The post-midterm prognosis for global health R&D
With less than two weeks to go until one of the most anticipated midterm elections in recent memory, there are big questions occupying the minds of Washingtonians and politics junkies from coast to coast: Will the Democrats regain control of the House of Representatives for the first time in eight years? Do they have any chance of retaking the Senate, or might recent swings in the polls signal that Republicans could tighten their hold on the chamber? And, what will it all mean for US support for global health research and development (R&D)? While nothing can be taken for granted in the current political climate, here are our best modest bets on what to expect once the dust settles on November 6.
Democrats will take back the House and focus on domestic priorities and oversight
Nita Lowey is the lead Democrat on both the full Appropriations Committee and the State, Foreign Operations, and Related Programs Subcommittee, and Rosa DeLauro (D-CT) serves as the ranking member of the Labor-HHS, and Education Subcommittee—both of whom are expected to win re-election easily.
House Energy and Commerce Committee (E&C): E&C—with jurisdiction over leading agencies in global health R&D, including NIH,
CDC, and FDA—will see bigger changes. Three Republican members are retiring—Joe Barton (R-TX), current Vice-Chairman Gregg Harper (R-MS),
and Ryan Costello (R-PA)—another two members are in toss-up races, and another five are in competitive races. In contrast, just one Democrat,
Gene Green (D-TX), the ranking Democrat on the Health Subcommittee, is retiring, and no Democrats currently on the committee are considered at
risk of losing re-election. Congressman Frank Pallone (D-NJ) currently serves as the lead Democrat on the full Committee.
Republicans will retain a narrow margin in the Senate—with no end to gridlock in sight
As in any election year, roughly one-third of Senate seats are up for grabs, but analysts have called the 2018 electoral map one of the most Republican-friendly
in a generation, with Democrats defending 26 of the 35 seats up for re-election—including 10 seats in states that voted for Trump in 2016.
The enthusiasm of the Democratic base may not be enough to reverse the narrow 51 to 49 margin that Republicans currently hold in the Senate. Democratic
pundits are confident incumbents can defend most of the seats in play but are increasingly pessimistic about picking up new seats in toss-up races
in Arizona, Texas, Nevada, and Tennessee—once seen as serious possibilities. In a complete reversal of their House prediction, the FiveThirtyEight
Forecast currently gives Republicans
a five in six chance of holding on to the Senate. Assuming Republicans maintain a slight majority, the leadership and make-up of key committees
are unlikely to change dramatically, though several key retirements will mean new faces are likely to join their ranks. In more detail:
Should the Republicans retain control of the Senate and Democrats take the House, as tentatively expected, gridlock in Washington is only expected to intensify, especially as moderates in both parties who have been more open to compromise have retired or been picked off in primaries. Even if Democrats wrestle control of both chambers, another two years of a Republican administration and the ramp-up of a presidential election that promises to be one of the most contentious in generations likely engenders new political challenges in every direction. Add to that the fact that the budget deal currently shaping annual appropriations will expire during the next session of Congress, and you’ve got a recipe for drama! Global health R&D advocates will have to think creatively about messages that could resonate in a divided government in a time of tightening budgets to ensure that critical investments and policies that support the creation of new health tools remain a priority no matter which wildly different midterm prediction comes to pass.