After the budget showdown, where does global health stand?

Even in these constrained economic times, it is critical to support global health and development programs that save lives and help grow the economies of developing nations—while at the same time promote American values, economic growth, and national security. Now more than ever, the United States needs a strong international affairs budget to meet our foreign policy goals, from improving public health to ending poverty, supporting democracy, and preventing conflict. It is also crucial that US policymakers continue to support the historical US commitment to harness science and research to tackle longstanding development challenges. Ending support for global health research, for example, would severely hurt the chances of winning the war against a range of diseases by ending work on new drugs, vaccines, and other health products.

Despite these compelling humanitarian, fiscal and security reasons to support global health and development, these programs are facing significant cuts in the wake of recent budget debates in Congress and the Administration. For example, the House Appropriations State and Foreign Operations Subcommittee late last month released its fiscal year (FY) 2012 appropriations bill, which includes cuts for many programs such as global health. The full House Appropriations Committee is scheduled to consider the bill in September. Also in September, the Senate will likely introduce its own bill, and advocates expect that it will include higher amounts of funding for global health and development.

In separate negotiations, President Obama and Congress on August 2 reached an agreement on a deal to raise the debt ceiling by $2.1 trillion over ten years. The deal set in motion federal budget cuts of $840 billion over ten years by enacting annual caps on discretionary spending. This agreement translates to billions of dollars of potential cuts for foreign aid, although the full impact in FY2012 will not be determined by House and Senate appropriators until this fall, when they return from recess.

Fortunately, some leaders in Congress recognize the continued importance of foreign aid programs. Senator John Kerry (D-MA) recently introduced a bill to authorize programs and initiatives to support key diplomatic and foreign policy priorities around the world. “We face tremendous foreign policy and national security challenges worldwide, from helping countries manage peaceful, democratic transitions in the Middle East, to preventing violence, conflict, and terrorism from engulfing key partners, and to leading humanitarian responses to forestall drought, famine, and natural disasters,” Senator Kerry said. He added that for these reasons, agencies such as the US Department of State and US Agency for International Development (USAID) need continued support.

The legislation also aims to reinforce USAID legacy, including the agency’s work to promote research, science, and technology. For example, the bill recognizes that investing in innovation has the potential to solve long-standing development challenges by leveraging the power of research and development and harnessing the private sector.

Protecting USAID’s scientific legacy is crucial, since research and science could be affected by the debt ceiling negotiations at some level. For example, annual caps on discretionary spending could not only affect USAID’s instrumental role in funding research—it could also result in cuts to grant programs at the National Institutes of Health and harm the budgets of the Centers for Disease Control and Prevention, the Department of Defense, and the US Food and Drug Administration. All of these agencies support lifesaving health research at home and abroad, and policymakers should therefore continue to support the country’s strong commitment to supporting science and research.

Above all, while Congressional appropriation decisions are not easy, cutting programs—particularly programs that help people at home and abroad—is not the solution. “Decisions made in the next five months over how to allocate the limited resources allowed under the new budget deal need to be done responsibly, equitably and in ways that do not ignore the plight of those living in poverty or put at risk global development programs that are important to long-term US national interests,” Larry Nowels of ONE wrote in a recent blog post, adding, “Those decisions also need to include all aspects of the US budget if we are to be successful in solving our fiscal crisis.”

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