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GHTC sent letters to the House and Senate appropriations subcommittees with jurisdiction over the US Agency for International Development and Department of State, Department of Health and Human Services, and Department of Defense, urging these subcommittees to sustain and protect global health R&D funding in the fiscal year 2019 (FY19) budget.

Last Friday, President Donald Trump signed into law a US$1.3 trillion spending bill to fund the US government through the rest of fiscal year (FY) 2018. Reluctantly signed by the President among a flurry of “will he, won’t he” tweets, the legislation represents a forceful rebuke by Congress of the Administration’s proposal to drastically slash funding for global health and medical research programs. Key US agencies and programs that advance global health research and development (R&D) not only saw their funding protected in the spending bill, but many also saw increases. This outcome demonstrates that our community’s appeals and messages have not fallen on deaf ears and that Congressional policymakers on both sides of the aisle want to see the United States continue its leadership in advancing innovation to improve the health of those in need around the world. Here are some of the key takeaways from the 2,000+-page bill: US Agency for International Development & State Department While the Trump Administration proposed slashing funding for global health programs at the US Agency for International Development (USAID) and the State Department by 25 percent, Congress stood firm in protecting these programs. The bill ultimately sustained overall funding for these programs at FY17 enacted levels. A few programs received increases including a boost of $15 million for GAVI, the Vaccine Alliance; $20 million for tuberculosis (TB); and $15 million for maternal and child health. Funding for USAID HIV and AIDS programming and family planning at State and USAID, which the President proposed eliminating fully, was protected at FY17 levels. Congress also directed $135 million from repurposed Ebola emergency supplemental funding to support USAID’s global health security programs.   USAID plays a leading role in developing health technologies for low-resource settings through its various global health programs, so it is critical that these programs receive adequate funding, so they can continue to prioritize R&D among their other activities. In light of the President’s proposal for deep cuts to these programs, a combination of level funding for some programs and increases for others is a positive sign in the midst of a challenging budget environment. National Institutes of Health   Strong bipartisan support for the National Institutes of Health (NIH) continued for FY18. While the President proposed a 21 percent cut to NIH funding, the final spending bill instead provided the agency with an increase of $3 billion—8.8 percent—over FY17 levels. This represents a historic funding high for NIH in actual dollars with increases spread across various NIH institutes and programs. Notably, the National Institute of Allergy and Infectious Diseases received a 7.2 percent increase—39 percent above the President’s FY17 request—while the Fogarty International Center, which was targeted by the Administration for elimination, received a boost of 5.2 percent compared to FY17.   NIH is the world’s leading funder of R&D for neglected diseases, providing approximately 40 percent of total global funding, so any changes to its funding produce a ripple effect felt by global health research institutes and people around the world. It is encouraging to see Congress continue its record of bipartisan support for NIH and take action to strengthen our nation’s leadership in medical research. Centers for Disease Control and Prevention   The US Centers for Disease Control and Prevention (CDC) also received a plus up in the FY18 omnibus. The agency saw its funding increased by $1.1 billion—nearly 15 percent—over FY17 levels. This was in sharp contrast to the 16 percent cuts proposed by the Administration. The CDC Center for Global Health (CGH) received a 12 percent increase, compared to a 21 percent proposed cut. This included a $1.5 million boost for parasitic disease and malaria and a substantial increase of $50 million for global health security programming, which supports implementation of the Global Health Security Agenda (GHSA). Funding for global immunization and AIDS programming within CGH remained level. The National Center for Emerging and Zoonotic Infectious Diseases also received a more modest 5 percent increase over FY17 funding.   CDC plays a critical role in advancing technologies and improving health systems to better detect, prevent, and respond to infectious disease threats worldwide. There was much concern surrounding the FY18 budget for CDC as the agency is facing a funding cliff. CDC and USAID received $1 billion from the Ebola emergency supplement to fund GHSA, but this money is set to run out in 2019. As a result, the agency has already announced plans to scale back its GHSA work in 39 of 49 countries. While more funding is still needed to sustain these programs, and the agency has yet to clarify how it will adjust programming in light of its FY18 appropriations; it is promising to see Congressional appropriators recognize the value of CDC’s engagement in improving global health security. Biomedical Advanced Research and Development Authority   The Biomedical Advanced Research and Development Authority (BARDA), which develops medical countermeasures against health threats including emerging infectious diseases and antimicrobial resistance (AMR), also received a boost in the FY18 spending bill. The agency saw its funding increased by $25 million—about 5 percent—over FY17 levels.   BARDA has played an increasing role in R&D for naturally occurring threats and emerging infectious diseases in response to the Ebola and Zika epidemics. With its focus on bridging the “valley of death” in product development and its ability to use unique contracting mechanisms to forge innovative and long-term private-sector partnerships, BARDA is well positioned to make an impact in this space. However, the agency has been constrained by a lack of dedicated funding for its emerging infectious disease portfolio. While it is promising to see appropriators increase the agency’s overall funding for FY18, GHTC will be pushing for more dedicated funding for emerging infectious diseases in FY19. Department of Defense   The Department of Defense’s (DoD) activities in infectious disease research also saw increases in the omnibus. DoD’s Peer Reviewed Medical Research Program—a program that conducts research on AMR, diarrheal diseases, emerging infectious diseases, malaria, TB, and vaccine development for infectious diseases—received $330 million in funding, which is an increase of $30 million over FY17 levels.   The FY18 spending bill is a big win for global health R&D stakeholders and advocates, but this victory may only be temporary. The legislation funds the government through the end of September, and the Trump Administration has once against proposed drastic cuts to global health and medical-research programs for FY19. So while the ink dries on this year’s spending bill and we take a moment to celebrate, GHTC is already gearing up for another difficult battle ahead on next year’s budget.

The Global Health Technologies Coalition (GHTC) announced today changes to its membership structure to better serve its existing membership and engage a broader group of global health research and development (R&D) stakeholders in its advocacy activities. Effective now, GHTC will begin offering three types of membership. Nonprofit and academic organizations, which currently comprise the GHTC membership, will change over to Advocate Members, and the coalition will introduce two new membership types—Associate Members for aligned private-sector companies and the Global Partners Network for counterpart nonprofits worldwide interested in the coalition’s multilateral advocacy. Effective immediately, GHTC will transition its existing member organizations to Advocate Members. In this role, these nonprofit members will continue to advise and help set the coalition’s US and multilateral advocacy strategy and priorities and operate as the core force driving forward GHTC’s advocacy activities through coalition working groups and direct engagement with policymakers. For the first time, GHTC will open its membership to private-sector companies whose work aligns with GHTC’s mission. As Associate Members, these private sector members will be able to inform and participate in certain coalition US advocacy activities, including joining public meetings and sign-on letters shaped by Advocate Members, as well as receive regular intelligence updates. To foster a network of advocacy organizations located around the world to inform and influence global health R&D policies at the multilateral level, GHTC has also launched the Global Partners Network. This membership type will be open to GHTC’s counterpart and aligned nonprofits and academic institutions in various countries and regions working to advance the global health R&D ecosystem. This network will share information on regional global health advocacy priorities and coordinate activities to advance supportive policies through key multilateral forums such as the World Health Organization, United Nations, and the G7/G20. “Creating new global health tools and getting them into the hands of people in need worldwide—more than ever—requires collaboration and partnership between multiple sectors and nations,” said Jamie Bay Nishi, GHTC’s Director. “GHTC is evolving its membership structure to better reflect this reality. We believe this new structure will encourage greater engagement in the coalition from a wider group of players in the global health R&D ecosystem, bringing both a broader and deeper set of perspectives and greater political force, as we work to advance policy solutions to accelerate the creation of new health technologies.” In addition to the new membership structure, GHTC has updated its institutional mission statement. GHTC’s Steering Committee approved the new membership structure and mission statement in February 2018 with the aim of increasing the impact and sustainability of the coalition. For more information about joining GHTC and membership benefits and pricing, email GHTC at jnishi@ghtcoalition.org.