The appropriations committees in the U.S. Senate and House of Representatives have approved funding for global health programs for the fiscal year 2018 at about the same levels as the previous year. In so doing, the committees ignored the budget proposed by President Donald Trump which called for cuts of $2.5 billion overall, including $225 million less for the Global Fund and $1 billion less for PEPFAR.
The U.S. 2018 fiscal year runs from 1 October 2017 to 30 September 2018.
The appropriations committees approved funding of $1.35 billion for the Global Fund; $4.6 billion for PEPFAR; $755 million for the President’s Malaria Initiative (PMI); and $290 million for Gavi (the Vaccine Alliance). Having been approved by the committees, the budget bills now move to the full Senate and the full House of Representatives for a vote.
If the $1.35 billion for the Global Fund is approved by Congress, it will be the first contribution by the U.S. towards its pledge of $4.3 billion for the period 2017-2019. For 2014-2016, the U.S. contributed $4.1 billion.
The appropriations committees also approved funding of about $74 million for the Fogarty International Center (FIC) at the National Institutes of Health. The Trump administration had proposed to eliminate the center. The FIC promotes and supports scientific research and training internationally to reduce disparities in global health.
In policy provisions included in the budget bills, the Senate and the House of Representatives went in opposite directions. The Senate Appropriations Committee voted to reinstate funding for the United Nations Population Fund (UNFPA) and to overturn the global gag rule, a longstanding Republican policy that forbids U.S. support for international health organizations that offer or discuss abortion services. The Mexico City Policy, the formal name of the global gag rule, was put into effect during the Reagan administration, and has existed under every Republican administration since.
Meanwhile, the House Appropriations Committee voted to maintain the global gag rule and to deny funding to the UNFPA.