Washington, DC Update

Posted 12 February 2024

ASTMH continues to advocate before Congress and the Biden administration. Letters that ASTMH led or joined include:
  • Letter to House and Senate Appropriations leadership urging for robust funding for NIAID.
  • Letter urging Office of Management and Budget leadership to provide robust funding for the CDC Advanced Molecular Detection program in the 2025 budget submission and protect the remaining unspent COVID relief funds for the program from being rescinded.
  • Letter to House Foreign Affairs Committee expressing support and urging for the passage of the Global Frontline Health Worker Resolution (H.Res. 389).

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Push to Finalize FY24 Spending Bills Continues, First March Shutdown Deadline Looms
House and Senate negotiators made some slight progress toward finalizing the fiscal year 2024 (FY24) spending bills. Following weeks of closely-held negotiations, top appropriators reached a deal on setting the suballocations – or the individual spending amounts – for each of the 12 spending bills, clearing a critical hurdle toward securing a full FY24 spending package. With the totals struck, sub-committee appropriators have been working to finalize their respective funding bills, which includes determining how much money each agency and office will be allocated and if any policy changes should be included as a condition of funding (known as a “policy rider”). On the issue of policy riders, House Appropriations Committee Ranking Member Rosa DeLauro (D-CT) has said previously that “Democrats will not accept any Republican poison pill policy changes,” while Speaker Mike Johnson (R-LA) has promised to deliver “meaningful policy wins” through the spending process. To stave off a government shutdown, appropriators must finalize a series of spending bills by March 1 (Agriculture-FDA, Energy-Water, Military Construction-VA and Transportation-HUD bill) and March 8 for the Defense Department and other remaining parts of the government, including Health and Human Services and USAID. If lawmakers are unable to finalize final spending bills by these deadlines, then they must move to either pass another stopgap funding bill, known as a continuing resolution (CR), which would put the funding deadlines further down the line, or risk a partial government shutdown.
Key House GOP Health Leader Not Running for Re-Election As PAHPA Remains in Limbo 
In a surprise retirement announcement, House Energy and Commerce (E&C) Chair Cathy McMorris Rodgers (R-WA) recently announced that she will leave Congress at the end of the year. McMorris Rodgers’s sudden departure creates a major vacancy on the powerful E&C committee, which has jurisdiction over healthcare, including the reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA), CDC and NIH and other key issues impacting global health. As for PAHPA, the unexpected leadership shakeup adds new uncertainty to the reauthorization of the must-pass pandemic preparedness bill. In the House, top E&C Democrats continue to insist that drug shortage policy language must be included in the final bill, while E&C Republicans are pressing for a five-year reauthorization without drug shortage language but with CDC oversight language. Meanwhile, the Senate companion bill, which does include expanded FDA authorities that address drug shortages, has not been called up for a floor vote, despite passing the Health, Education, Labor, and Pensions (HELP) Committee on a bipartisan basis months ago. Given the approaching March 1 and March 8 deadlines under the current two-tranche funding agreement, which extended certain PAHPA provisions, the Labor, Health and Human Services, Education, and Related Agencies FY24 appropriations bill may be the most viable legislative vehicle for passing the bill without further delay. However, ongoing uncertainty around a final FY24 spending package and controversial policy differences could dim the prospects of PAHPA being included in any spending agreement.   
Bipartisan Support Grows for Adding Coccidioidomycosis to FDA Priority Review Voucher Program
Bipartisan and bicameral legislation that would add coccidioidomycosis, the fungal causative agent of Valley Fever, to the FDA Priority Review Voucher (PRV) Program (H.R. 6227/S.3220) recently received several new cosponsors. As of this writing, the House bill (H.R. 6227, sponsored by Rep. David Schweikert (R-AZ), now has 29 cosponsors, 13 Democrats and 16 Republicans. Rep. Stephanie Bice (R-OK), Rep. Teresa Leger Fernandez (D-NM) and Rep. August Pfluger (R-TX) were the latest to support the bill. In the Senate, Sen. John Hickenlooper (D-CO) recently signed onto the chamber’s bill (S.3220), sponsored by Sen. Mark Kelly (D-AZ), joining Sen. Kyrsten Sinema (I-AZ) and Sen. Markwayne Mullin (R-OK).
COVID Oversight Subcommittee Holds Hearing on HHS Compliance
The Select Subcommittee on the Coronavirus Pandemic recently held a hearing titled, “Overseeing the Department of Health and Human Services’ (HHS) Compliance with Congress.” The hearing included testimony from HHS Assistant Secretary for Legislation Melanie Egorin. Select Subcommittee Chair Brad Wenstrup (R-OH) strongly criticized HHS for failing to comply with congressional oversight requests, accusing the agency of stonewalling the subcommittee. Throughout the hearing, Assistant Secretary Egorin adamantly defended HHS’s response to oversight inquiries by the Select Subcommittee, claiming the Department has been exceptionally responsive. Egorin also shared that HHS has provided the Subcommittee with more than 35 document productions consisting of more than 10,000 pages.
HHS Releases New Vector-Borne Diseases Strategy
As part of the Kay Hagan Tick Act, authored by Sen. Collins and Sen. Tina Smith (D-MN) and signed into law in December 2019, HHS released its National Public Health Strategy to Prevent and Control Vector-Borne Diseases in People. The strategy is the largest formal federal coordination effort focused on vector-bone diseases (VBD) prevention and control. The report identifies ways the federal government can respond to existing and emerging challenges around VBDs, including supporting expanded surveillance capabilities; modernizing data collection; developing new diagnostic tools and approaches; assessing the impacts of climate change; developing new vaccines; investing in forecasting and outbreak analytics; and other new initiatives to combat VBDs. “This national public health strategy is a critical step in helping to slow the spread of tick and other vector-borne illnesses that have affected far too many families and communities throughout Maine and the United States,” Sen. Collins said.

White House Names U.S. Global Health Security Coordinator
As mandated by the Global Health Security Act, President Joe Biden announced that Dr. Stephanie Psaki will serve as the first United States Coordinator for Global Health Security. Dr. Psaki currently holds a position on the National Security Council as Deputy Senior Director for Global Health Security and Biodefense and Director for Global Health Response. Psaki will serve concurrently on the NSA and as Global Health Security Coordinator. Prior to joining the White House, she worked in the HHS Office of Global Affairs. “The Coordinator position will help provide clear, focused and accountable leadership for the federal government’s pandemic preparedness, prevention, and response efforts,” GHSA author Rep. Gerry Connolly (D-VA) said in a statement.

ARPA-H Releases Inaugural Strategic Plan
The Advanced Research Projects Agency (ARPA-H) recently released its first Strategic Plan. The multi-year plan describes how the agency will take an “investment approach” to advance several areas that may impact global health, including new technologies, improving healthcare access and affordability, health system resilience, and data. The report included a dedicated objective to “ensuring that relevant and comprehensive data is accessible for research, analysis, and innovation across the entire health ecosystem, including with international partners,” and highlighted the role of international coordination and collaboration to U.S. leadership on biomedical and health science.