In the face of a Republican-led effort to slash funding for global health programs, the Obama Administration proposed budget for 2012 calls for slightly increasing the investment on its Global Health Initiative (GHI) by 11% to $9.8 billion. Although several programs go up or down by roughly 10%, the Global Fund to Fight AIDS, Tuberculosis and Malaria would receive a 23% boost in its current budget, set in fiscal year 2010, to $1.3 billion. Congress is still formulating a continuing resolution that would fund the federal government through the rest of fiscal year 2011, which started 1 October. The increase “is good news in this funding environment—any boost is, especially if you compare to the level of cuts proposed in the House continuing resolution on Friday,” says Jirair Ratevosian, a policy analyst with the American Foundation for AIDS Research in Washington, D.C.
The continuing resolution introduced by the chair of the appropriations committee, Representative Hal Rogers (R-KY), immediately led to loud cries of protest from the global health advocates. In all, it would cut $783.5 million from the main component of GHI, the Global Health and Child Survival effort, which supports treatment and prevention programs for HIV/AIDS, tuberculosis, malaria, and neglected tropical diseases and family planning and nutrition efforts. The continuing resolution would take away another $300 million in contributions to the Global Fund.
Advocates have spelled out the dire impact they believe the proposed House cuts would have on global health. According to the Health Global Access Project (GAP), a nonprofit based in New York City, the cuts would mean nearly 1.5 million people would likely die for lack of anti-HIV treatment, 12 million families would not receive bednets to prevent malaria, and more than 400,000 would not have access to TB drugs. Health GAP analyst Matthew Kavanagh says global health investments cannot wait for better economic times. “We’re glad amidst the freeze on spending that the president is realizing that things like infectious disease pandemics don’t take a break,” says Kavanagh.
Although HIV/AIDS advocates are the most vocal, many other groups are deeply concerned about the House actions. Peter Hotez of the George Washington University Medical Center in Washington, D.C., specializes in neglected tropical diseases (NTDs), a field that has had a roller-coaster ride of hope and despair the last year. The 2010 budget appropriated only $65 million for NTDs, but Obama’s proposed 2011 budget promised to raise that amount to $155 million. The proposed 2012 budget, however, drops that down to $100 million. “It’s such a good buy for public health,” says Hotez, who said an increase would allow the United States to reach beyond the dozen countries it now helps combat NTDs.
Helene Gayle, head of CARE USA, worries about cuts to both nutrition and reproductive health. “Undernutrition is one of the most critical issues facing the world’s poor today, affecting virtually all other aspects of a person’s health and well-being,” says Gayle, who notes that it’s ultimately an economic issue, too. “Such drastic cuts in GHI funding will contribute to pushing millions more people around the world into poverty this year, with Africa expected to be hardest hit.”
See our complete coverage of Budget 2012.
*This item has been corrected. The first version of this story compared the FY2012 budget request for GHI to FY2011. It now compares the FY2012 request to the currently funded amount, which is based on the FY2010 enacted budget. The current Global Fund support is $1.05 billion, not $1 billion, which means the increase donation is actually 24%, not 30% as originally reported.