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GHTC submitted written testimony to the House appropriations subcommittees with jurisdiction over the US Agency for International Development and Department of State and the Department of Health and Human Services and its sub-agencies urging these subcommittees to sustain and protect global health R&D funding in the fiscal year 2020 (FY20) budget.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign-up now to receive our weekly R&D News Roundup email. A phase II clinical trial, led by the Drugs for Neglected Diseases initiative (DNDi), found that a two-week treatment of benznidazole was just as effective in treating Chagas— a parasitic disease which causes permanent damage to the heart as well as the nervous and digestive systems—as the conventional eight-week treatment course. The shorter treatment means reduced side effects, which range from skin rashes to peripheral neuropathy, and thus also improved treatment adherence—both of which are critical for the control and elimination of Chagas disease. DNDi hopes to make the disease less debilitating for future patients “and turn this breakthrough discovery into a reality for people affected by the disease.” On Monday, March 11, the Trump administration released its budget proposal for fiscal year 2020. While the budget proposal requested US$291 million for the President’s domestically-focused “Ending the HIV epidemic” plan, —which includes funding for biomedical interventions—the global health community has called out the proposed reduction in funding to fight HIV globally also included in the President’s 2020 budget proposal. Overall, the President’s Budget Request proposes deep cuts to biomedical research across a wide range of federal agencies and to global health programs at the Department of State and the US Agency for International Development. TB Alliance announced that the US Food and Drug Administration (FDA) has accepted a new drug application for pretomanid, a novel tuberculosis (TB) drug candidate, as part of a treatment regimen for extensively drug-resistant TB; treatment-intolerant, multidrug-resistant TB; and treatment-nonresponsive, multidrug-resistant TB. Pretomanid would be used in combination with bedaquiline and linezolid. In a clinical trial in South Africa using this treatment regimen, 89 percent of study participants resolved their clinical infection after six months of treatment and six months of post-treatment follow up. The FDA granted priority review of this new drug application leveraging the Prescription Drug User Fee Act with an action date expected in the third quarter of this year.

For the third consecutive year, the Trump administration has proposed significant cuts to critical government programs that advance innovation to improve the health of millions of people in need around the world, including Americans. The Global Health Technologies Coalition (GHTC) is deeply concerned by President Trump’s fiscal year (FY) 2020 budget proposal. If enacted, the funding reductions proposed would undermine the United States’ legacy of global leadership in the development of vaccines, drugs, diagnostics, and other technologies for neglected diseases and conditions that affect the world’s most vulnerable people.The proposal cuts funding to global health research and development (R&D) at the US Agency for International Development (USAID), Centers for Disease Control and Prevention (CDC), and National Institutes of Health (NIH). If enacted, groundbreaking research and the creation of new tools to address the world’s greatest global health challenges would slow or stop. These cuts would also weaken global health security, undermining our ability to prevent and contain disease outbreaks. For example:The elimination of HIV/AIDS research funding at USAID in the proposal would threaten progress towards game-changing innovations to prevent HIV/AIDS. As the administration proposes bold goals to counter the HIV/AIDS epidemic in the United States, it is critical to continue supporting R&D for new approaches to defeat AIDS in America and beyond. This is just one example of this proposal’s potential impact on global health R&D in the International Affairs account—overall, the proposed 28 percent cut to global health programs at USAID and the State Department threatens decades of lifesaving progress and runs counter to our international interests.Reduced funding for CDC’s global health activities at the Center for Global Health (CGH) and the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) would further constrain an agency already under-resourced to address the magnitude and range of health challenges we face. While GHTC welcomes the administration’s continued commitment to and investment in global health security efforts, this increased funding should not come at the expense of other vital CGH programs that support R&D of technologies and other activities to detect, prevent, and respond to health threats. Likewise, proposed reductions to NCEZID programs that develop interventions to combat infectious diseases run counter to the administration’s global health security goals and will directly compromise domestic and international preparedness.The proposed cut of more than US$4.5 billion to NIH would erode America’s leadership in medical research—leadership Congress has bolstered by increasing funding for NIH by $5 billion over the past three years. Disproportionate cuts to the National Institute for Allergy and Infectious Diseases (NIAID) and the Fogarty International Center at NIH would jeopardize the development of new tools for global health threats like Ebola and undermine research collaborations with other countries who serve as key partners and allies in mitigating global disease threats.While the proposal’s cuts to global health programs at USAID, the State Department and essential research activities at CDC and NIH are worrisome, GHTC was pleased to see steady funding for the Biomedical Advanced Research and Development Authority and a funding boost for the Food and Drug Administration included in the budget request. These entities play important roles in the global health R&D ecosystem, and GHTC appreciates the administration’s recognition of their contributions.“The United States is the global leader in research and development of new tools for the world’s most pressing health challenges—benefiting Americans at home and communities around the world,” said Jamie Bay Nishi, GHTC’s Director. “Cutting funding for global health R&D programs at USAID, CDC, and NIH would undermine decades of patient investment in R&D which is on the cusp of delivering ground-breaking new tools to prevent, treat, and respond to the most pressing global health challenges and health emergencies. We have seen past budget cuts shelve promising research on tools for threats like Ebola and cannot afford to be caught empty-handed for the next health crisis.”Strong congressional support for global health R&D has maintained and increased funding for this lifesaving work despite past proposals for cuts by the Trump administration, and we urge Congress to continue its history of bipartisan support for global health and medical research and for a third year in a row reject this short-sighted budget proposal.