister of foreign trade and development cooperation’s] story highlights how a continent wracked by doubts about the European project is adapting to the new uncertainty about U.S. leadership caused by the Trump presidency. … The day after Trump’s memorandum [reinstating and expanding the Mexico City policy] was issued, Ploumen set out to fill the funding gap. She launched the She Decides fund; the Netherlands immediately pledged $10 million…”

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Tanzania's Efforts To Shut Down AIDS Programs Offering Services To Gay People Incites Fear, Sparks Concern From U.S. Officials

NPR: People With HIV Are Panicking Due To Tanzania’s Crackdown On Gays
“…Last August, [Tanzania’s] justice minister suspended HIV prevention programs, funded by the U.S., that were aimed at gay men — and warned that any nonprofit that supports homosexuality would be suspended. Since then, there has been a continued effort to wind back or stop such programs. .. Tanzania currently receives approximately $380 million a year from PEPFAR, the U.S. program that supports programs to prevent HIV and AIDS and provides medications for people who are HIV positive. ‘We have been consistent in expressing concern on the statements and actions taken by certain Tanzanian officials targeting health care providers and civil society organizations that provide services to key populations at risk of HIV/AIDS,’ a USAID spokesman wrote in an email to NPR. ‘We urge Tanzania to maintain its prior commitments to combat the HIV/AIDS epidemic and to serve all of its people and populations equally without bias or discrimination’…” (Fallon, 3/15).

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Climate Change Must Be Addressed To Improve Health, Lower Risk Of Disease Outbreaks, Medical Consortium Says

NBC News: Climate Change Needs to Be Tackled for Better Health, Medical Groups Urge
“…Climate change is helping illness and disease spread and become more common, a new consortium of medical groups said Wednesday. It’s not just extreme heat and flooding, but more intense storms — including blizzards — and a steady warming trend that lets disease-carrying mosquitoes thrive, the new Medical Society Consortium on Climate Health said. … [H]ealth experts are worried that the new administration of Donald Trump is not just less worried about the problem, but might be downright hostile to efforts to slow the human impact on climate change…” (Fox, 3/15).

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Agile, Innovative Polio Immunization Campaigns Help Pakistan Edge Closer To Eradication

The Guardian: Polio’s last stand: frantic effort to eradicate Pakistan’s ‘badge of shame’
“…Here in Pakistan, home to almost all of the world’s polio cases just a few years ago, [a mobile population] require[s] a vaccination strategy as agile and stubborn as the virus itself. At hundreds of sites, teams of health workers verify that every child passing through [toll plazas] receives the vaccine. Another child, another family, another generation is protected, and Pakistan moves one step closer to having zero polio cases…” (Hyland, 3/15).

The Guardian: Pakistan and Afghanistan close to defeating Polio — in pictures
“Vaccinations at border crossings and other innovative solutions reach children who have missed the chance to be protected against the devastating virus” (Grant, 3/15).

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Editorials and Opinions

Congress Should Reject Cuts To U.S. Foreign Aid, Poverty Alleviation Programs

News & Observer: Seeing the fruits of U.S. aid, fearing the toll of cuts
Lindsay K. Saunders, leader of the RESULTS Raleigh Group

“…Putting foreign assistance on the chopping block would be a serious mistake, by any definition of national interest. … For decades, the United States has been a leader in fighting extreme poverty. And by working in partnership with developing nations, global poverty has been cut in half since 1990. Currently, millions of kids are able to go to school and get vital medical treatment because of anti-poverty programs supported by the U.S. government. Healthy, educated children become healthy, educated adults who contribute to their communities and economies in a myriad of ways. This benefits all of us. … By investing in effective and efficient development programs, we can continue to make progress on poverty, and bolster country self-reliance. I strongly urge our members of Congress to reject any cuts to global anti-poverty programs. We must keep our commitments to these development programs…” (3/15).

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Investing In Nutrition Critical To Improving Health Of Women, Girls, Paves Way For Reaching Gender Equity

Huffington Post: Proper Nutrition Is Essential To Empowering Women And Girls
Kristen Ostling, senior manager for advocacy and global impact, and Samantha Grills, policy and advocacy officer, both at the Micronutrient Initiative

“…By investing in nutrition, societies become more sustainable and equal — a point most starkly reflected by the fact that 12 of the 17 global Sustainable Development Goals (SDGs) are directly related to advancements in nutrition. … [M]any governments and multilateral actors are increasingly recognizing the fundamental importance of prioritizing nutrition. … Reducing the prevalence of malnutrition will improve the health, capacity, and opportunity of millions of women and girls around the world, paving the way for improvements in gender equity and women’s rights. By recognizing nutrition as the fundamental cornerstone of women’s rights and empowerment that it is, and responding in kind through increased action and resources towards ending malnutrition, Canada will continue to be a world leader on gender equality and nutrition. If we ensure that all women and girls have the health and wellness to grow, learn, earn, and lead, the entire world will be a more just and prosperous place” (3/15).

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From the Global Health Policy Community

CGD Podcast Examines Key Takeaways From Event On U.S. Foreign Aid

Center for Global Development’s “CGD Podcast”: Cutting Foreign Aid: What Will It Mean for the U.S.? — CGD Podcast
In this podcast, Rajesh Mirchandani, vice president of communications and policy outreach at CGD, discusses highlights from an CGD event during which experts from across the political spectrum — including Scott Morris, director of the U.S. Development Policy Initiative at CGD, Danielle Pletka of the American Enterprise Institute, Jim Roberts of the Heritage Foundation, and John Norris of the Center for American Progress — discussed what the Trump administration’s potential cuts to foreign assistance might mean for the U.S. moving forward (3/15).

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Members Of European Parliament Debate U.S. Reinstatement Of Mexico City Policy

European Parliament News: U.S. “global gag” anti-abortion rule a major setback for women’s health, say MEPs
“Political group speakers reacted to President Donald Trump’s reinstatement of the ‘global gag’ rule in a debate with E.U. humanitarian aid Commissioner Christos Stylianides on Tuesday. … Stylianides expressed concern over the presidential memorandum regarding the Mexico City policy, signed by U.S. President Donald Trump…” The press release includes comments about the policy from several members of the European Parliament (3/14).

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Lessons Learned From Zika, Ebola Epidemics Should Inform Global Pandemic Preparedness

Harvard Business Review: The World Is Completely Unprepared for a Global Pandemic
In this online article, Ranu S. Dhillon, an instructor at Harvard Medical School and a physician at Brigham and Women’s Hospital in Boston who served as an adviser to the president of Guinea during the Ebola epidemic; Devabhaktuni Srikrishna, founder of Patient Knowhow who also worked on the Ebola outbreak in Guinea; and David Beier, managing director of Bay City Capital, discuss the potential threat of deadly pandemics and outline “four lessons from the gaps exposed by the Ebola and Zika pandemics. Faster Vaccine Development … Point-of-Care Diagnostics … Greater Global Coordination … Stronger Local Health Systems … Investing in our ability to prevent and contain pandemics through revitalized national and international institutions should be our shared goal. However, if U.S. agencies become less able to respond to pandemics, leading institutions from other nations … would need to step in to fill the void…” (3/15).

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G7, G20 Leadership Vital To Improving Global Food Security, Agricultural Development

Chicago Council on Global Affairs: A Food-Secure Future: G7 And G20 Action On Agriculture And Food
As part of the Chicago Council on Global Affairs new blog series “A Food-Secure Future,” Isabel DoCampo, research associate at the Chicago Council, examines the commitments made by the G7 and G20 on global food security and “the ways in which they’ve influenced major players in the agriculture and food security space.” DoCampo writes, “[The G7 and G20 have] set the tone for global action on these issues. Looking forward, their continued leadership on food security, agriculture, and the many challenges faced by our food system — challenges that will demand the undivided attention of the global community — will be critical to ending hunger and malnutrition for good” (3/15).

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Wilson Center Event Highlights Results From Global Midwifery Survey

Woodrow Wilson Center’s Environmental Change and Security Program’s “New Security Beat”: Midwives’ Voices, Midwives’ Realities: Results From the First Global Midwifery Survey
Nancy Chong, intern for the Wilson Center’s Maternal Health Initiative, discusses a Wilson Center event reporting results from a survey of midwives. Speakers at the event included Samara Ferrara, a midwife from Mexico; Mary-Ellen Stanton, senior maternal health adviser at USAID’s Bureau for Global Health; Frances Day-Stirk, president of the International Confederation of Midwives; Nancy Kamwendo, a national coordinator for the White Ribbon Alliance; and Fran McConville, a technical officer of midwifery for the WHO. The participants discussed the importance of midwives to improving maternal health outcomes and outlined challenges that midwives often face (3/15).

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Aidspan Publishes New Issue Of 'Global Fund Observer'

Aidspan: Global Fund Observer
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, published Issue 307 of the “Global Fund Observer.” The newsletter features articles on various topics, including an analysis on issues surrounding the Global Fund’s selection process for a new executive director; an announcement that the Global Fund Board has appointed Marijke Winjroks, who is currently chief of staff at the Global Fund, as the fund’s interim executive director; and a news article on how proposed cuts to U.S. foreign aid might affect the Global Fund (3/15).

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From KFF

White House Releases FY18 Budget Blueprint

The White House released its budget blueprint on March 16, 2017 providing initial information on its budget request for FY18 (the full budget request is expected in May). While detail on funding levels for most global health programs is not specified, the blueprint does include total funding for the U.S. Agency for International Development (USAID) and the Department of State and highlights some specific global health programs and related areas:

  • USAID & State Department and Department of Treasury International Programs:
    • Total Funding: $39.1 billion, an $18.1 billion (-32%) cut from the FY17 Continuing Resolution (CR) level. This includes $25.6 billion for base activities ($10.1 billion or 28% below the FY17 CR) and $12.0 billion for Overseas Contingency Operations (OCO) ($7.2 billion or 37% below the FY17 CR) at USAID and the State Department, as well as $1.5 billion for Department of Treasury International Programs ($803 million or 35% below FY17 CR).
    • PEPFAR: “Provides sufficient resources to maintain current commitments and all current patient levels on HIV/AIDS treatment under the President’s Emergency Plan for AIDS Relief (PEPFAR).”
    • Global Fund: “The Budget also meets U.S. commitments to the Global Fund for AIDS, Tuberculosis, and Malaria by providing 33 percent of projected contributions from all donors, consistent with the limit currently in law.”
    • Malaria: “[M]aintains funding for malaria programs.”
    • Gavi, the Vaccine Alliance: “Provides sufficient resources on a path to fulfill the $1 billion U.S. pledge to Gavi, the Vaccine Alliance.”
    • International Organizations:
      • United Nations: “Reduces funding to the UN and affiliated agencies, including UN peacekeeping and other international organizations, by setting the expectation that these organizations rein in costs and that the funding burden be shared more fairly among members. The amount the U.S. would contribute to the UN budget would be reduced and the U.S. would not contribute more than 25 percent for UN peacekeeping costs.”
      • Multilateral Development Banks: “Reduces funding for multilateral development banks, including the World Bank, by approximately $650 million over three years compared to commitments made by the previous administration.”
    • Details on funding for other global health programs (e.g. tuberculosis, family planning and reproductive health, maternal and child health, etc.) was not included in the blueprint.
  • Department of Health and Human Services (HHS):
    • National Institutes of Health (NIH): Total funding would be $25.9 billion, a $5.8 billion (-18%) cut from the FY17 CR level. Additionally, the blueprint eliminates funding for the Fogarty International Center (FIC).
    • Public health, emergency preparedness, and prevention programs: “[T]he Budget restructures similar HHS preparedness grants to reduce overlap and administrative costs and directs resources to States with the greatest need. The Budget also creates a new Federal Emergency Response Fund to rapidly respond to public health outbreaks, such as Zika Virus Disease. The Budget also reforms the Centers for Disease Control and Prevention through a new $500 million block grant to increase State flexibility and focus on the leading public health challenges specific to each State.”
  • U.S. Department of Agriculture (USDA): Eliminates funding for the McGovern-Dole International Food for Education and Child Nutrition Program.

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New Kaiser Family Foundation Fact Sheet Provides Overview Of WHO, U.S. Engagement With Organization

Kaiser Family Foundation: The U.S. Government and the World Health Organization
This new fact sheet provides information about the World Health Organization (WHO) and the U.S. government’s engagement with the WHO.

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