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In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. National Institutes of Health Director Francis Collins warns that sequestration and budget cuts may be putting gains in science, technology and medicine at risk. In related news, sequestration cuts have reduced federal grants and delayed research projects, restricting the nation’s ability to innovate, according to a survey of organizations representing 300 research universities. On the fifth annual World Pneumonia Day, a call to action in The Lancet Global Health asks for new innovations to transform pneumonia diagnosis and treatment. From December 3 to 5, the World Health Organization and Member States will evaluate and assess new innovative mechanisms to coordinate and fund global health research and development. GHTC member the Global Health Innovative Technology Fund has granted $5.7 million to six global partnerships working on innovative drugs and vaccines against malaria, tuberculosis, and Chagas disease.

In this guest post, Emily Donaldson—program coordinator atAVAC: Global Advocacy for HIV Prevention—writes about an upcoming congressional briefing on November 18 that will highlight the latest in HIV and AIDS research and development. The world has made enormous strides in beginning to end the AIDS epidemic. Yet, there were still 2.3 million people newly infected with HIV in 2012. In order to continue to bring down new infections, it is essential to achieve high coverage rates of treatment and prevention methods, including voluntary medical male circumcision, male and female condoms, and harm reduction. In the long-term, new prevention tools, especially an effective preventive HIV vaccine, are critical for achieving maximum impact and ending the AIDS pandemic. Research to develop new prevention tools is critical for achieving maximum impact and ending the AIDS pandemic. Credit: PATH/Evelyn Hockstein. Since the Military HIV Research Program’s (MHRP) landmark RV144 trial first showed that an HIV vaccine was possible, MHRP, the National Institutes of Health (NIH), and partners have worked to build on those results. Additionally, US government-supported research in a range of new vaccine candidate strategies are moving forward in trials and in basic research for future clinical testing. At the same time, NIH and the US Agency for International Development (USAID) are developing new antiretroviral-based prevention options, such as treatment-as-prevention, pre-exposure prophylaxis, and microbicides. Through research programs like those at the MHRP, NIH, and USAID, the US can dramatically advance science and play a critical role in stopping the spread of the epidemic. Join us at a congressional briefing, Monday, November 18, as we call on Congress to invest in HIV prevention research. amfAR, The Foundation for AIDS Research AVAC: Global Advocacy for HIV Prevention Center for Global Health Policy International AIDS Vaccine Initiative In cooperation with Congresswoman Barbara Lee invite you to a Congressional Briefing The Role of HIV Research in Ending AIDS: New Developments in HIV Vaccine and Prevention Science Monday, November 18, 2013 12:00-1:30 p.m. Capitol Visitor Center, South Congressional Meeting Room Lunch will be provided Speakers include: Carl Dieffenbach, director of the National Institute of Allergy and Infectious Diseases’ Division of AIDS Margaret McGlynn, president and chief executive officer, International AIDS Vaccine Initiative Fredrick Sawe, associate director International Clinical Research, MHRP Christina Polyak, research physician, MHRP, Walter Reed Army Institute of Research Christine Lubinski, vice president for Global Health, Infectious Disease Society of America Kevin Fisher, policy director, AVAC: Global Advocacy for HIV Prevention, moderator For more information or to RSVP, please contact Emily Donaldson at AVAC at edonaldson@avac.org or 646-369-1476.

After two-and-a-half weeks in limbo, government employees were able to return to work on October 17th—when Congress finally reached a temporary agreement to re-open the government. As we’ve highlighted previously, many federal employees involved in the day-to-day work of global health research programs were furloughed during the government shutdown, leading to lost research and delayed studies. While government employees have been catching up on email and trying to recover work that was slowed or halted by the shutdown, policymakers have been taking tentative steps toward negotiating a longer-term budget deal. While we have more answers now than we did a week ago, things are still murky—and long-term answers about the budget are still unknown. Policymakers have been taking tentative steps toward negotiating a long-term budget deal that will impact global health and research programs. October budget deal The congressional deal reached on October 17th contained short-term fixes to three major issues: It extended current spending levels through January 15, 2014. It extended the debt ceiling through February 7, 2014. It created a new committee tasked with developing and approving a long-term plan to fund the government by December 13, 2013. Spending levels for federal research programs The deal extended current fiscal year (FY) 2013 post-sequester spending levels through January 15, 2014. While FY 2013 levels for global health initiatives, including research programs, at the State Department and US Agency for International Development have fared relatively well when compared with other foreign aid accounts, we saw drastic cuts at agencies such as the National Institutes of Health, the Centers for Disease Control and Prevention, and the Department of Defense—all of which support vital global health research and product development efforts. These funding cuts will remain in the budget deal reached last month. It’s detrimental to scientific progress when increasingly reduced research budgets become the norm. Coupled with the lack of a compromise on the debt ceiling level, such actions hurt US financial credibility and the nation’s leadership in research for new technologies to aid in the fight against disease. Budget Conference Committee As part of the shutdown deal, Congress established a Budget Conference Committee, tasked with coming to agreement that both chambers can agree upon to fund the government past January 15, 2014. Leading the Budget Committee is House Budget Chair Paul Ryan (R-WI) and Senate Budget Chair Patty Murray (D-WA). The conference is a bi-partisan, bi-cameral group made up of 29 Members. While the committee has several options, a major focus will be replacing the sequester. A second round of sequestration cuts will automatically kick in on January 15, 2014, if Congress doesn’t pass a budget solution that includes targeted, smart cuts. Both Republicans and Democrats have expressed an eagerness to reach a deal, but ideas for how to do so continue to appear miles apart, with no sign of moving toward a compromise. It is more likely that if the Budget Conference Committee comes to an agreement, it will address the final FY 2014 budget—including the upcoming January 15, 2014, sequester cuts—but go no further. This approach is really nothing new, since it essentially replaces the normal order of appropriations for FY 2014. The Budget Conference Committee held its first meeting on October 30th, and its next public meeting is scheduled for November 13th. Opposition to the continued budget purgatory seems universal. Several advocacy groups, including InterAction and the Business Roundtable, have sent letters to members of the committee urging them to come to an agreement quickly. We agree with these pleas for a long-term budget solution. As we saw earlier this year, debating budgets for two different fiscal years simultaneously is not productive and is a poor way to set programmatic priorities. While it may seem usual business these days to have concurrent debates on the traditional budget, the sequester cuts, and the debt ceiling, we’re hopeful that this budget conference committee will act boldly to reset the process by rapidly agreeing on final FY 2014 funding levels and a long-term debt ceiling compromise. Congress and the Administration should then be able to move on to the myriad of other priorities they have on their plates.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The World Medical Association has adopted and published a revised version of the Declaration of Helsinki, which sets standards regarding medical research involving human subjects. The changes reflect a call to increase protection for people taking part in medical research. GHTC member Aeras and the Statens Serum Institut have initiated a new clinical studyfor a candidate tuberculosis (TB) vaccine. In related news, GHTC member the Global Health Innovation and Technology (GHIT) Fund announced that it will invest $720,000 for early work on a novel vaccine candidate against TB being co-developed by Japan’s Create Vaccine Co., Ltd. and Aeras. The Kaiser Family Foundation released a new public opinion survey on the US role in global health. The survey finds that Americans’ basic level of support for current levels of US spending on efforts to improve health for people in developing countries has held relatively steady in recent years. GHTC member the International AIDS Vaccine Initiative (IAVI) has released its 2012 annual progress report, which details IAVI’s progress, accomplishments, and key partnerships over the past year. The White House's Office of Management and Budget (OMB) recently confirmed that sequestration has drained about $85 million in user fees from the US Food and Drug Administration. The cuts are expected to continue, according to an OMB response to Rep. Anna Eshoo (D-CA), which she released this week. GHTC member TB Alliance has entered into a collaboration with Svizera Europe, one of the leading global supply and distribution companies for TB treatments. The partnership aims to create and enable access to new medicines for childhood TB.