DC/Global Policy Update

Posted 13 August 2024

LATEST FROM DC
ON THE HILL 
IN THE ADMINISTRATION 
 
ASTMH continues to advocate before Congress and the Biden administration. Letters that ASTMH led or joined include:
  • Statement in response to a Request for Information (RFI) on the NIH’s proposed Draft Public Access policy.
  • Letter welcoming Dr. Daniel Singer to his new role as Acting Director of the Division of Regulatory Science and Compliance (DRSC) at the CDC.
  • Letter to House of Representatives opposing proposed cuts to the CDC as the chamber prepares to bring the FY 2025 Labor-HHS-Education appropriations bill to the House floor for a vote.
ON THE HILL
House Gets an Early Start to August Recess, Senate Greenlights Key Funding Bills Before Breaking for Summer
Despite ambitious hopes by House Republicans to pass all 12 annual funding bills before the August recess, the House made an early exit from Washington, leaving outstanding funding legislation as a major to-do item once Congress returns in September. This includes approving funding for the fiscal year (FY) 2025 Labor-HHS-Education appropriations bill, which provides funding for key global health programs at the NIH, the CDC, the Advanced Research Projects Agency for Health (ARPA-H) and Biomedical Advanced Research and Development Authority (BARDA).

Meanwhile, before leaving town, the Senate Appropriations Committee was able to pass its State, Foreign Operations, and Related Programs (SFOPs), LHHS and Defense appropriations bills. In the SFOPS bill, the USAID’s Neglected Tropical Diseases (NTD) and Malaria Programs were level-funded (i.e., funded at the same level as the prior fiscal year), whereas the Global Health Security account at USAID received a $30 million increase above the FY24 level. The bill also notably included an extension of the President's Emergency Plan for AIDS Relief (PEPFAR) from March 25, 2025 to September 30, 2026. Additionally, there was some strong language included in the report accompanying the SFOPS spending measure around leveraging innovation to combat malaria, which ASTMH advocated for.

As for LHHS, the report included positive language across key global health priorities that ASTMH advocated for including, but not limited to, recognizing the role of CDC in the fight against malaria and parasitic diseases; emphasizing the need for increased resources for Fogarty Internal Center; prioritizing neglected disease research at NIH; and tackling other infectious disease prevention and treatment areas such as mycotic diseases (i.e., valley fever), TB and vector-borne diseases. Unlike the House bill, the Senate’s proposed measure did not contain a sweeping reorganization of NIH, which included splitting the National Institute of Allergy and Infectious Diseases (NIAID) into two institutes among other consequential policy changes. There was also some language related to “risky research” and foreign influence, including reiterated support for the Policy for Oversight of Dual Use Research of Concern and Pathogens with Enhanced Pandemic Potential issued in May 2024 by NIH. As for funding, as expected, the Senate LHHS bill fared far better for global health programs than its proposed House companion. Below are highlights from the bill.

The DoD report contained critical language, advocated for by ASTMH, that secures malaria on the list of conditions eligible for funding under the Peer-Reviewed Medical Research Program, as well as additional language supporting the development of medical countermeasures to combat infectious diseases.
With lawmakers on recess for the rest of August and a government shutdown deadline of September 30, it is increasingly likely that Congress will move to pass a short-term spending measure, known as a continuing resolution (“CR”), to fund the government through the rest of the year. This would give Congress time to negotiate significant funding differences around a full spending package while steering clear of a chaotic fall spending fight and lame-duck session following the November elections.

Proposed FY25 Senate Funding for Key Global Health Programs in LHHS Spending Bill
*FY24 Enacted Levels = Proposed funding in billions or millions with percent increase/decrease (+/-) compared minibus
*FY25 (H) = Proposed funding in billions or millions with percent increase/decrease (+/-) compared to House proposal
  • National Institutes of Health (NIH):
    • FY24: $1.77B+ (+3.6%)
    • FY25 (H): $1.77B+ (+3.6%)
    • National Institute of Allergy and Infectious Diseases (NIAID):
      • FY24: $130M+ (+2.0%)
      • FY25 (H): $61.28M+ (+0.9%)
    • Fogarty International Center (FIC):
      • FY24: No change, flat-funded ($95.16M)
      • FY25 (H): No change, flat-funded ($95.16M)
    • Advanced Research Projects Agency for Health (ARPA-H):
      • FY24: No change, flat-funded ($1.5B)
      • FY25 (H): $1M+ (+66.7%)
  • Centers for Disease Control and Prevention (CDC):
    • FY24: $173M+ (+1.9%)
    • FY25 (H): $1.95B+ (+20.7%)
  • Center for Global Health Center:
    • FY24: $4.76M+ (+0.7%)
    • FY25 (H): $133.7M+ (+19.2%)
  • Division of Parasitic Disease and Malaria (DPDM):
    • FY24: $1M+ (+3.4%)
    • FY25 (H): $1M+ (+3.4%)
  • National Center for Emerging and Zoonotic Infectious Disease (NCEZID):
    • FY24: $44.73M+ (+5.9%+)
    • FY25 (H): $24.23M+ (+3%)
  • Global HIV/AIDS:
    • FY24: No change, flat-funded ($128.9M)
    • FY25 (H): $128.9M+ (+100%) (House bill completely cut program)
  • Biomedical Advanced Research and Development Authority (BARDA):
    • FY24: $55M+ (+5.4%), with $10M carve out for “Disease X” funding
    • FY25 (H): $30M- (-2.8%)
Top Senate Democrat Introduces Bill to Ensure Consistent Funding for Biomedical Research
Senate Majority Whip Dick Durbin (D-IL) recently introduced the American Cures Act (S.4879), which would help secure long-term investments for biomedical research across the federal government. The bill seeks to address the unpredictable nature of the annual appropriations process by providing consistent funding through mandatory annual increases for top biomedical research agencies, including the NIH, CDC and the Department of Veterans Affairs (VA). The bill specifically increases biomedical research funding for each of these agencies at an annual rate of inflation plus 5 percent through 2034, enabling the agency’s funding to grow irrespective of the annual appropriations process. If enacted, beginning in 2025, funding for NIH would start with $52.5 billion to $104.9 billion by 2034, CDC from $9.9 billion to $19.9 billion, DoD research from $3.5 billion to $7.1 billion, and VA research from $1 billion to $2 billion. “This reliable, long-term investment would allow the agencies to plan and manage strategic growth while maximizing efficiencies and providing certainty to young researchers that there will be opportunities to pursue federally funded research,” said Sen. Durbin in a statement on the legislation. Sen. Durbin also notably acknowledged how Congress has failed to provide federal research agencies – in particular NIH – with vital funding increases in the past two fiscal years. Sen. Richard Blumenthal (D-CT), Sen. Chris Van Hollen (D-MD) and Sen. Sherrod Brown (D-OH) are also cosponsors of the legislation.
 
Bipartisan Diplomacy Bill Introduced in the Senate
Sen. Tim Kaine (D-VA) and Sen. Todd Young (R-IN) recently introduced the Fully Funding Our National Security Priorities Act (S.4819), which reinforces the role of the U.S. Department of State and USAID as key national security agencies. The legislation mandates that the pair of agencies submit an annual underfunded priorities list to Congress during the annual appropriations process for further assessment. While global health is not directly mentioned, the senators warn how underinvesting in diplomatic and development programs harms the U.S.’s ability to counter China. “I’m introducing this legislation to empower the State Department and USAID and provide a clearer picture to Congress of where we need to allocate resources to ensure we can effectively respond to emerging threats and global challenges,” said Sen. Kaine in a statement on the legislation.
 
Senate Committee Holds Hearing on Gain-of-Function Research Bill  
Sen. Rand Paul (R-KY), Ranking Member of the Senate Homeland Security & Governmental Affairs Committee, introduced the Risky Research Review Act (S.4667). The legislation would establish a first-of-its-kind Life Sciences Research Security Board, an independent review board housed within the Executive Branch that would be charged with assessing whether or not “high-risk” research should receive federal funding. More background on the bill can be found here. Following the introduction of the bill, the Senate Homeland Security & Governmental Affairs Committee held a hearing with witnesses from various academic institutions as well as former CDC Director Dr. Robert Redfield, who voiced his support for the bill. During the hearing, Dr. Redfield notably called for a moratorium on gain-of-function research, while other witnesses debated whether the White House Office of Science and Technology’s policy overseeing high-risk research goes far enough.  A markup of the bill was scheduled for July 24 but was not considered by the committee before the Senate adjourned for August recess.
 
Republican Senator Pens Letter Criticizing Pandemic Fund Pledge
Sen. Eric Schmitt (R-MO) sent a letter to Treasury Secretary Janet Yellen criticizing the announcement that the United States would pledge up to $667 million to support the Pandemic Fund through 2026. In a strongly-worded letter, Sen. Schmitt called the commitment a “blatant waste of taxpayer dollars” and “wildly un-American.” Among his criticism, he expressed concern over the influence of the Chinese Communist Party on the governance of the Pandemic Fund and referenced an inconclusive U.S. intelligence report that left open the possibility of the lab-leak hypothesis as the origin of the pandemic. He vowed to block any taxpayer dollars from going toward the request, which is subject to the appropriations process, and urged Secretary to revoke the commitment.
 
IN THE ADMINISTRATION
CDC Releases 2023 Global Health Annual Report
The CDC recently released its 2023 Annual Report that highlights the agency’s efforts to combat global health threats. Key areas of focus include data and surveillance; strengthening laboratory capabilities, including antimicrobial resistance monitoring; fortifying the global health workforce; and developing strategies and countermeasures to treat and control the outbreak of diseases. You can view the full report here.
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