Washington, DC Update

Posted 14 July 2020

  • A letter led by ASTMH in collaboration with the Entomological Society of America to Congressional leadership urging them to publically support and fund the WHO.
  • A letter objecting to the U.S. Immigration and Customs Enforcement (ICE) proposed changes to the Student and Exchange Visitor Program (SEVP).  
  • A letter to Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander thanking him for publishing the white paper “Preparing for the Next Pandemic,” while encouraging him to strengthen the U.S. approach to antimicrobial resistance.
  • A letter to Health and Human Services Secretary Alex Azar urging him to strengthen and affirm the role of the CDC, in light of rumors pointing to reorganization.
  • A letter in support of the Research Investment to Spark the Economy (RISE) Act, introduced by Representatives Diana DeGette (D-CO), Fred Upton (R-MI), Eddie Bernice Johnson (D-TX), Frank Lucas (R-OK), Anna Eshoo (D-CA) and Anthony Gonzalez (R-OH), that would authorize $26 billion in supplemental research funding.
  • A letter to Congressional leadership in support of a public health loan repayment program.
Congress and COVID-19

With COVID-19 cases surging, especially in the southern and western United States, Congress is once again discussing a coronavirus relief package. The tentative timeline would see a bill come together in early August. Senate Majority Leader Mitch McConnell (R-KY) has stated that any new bill must include liability protections for businesses and healthcare facilities, which Democrats have rejected. This issue threatens to delay or even derail a new relief package entirely.
 
While Congress debates new domestic COVID-19 relief, the Trump Administration formally notified the WHO of U.S. withdrawal. Withdrawal will take effect on July 6, 2021, barring a change in Administration or Congressional action.

U.S. Officially Notifies the WHO of Withdrawal

Now that the U.S. has officially delivered a letter to U.N. Secretary-General António Guterres announcing withdrawal, the U.S. must wait one year and pay all outstanding dues. Sen. Bob Menendez (D-NJ), Ranking Member on the Senate Foreign Relations Committee, harshly criticized the decision. Many Congressional Republicans in contrast publicly supported the move. Former Vice President Joe Biden, the presumptive Democratic presidential nominee, has promised that he will have the U.S. rejoin the WHO “on day one” if elected. Meanwhile, the WHO has committed to an independent review of its coronavirus pandemic response.

New Coronavirus Package Takes Shape

Aside from the contentious liability issue, Sen. McConnell has said the new package will focus on education, jobs and healthcare. Sen. Roy Blunt (R-MO), who chairs the important Senate Appropriations Committee subcommittee that oversees the Department of Health and Human Services, has said he’s already drafting part of the bill. He will include additional funding for testing, therapeutics and vaccine research. 

House Appropriations Committee Advances Fiscal Year 2021 Legislation

The House Appropriations Committee’s various subcommittees have now passed all 12 annual appropriations bills along to the full committee for review. The full committee passed the FY2021 State, Foreign Operations and Related Programs (SFOPs) bill on July 9 (more on that below) and started considering remaining bills during the week of July 13. A reminder that these are the standard yearly funding bills, not supplemental funding for COVID-19.  Also, the Senate still needs to act and then the House and Senate must work out their differences.
This means there is a long way to go. 

Notably, the SFOPs bill included funds for the WHO despite U.S. withdrawal. Other highlights include:
  • ↑ 2% overall increase for Global Health Programs at USAID compared with enacted amounts in FY2020
  • ↑ $25 million increase for Global Health Security
  • ↑ $10 billion in emergency funding for the international COVID-19 response. This includes:
    • $150 million for the USAID Emergency Reserve Fund
    • $750 million for GAVI
    • $800 million for the Global Fund
  • ↓ Malaria programs received a $15 million cut.
The Labor, Health and Human Services, Education and Related Agencies bill has only passed the subcommittee stage, but it includes:
  • ↑ 1.2% general increase in funding
  • $24.425 billion in emergency funding, including but not limited to:
    • $5 billion for NIH
    • $9 billion for CDC
    • $4.5 billion for BARDA
  • ↑ A regular $500 million increase for NIH
  • ↑ $232 million increase for CDC
  • Flat funding for BARDA
  • $400 million for the Infectious Diseases Rapid Response Reserve Fund

Senate Foreign Relations Committee Holds Hearings on International Pandemic Response and Preparedness

Committee Chairman James Risch (R-ID) struck a measured tone in two recent hearings that he convened on international pandemic response, explicitly declaring that he was not out to blame the WHO for every misstep. Chairman Risch focused on the best way to create a “global fireman” for pandemics. 
 
While Administration witnesses in the first hearing defended withdrawal from the WHO, the expert panelists in the second hearing were much more blunt in criticizing the decision. Committee Democrats similarly criticized the Administration’s pandemic response, while committee Republicans in the first hearing focused their fire on China. Chairman Risch nevertheless committed to passing a bipartisan Global Health Security Act through the committee.
 
Antimicrobial Resistance Fund Announced
 
A number of leading pharmaceutical companies, including Glaxo-Smith-Kline, Novo Nordisk and Merck, have announced the Antimicrobial Resistance Action Fund, which aims to produce two to four new antibiotics by the year 2030. The companies have already raised almost $1 billion and have worked with the WHO and European Investment Bank in establishing the fund.