Washington DC Update

Posted 12 February 2018

After an hours-long shutdown early February 9, Congress passed a short-term continuing resolution (CR) that funds the government through March 23. The CR was coupled with a two-year budget deal to raise discretionary defense and non-defense spending caps, imposed by a 2011 budget bill commonly referred to as “sequestration.” The budget deal raised the caps by $300 billion over the next two years. Included within the budget deal is more than $1 billion in cuts to the Prevention and Public Health Fund, which comprises 12 percent of the CDC’s annual budget. We are hopeful that a final FY18 funding bill is completed by March 23, with the extra money under the new caps giving Congress some breathing room on funding decisions.
Fiscal Year 2019
And now on to FY19. On Monday, February 12, the Trump Administration released its preliminary fiscal year 2019 budget. The budget would either request level funding for NIH or increase NIH funding by $1.449 billion to $35.517 billion, depending on which type of budget number is used. The National Institute of Allergy and Infectious Disease (NIAID) request is $4.76 billion (a $111 million cut) and the Fogarty International Center (FIC) would not be eliminated this year.  The request for Fogarty is $70 million for FY 2019 — $2 million less than FY17. The CDC would be funded at $11.1 billion for total program-level spending for 2019, down from roughly $12 billion in 2018 spending levels. Overall global health programs are proposed to be funded at $409 million, a $23 million cut.
The Department of State would be funded at $37.8 billion, is a reduction of nearly $20 billion from the $55.6 billion enacted for FY 2017. Overall global health programs would be funded at $6.3 billion, a $177.899 million cut from FY 2018 estimates. The bilateral malaria program request for FY19 is $674 million, down from $755 million. The NTD program is cut by $25 million to $75 million in the budget request.  Global health security funding goes from $142.5 million in FY17 to $72.5 million in the FY19 request, and that money is repurposed from Ebola supplemental funding. Finally, the Administration is requesting only $925 million for the Global Fund, down from the FY17 funding level of $1.35 billion.
There are many steps in the budget process throughout the year. This week begins the testimony of departmental Secretaries before the committees of jurisdiction to defend the administration’s budget and blueprint for their respective agencies. Newly-confirmed HHS Secretary Alex Azar will testify on Capitol Hill three times this week. Secretary of State Rex Tillerson is slated to appear before the Senate Foreign Relations Committee on February 28; a date for his hearing before the House Foreign Affairs Committee has not yet been set.
New HHS Secretary, CDC Director’s Resignation
On January 24, Alex Azar was confirmed by the Senate by a vote of 55-43 and assumed the role of Secretary of Health and Human Services (HHS) on January 29. In an unusual first week, Secretary Azar accepted the resignation of CDC Director Brenda Fitzgerald on January 31. Fitzgerald’s tenure as CDC Director was marred in controversy, most notably around her financial holdings. Fitzgerald neglected to divest her financial holdings in particular areas, thus impeding her from serving fully in the capacity of Director. In a January report from Politico, it was revealed that Fitzgerald had bought shares in a Japanese tobacco company one month after assuming the role of Director. Dr. Anne Schuchat is serving once again as Acting CDC Director.