ASTMH continues to advocate before Congress and the Biden administration. Letters that ASTMH led or joined include:
- Letters urging Senators to support the nomination of NIH Director nominee Dr. Monica Bertagnolli.
- Letter endorsing the Public Health Infrastructure Saves Lives Act to strengthen state, local, tribal and territorial (SLTT) public health infrastructure.
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Debt-Ceiling Crisis Averted, Global Health Programs Likely Stagnate in FY2024 Appropriations
President Joe Biden signed
The Fiscal Responsibility Act of 2023 (FRA) on June 5, averting an unprecedented U.S. default and suspending the nation’s borrowing cap, or debt ceiling, until January 1, 2025. After several rounds of tense negotiations, the Republican-controlled House voted 314 to 117 and the Democratic-controlled Senate voted 63 to 36 to approve. The budget agreement will increase the debt limit for the next two years. Once certain adjustments are made to non-defense, there will be approximately $637 billion remaining for other non-defense programs, including key federal global health agencies and initiatives. This means that funding for non-defense programs will remain relatively flat for the upcoming FY24 appropriations year. The FRA also notably claws back $27 billion in funding that had already been committed to NIH, CDC and the Administration for Strategic Preparedness and Response to combat the COVID-19 pandemic. Funding remains preserved for Project Next Gen, a federal initiative to help develop the next generation of COVID vaccines and therapies, and other genomic surveillance and vaccine programs led by the CDC.
Even though the funding caps on non-defense spending are not as deep as originally proposed by House Republicans, they will play a significant role in FY24 funding impacting key federal global health programs. Federal global health-related programs will likely see a stagnation of funding or some level of rollback. While some programs or agencies may receive a small increase in funding, it is unlikely that key agencies such as the NIH or CDC will receive multibillion dollar increases like previous spending years. The budget agreement also includes a provision that incentivizes Congress to pass all 12 appropriations bills by January 1, 2024—or risk a 1% funding cut across the board.
Biden Expected to Announce New CDC Director
President Biden
plans to appoint Dr. Mandy Cohen, former secretary of the North Carolina Department of Health and Human Services (NCDHHS), as the next Director of the CDC. An internal medicine physician, Cohen served as Director of NCDHHS for five years, helping guide the state’s COVID-19 response. Prior to serving the 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). Dr. Cohen currently serves as an executive at Aledade, a private-sector firm that aims to improve primary care health practices. If confirmed, Dr. Cohen would succeed CDC chief Dr. Rochelle Walensky, who will leave the agency at the end of June. Her appointment will not require Senate confirmation.
Disease X Act Introduced
Reps. Lori Trahan (D-MA), Michael Burgess (R-TX), Dan Crenshaw (R-TX) and Susie Lee (D-NV) introduced the Disease X Act of 2023 (
H.R.3832). The bipartisan bill would create a Disease X medical countermeasures (MCM) program at the Biomedical Advanced Research and Development Authority (BARDA) for “unknown viral threats with pandemic potential.” The Act would direct BARDA to accelerate and support the advanced research, development and procurement of countermeasures and products to address Disease X threats. It would also allow HHS to award contracts, grants and cooperative agreements to promote the development of Disease X medical countermeasures for viral families with pandemic potential. Bill sponsor Rep. Lori Trahan (D-MA) is the co-founder the bipartisan Congressional Pandemic Preparedness Caucus.
House Energy and Commerce Oversight Subcommittee Holds Hearing on CDC Accountability and Reform
The House Energy and Committee Oversight Subcommittee held a
hearing on June 7 titled “Looking Back Before Moving Forward: Assessing CDC's Failures in Fulfilling its Mission.” Hearing witnesses included Mary Denigan-Macauley, Director of Public Health, U.S. Government Accountability Office; Dr. Tracy Beth Høeg, Epidemiologist, Department of Epidemiology and Biostatistics, University of California, San Francisco; Dr. Georges Benjamin, Executive Director, American Public Health Association; and Dr. Charity Dean, CEO & Founder, The Public Health Company. No representatives from the CDC were invited to testify, a decision that Frank Pallone (D-NJ) strongly criticized. Republicans on the subcommittee collectively condemned the CDC for not providing Congress with information on the agency’s Moving Forward reorganization plan. "Until we get full cooperation, the CDC requests for new legal authorities cannot and will not move forward," said Rep. Brett Guthrie (R-KY), Chair, Energy and Commerce Health Subcommittee.
House Energy and Commerce Committee and Health Subcommittee Holds Hearing on Pandemic Preparedness Bills
The House Energy and Committee (E&C) Subcommittee on Health held a
hearing June 13, “Legislative Solutions to Bolster Preparedness and Response for All Hazards and Public Health Security Threats.” Hearing witnesses included Dr. Gerald Parker, Associate Dean for Global One Health and Director, Pandemic and Biosecurity Policy Program, Texas A&M University; Dr. Raynard Washington, Director, Public Health Department, Mecklenburg, County, Health and Human Services Agency Mecklenburg County, North Carolina; Ms. Phyllis Arthur, Senior Vice President, Infectious Disease and Emerging Science Policy, Biotechnology Innovation Organization (BIO); Dr. Julie R. Gralow, Chief Medical Officer and Executive Vice President, American Society of Clinical Oncology; and Mr. Ted Okon, Executive Director, Community Oncology Alliance.
Committee members asked hearing witnesses to weigh in on
20 bills that would help prepare and respond to public health security threats and hazards. Notable bills for discussion included, but were not limited to the Disease X Act of 2023 (
H.R.3832), the Biosecurity Infrastructure for Operational (BIO) Early Warning Act, the Diagnostic Testing Preparedness Plan Act (DTPP) (
H.R.3795), the CDC Leadership Accountability Act (
H.R.3813), and the PHE Congressional Review Act of 2023 (discussion draft
here). The bipartisan DTPP Act was introduced by Reps. Greg Pence (R-IN), Larry Bucshon (R-IN), Andre Carson (D-IN) and Kim Schrier (D-WA), and directs ASPR to develop a national diagnostic testing plan to be used during a public health emergency, which must include public-private coordination. The CDC Leadership Accountability Act introduced by House Energy and Commerce Health Subcommittee member Rep. Brett Guthrie (R-KY) would require the CDC Director to be confirmed by the Senate following June 1, 2023. The PHE Congressional Review Act of 2023 proposed by Reps. Greg Murphy (R-NC) and Brett Guthrie (R-KY) would grant Congress more authority to end public health emergencies.
USAID to Provide Contribution to Pandemic Fund
President Biden recently
announced at the G7 Summit in Japan that USAID will provide a $250 million contribution to the Pandemic Fund. The planned investment was part of the $900 million enacted by Congress in FY23 for global health security. According to USAID, the commitment will “continue to serve as a catalyst for additional contributions from other donors, while complementing USAID’s expanding global health security efforts.” President Biden in his budget request to Congress has asked for an additional $500 million for the Pandemic Fund in FY24.