ASTMH continues to advocate before Congress and the Biden administration. Letters that ASTMH led or joined include:
- A letter warning House Appropriations leadership how proposed cuts included in the State and Foreign Operations and Related Programs) budget severely undercuts critical global health and humanitarian assistance programs and urging for robust funding in FY24.
- A letter urging House Energy & Commerce leadership to find a bipartisan solution to current disagreements over the Pandemic and All-Hazards Preparedness Act (PAHPA) and reauthorize the bill this year.
- A letter to NIH leadership expressing concern about the new agency policy on increased scrutiny and reporting requirements over international recipients of NIH subawards.
• FY24 Appropriations Process Continues with Deep Cuts to Global Health Programs Looming
• PAHPA Reauthorization Ramps Up, September 30 Deadline Looms
• NIH Announces Controversial New International Subaward Reporting Policy
• Director of National Intelligence Publishes Report on COVID Origins
• Biden Taps New CDC Director
• CDC Chief Malaria Branch Will Move to NCEZID
• NCEZID Releases 2022 Accomplishments Report
• Disease X Act of 2023 Introduced in Senate
• Bipartisan Bill Advances Authorizing New Office of Health Security at DHS
FY24 Appropriations Process Continues with Deep Cuts to Global Health Programs Looming
Both chambers recently convened to finalize their topline budget numbers for all 12 appropriations (funding) bills for fiscal year (FY) 2024. In the House, proposed
budgets, unsurprisingly, reflect steep spending cuts to most of the 12 bills, reverting funding back to FY 2022 levels as promised to Freedom Caucus members by Speaker Kevin McCarthy (R-CA) as part of passing the debt-ceiling limit deal. The proposed cuts, if enacted, would significantly impact global health programs across the federal government. The Senate also published
its topline numbers for FY24, which are largely guided by the debt-ceiling limit deal. Like the House, the Senate proposal would also see across-the-board cuts to agencies impacting key global health programs. The House and Senate appropriators ultimately steer funding outcomes.
The House Appropriations Committee recently released
its FY24 State, Foreign Operations, and Related Programs bill
text and held markups. The House GOP-advanced bill would provide $52.5 billion, which reflects a 12% or $7.2 billion cut from fiscal year 2023 (FY23) enacted levels. The proposed bill would provide $10 billion in funding for global health programs at the Department of State and USAID—a $542 million, or 5%, cut from FY23 levels. Aside from proposed funding cuts to global health programs, the bill also includes funding prohibitions for WHO, the Wuhan Institute of Virology, and the EcoHealth Alliance, as well any gain-of-function research and labs in adversarial nations like China, Cuba, Iran, Russia, Venezuela and North Korea. It is important to remember that this Hill bill text and dollar amounts are drafts and will still need to be reconciled with Senate proposals.
PAHPA Reauthorization Ramps Up, September 30 Deadline Looms
Senate Committee on Health, Education, Labor, and Pensions (HELP) staff recently released
a discussion draft to reauthorize the Pandemics and All-Hazards Preparedness Act (PAHPA), which is set to expire September 30 and is viewed as “must-pass” legislation. The discussion draft signifies general agreement between committee staff on advancing the bill. However, there are some non-consensus areas that Chair Bernie Sanders (I-VT) and Ranking Member Bill Cassidy (R-LA) are seeking feedback on, with Sanders expressing concern over drug pricing and Cassidy looking to extend the FDA’s priority review voucher program.
The House Energy and Commerce (E&C) Subcommittee on Health will move ahead with markups of its version of PAHPA before advancing the bill to the full E&C committee later this month. Partisan divides over PAHPA reauthorization in the subcommittee have centered around including FDA-related policy to address drug and supply chain vulnerabilities. Ranking Member Frank Pallone (D-NJ) has doubled down
on the idea that efforts to address the national drug shortage crisis should be included as part of the 2023 PAHPA reauthorization, saying that “[The shortages are] a clear and present emergency that demands action and PAHPA is the natural place to do it.” Pallone has repeatedly called out Republicans for rebutting the idea of including bills in PAHPA that would vest more authority in the FDA to respond to the national drug shortage crisis, citing that all previous reauthorizations of the law have included FDA policy. House Republicans argue that empowering the FDA with new authorities through PAHPA would likely subject the bill to further amendments from House Republicans.
NIH Announces Controversial New International Subaward Reporting Policy
The NIH announced
a new policy that will increase scrutiny over subawards to foreign researchers. The policy change will, among other things, require foreign researchers working on NIH-funded projects to “provide copies of all lab notebooks, all data and all documentation that supports the research outcomes as described in the progress report…no less than once every six months, or more frequently based on risks.” The announcement aligns
with House Energy and Commerce Republicans request for increased oversight of the NIH and NIH-funded research. The global research community, including ASTMH, has expressed collective alarm about the potential unintended consequences of the policy on breakthrough science and innovation. The policy was created following audits of NIH by the HHS Office of Inspector General and Government Accountability Office. The policy is set to go into effect October 1.
Director of National Intelligence Publishes Report on COVID Origins
The Office of the Director of National Intelligence released a long-anticipated report
on potential links between the Wuhan Institute of Virology (WIV) and the origins of the COVID-19 pandemic. The declassified report was mandated by the COVID-19 Origin Act of 2023, which was signed into law by President Joe Biden this past March. The four main topics studied in the report include: the U.S. Intelligence Community’s assessment on COVID-10 origins, WIV activities performed with or on behalf of the People’s Liberation Army, coronavirus research and related activities performed at WIV, and WIV researchers who fell ill in the fall of 2019. Overall, the report’s findings were inconclusive and noted that “both a natural and laboratory-associated origin remain plausible hypotheses to explain the first human infection.” House Energy and Commerce Chair Cathy McMorris Rodgers (R-WA) criticized
the report, calling it a “slap in the face of Americans who deserve full transparency” and urging for further declassification of all information related to the pandemic’s origin.
Biden Taps New CDC Director
President Biden announced
that he will appoint Dr. Mandy Cohen, former secretary of the North Carolina Department of Health and Human Services(NCDHHS), as the next Director of the CDC. Her appointment does not require Senate confirmation. “Dr. Cohen has been recognized by leaders from both parties for her ability find common ground and put complex policy into action,” said President Biden. An internal medicine physician, Cohen served as Director of NCDHHS for five years, helping guide the state’s COVID-19 response. Prior to serving NCDHHS, she was the Chief Operation Officer, Chief of Staff, and Senior Adviser to the Administrator at the Centers for Medicare and Medicaid Services (CMS). Cohen currently serves as an executive at Aledade, a private-sector firm that aims to improve primary care health practices. Dr. Cohen will succeed CDC Chief Dr. Rochelle Walensky, who left her post at the end of June.
CDC Chief Malaria Branch Will Move to NCEZID
As part of CDC’s Moving Forward initiative, the agency announced that it will move the Division of Parasitic Diseases and Malaria to the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) from its current organizational location under the CDC Center for Global Health. The organizational changes go into effect October 1.
NCEZID Releases 2022 Accomplishments Report
CDC NCEZID recently published
its 2022 Accomplishments Report. The report reflects on critical public health successes led by the NCEZID throughout 2022, including responding to Mpox and launching the Global Antimicrobial Resistance Laboratory and Response Network, among other highlights.
Disease X Act of 2023 introduced in Senate
Senators Tammy Baldwin (D-WI) and Thom Tillis (R-NC) recently
introduced the Disease X Act of 2023. Like the House companion bill, the Senate proposal would establish a Disease X Medical Countermeasures Program at BARDA and would provide $40 million per year for five years specifically for Disease X Medical Countermeasures Program. "Regardless of whether the next pandemic is naturally occurring, accidentally released or deliberately caused, we cannot afford to wait for the next viral threat to arise. That’s why I am joining my Republican and Democratic colleagues to take action to develop new antivirals, vaccines and diagnostics for unknown threats, so we are ready to respond to Disease X,” Sen. Baldwin said in a statement
Bipartisan Bill Advances Authorizing New Office of Health Security at DHS
The Senate Committee on Homeland Security & Governmental Affairs recently passed
a bipartisan bill, authored by Senators Gary Peters (D-MI) and John Cornyn (R-TX), that would formally establish an Office of Health Security in the Department of Homeland Security. The bill now moves to the full Senate for consideration. The office would serve as the principal medical, workforce health and safety, and public health authority for DHS. The bill also authorizes the National Academies of Science, Engineering, and Medicine to issue reports on the role of DHS in preparing, detecting and responding to biological health security threats, and provide recommendations to improve departmental bio-surveillance efforts against biological threats.