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March 12, 2020

GHTC director Jamie Bay Nishi delivered in-person testimony on March 12, 2020 before the House Appropriations Subcommittee on State, Foreign Operations, and Related Programs on the fiscal year 2021 (FY21) budget for Global Health Programs at the US Agency for International Development (USAID) and State Department. View her testimony below as prepared:

Chairwoman Lowey, Ranking Member Rogers, and members of the Committee, thank you for the opportunity to provide testimony on FY21 appropriations for global health programs at USAID and the State Department. We appreciate your committed leadership in global health, and we hope that your support will continue. I am sharing this testimony on behalf of the Global Health Technologies Coalition, a group of 30 organizations advancing policies to accelerate the creation of new drugs, vaccines, diagnostics, and other tools that bring healthy lives within reach for all people. 

To this end, we strongly urge the Committee to continue its established support for global health research and development by:

First: Sustaining and supporting US investment in global health research and product development by rejecting cuts to global health programs called for by the Administration for FY21 and supporting at minimum sustained funding at FY20 levels for each disease or population-specific program under the USAID and State Department global health accounts. 

Second: Instructing USAID to prioritize R&D within each of the disease and condition areas under their Global Health Programs account and requiring leaders at State and USAID to work together with other US agencies to develop a whole-of-government global health R&D strategy to ensure that US investments are efficient, coordinated, and streamlined.

Third: Calling for the expansion of the annual report on USAID’s health-related research and development strategy, which is vital for transparency and oversight, and for the public release of the annual report required by the Global Health Innovation Act, which details the development and use of global health innovations by the Agency.

The recent outbreak of COVID-19 has demonstrated once again that we do not have all the tools needed to prevent, diagnose, and treat many neglected and emerging infectious diseases—a reality we also saw during the Zika epidemic and West Africa Ebola epidemic just a few years ago. Yet, the impact of the ERVEBO Ebola vaccine on the now-waning epidemic in the Democratic Republic of the Congo demonstrates the power of having the right tool at the right time to respond to a health emergency. This new vaccine, developed with critical US government funding, is 97.5% effective – a game-changer for this and future outbreaks.

As the only US agency with a mandate to focus on global health and development, USAID is uniquely positioned to support the end-to-end development of new global health technologies in a way that is not replicated elsewhere in the US government. USAID’s global presence and unique understanding of the needs of patients in different settings and contexts is key to developing health innovations that are transformative on the ground. 

However, for the vast majority of USAID’s global health programming, there are no dedicated funding streams expressly supporting R&D. This means that decisions on USAID’s R&D investments are made at the program level, based on overall funding allocations for each disease or population-specific health area. Funding cuts would put significant strain on USAID’s global health programs and jeopardize the agency’s ability to balance current programming needs with needs for new drugs, vaccines, diagnostics, and other tools to accelerate global health gains.

In addition, while there are areas of USAID’s global health portfolio that are leading the way in R&D, there are areas where a lack of resources and prioritization are acute. For example:

  • USAID does not currently incorporate research for new vaccines for tuberculosis into its programming despite TB becoming the world’s largest infectious disease killer, and
  • New tools are needed to reach the end game for neglected tropical diseases, including more sensitive diagnostics to ensure that elimination goals have been met. 

Diseases know no borders. As we’ve seen with COVID-19, health crises abroad can become health crises at home. It is imperative that we sustainably invest in R&D for a broad range of neglected infectious diseases so that we have tools ready to go when we need them. 

On behalf of the members of GHTC, I would like to extend my gratitude to the Committee for the opportunity to testify, and for your continued support of these life-saving investments. 

View video of testimony here (1:30:00).