DC/Global Policy Update

• Letters to Congressional leaders urging robust funding for global health; nutrition; and water, sanitation, and hygiene (WASH) programs within the International Affairs (150) and Health (550) accounts for Fiscal Year (FY) 2025 appropriations across both the State and Foreign Operations and Related Programs (SFOPS) and Labor, Health and Human Services, Education, and Related Agencies (LHHS) spending measures.
• Letter to Appropriations Committee leaders urging them to finalize the LHHS spending bill by the end of the 2024 and ensure robust investment in NIH.
• Letters to Appropriations Committee leaders calling for the highest funding level possible for the Advanced Molecular Detection in the final FY 2025 LHHS appropriations bill.
• Letter to OMB Director Shalanda Young calling for the highest levels of funding for lifesaving U.S. government programs that combat malaria in the FY 2026 budget request.
• Letter to Office of Management and Budget Director Shalanda Young urging for continued support of the U.S. Agency for International Development (USAID) Neglected Tropical Diseases Program and robust investment in program as the agency develops the FY 2026 budget.
• Statement calling upon Congress to support increased health worker line-item funding, support language in the FY25 Senate Appropriations bill, and advance the Health Worker Resolution (H.Res. 389) in the House.

ON THE HILL
119^th Congress Underway
The 119th Congress convened for the first time on January 3. Republicans hold a majority in both chambers following the November 2024 elections. After initially being rejected on the first ballot, Speaker Mike Johnson (R-LA) secured his post by flipping two Republican votes. Johnson will preside over the narrowest House majority in nearly 100 years, with just a four-seat difference.
In the Senate, Sen. John Thune (R-SD) was elected as the new Majority Leader, marking a significant leadership shift from Sen. Mitch McConnell (R-KY), who was the longest-serving leader in Senate history. The new Congress includes 12 new senators and over 60 new House members.
Since the start of the new session, conference leadership has been finalizing committee leadership and assignments. Notable changes in committee leadership include:

• Rep. Brett Guthrie (R-KY) as Chair of the Energy & Commerce (E&C) Committee.
• Rep. Buddy Carter (R-GA) as Chair and Rep. Diana DeGette (D-CO) as Ranking Member of the E&C Health Subcommittee.
• Rep. Lois Frankel (D-FL) as the Ranking Member of the SFOPS Appropriations Subcommittee.
• Rep. Brian Mast (R-FL) as Chair of the House Foreign Affairs Committee.
• Sen. Jeanne Shaheen (D-NH) as Ranking Member of the Senate Foreign Relations Committee.

Looking ahead, legislative priorities in the coming weeks and months will focus heavily on budgetary issues and confirmation hearings for President Trump’s cabinet nominees and other key agency leaders. Congress must finalize a spending package for FY 2025 before the March 14 deadline, while simultaneously preparing for the FY 2026 appropriations process. Ongoing disagreements over top-line spending levels for a long-term FY 2025 spending deal continue to complicate the negotiations process.

Republicans are also working to determine their strategy for the budget reconciliation process*, with ongoing debates about whether it will be handled through a single bill or two separate measures.
* Reconciliation is a process only used when one party controls the House, Senate and White House, which allows passage in the Senate with 50 votes and no filibuster in exchange for focusing only on provisions with major impact on the budget and mandatory (entitlement) spending.  This has been used in the past to pass the Affordable Care Act, the Trump tax cuts and the Inflation Reduction Act.

Senate Begins Confirmation Hearing Scheduling
The Senate will soon begin holding confirmation hearings for individuals President-elect Trump has nominated to serve in key cabinet positions. Of particular interest to the global health community, the following hearings have already been scheduled:
January 15

• 10:00 AM ET: The Senate Foreign Relations Committee will hold its confirmation hearing for Sen. Marco Rubio (R-FL) to serve as Secretary of State. The Secretary of State will oversee the Bureau of Global Health Security and Diplomacy, which encompasses critical programs such as the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
• 1:00 PM ET: The Homeland Security and Governmental Affairs Committee will hold its confirmation hearing for Russell Vought to serve as Director of OMB. Vought will play a critical role in developing and implementing the president’s budget, including funding for global health programs.

As of this writing, a confirmation hearing for HHS Secretary nominee RFK Jr. has not yet been scheduled. Sen. Finance Chair Mike Crapo (R-ID), who will play a key role in advancing the nomination, has suggested that a hearing could be scheduled in late January. Over the past several weeks, RFK Jr. has been meeting with senators on both sides of the aisle to build support for his nomination, including with Senate Health, Education, Labor, and Pension Committee Chair Bill Cassidy (R-LA). Additionally, a USAID Administrator has not yet been named. Nominations for key agency leadership roles at the Food and Drug Administration (FDA), CDC and NIH have also not yet been scheduled. These hearings will likely occur later in the process after cabinet officials have been confirmed. For more details on the nominees related to global health, see our December blog post, Who’s Who: President-Elect Trump’s Nominees and Possible Impacts for Global Health.
 
Cures 2.1 Framework Released
Prior to the start of the 119th Congress, Rep. Diana DeGette (D-CO) and the now-retired Rep. Larry Bucshon (R-IN-8) released a discussion draft of potential updates to Cures 2.0, referred to as Cures 2.1. DeGette will serve as Ranking Member of the House Energy & Commerce Health Subcommittee, which will play a critical role in advancing the legislation. While many of the proposals in the draft focus on domestic health issues, there is a dedicated focus on Fostering Innovation that includes structural reforms to the Advanced Research Projects Agency for Health (ARPA-H) and efforts to accelerate approvals at the FDA. With Rep. Bucshon now retired, Rep. DeGette must identify a Republican co-champion to support and advance the legislation.

House Foreign Affairs Chair Calls for Hold on Funding at State Department and USAID
On January 8, House Foreign Affairs Committee Chairman Brian Mast sent a letter to Secretary of State Antony Blinken and USAID Administrator Samantha Power requesting that both agencies cease disbursements for “controversial” programs in the final days of the Biden administration. Specifically, Mast cites “hundreds of millions of dollars of proposed obligations for initiatives that offer no clear national security benefit to the U.S. or its allies,” including “millions of dollars to combat climate change in the war-torn Middle East or fund LGBTQI awareness in Zimbabwe.”

Co-Chair of Senate Malaria and NTD Caucus Highlights Importance of Global Health
Senate Caucus on Malaria and NTDs Co-Chair Roger Wicker (R-MS) shared a blog post before the end of the 118^th Congress highlighting how global health advances U.S. national security interests. “I rejoice that these individuals have been spared from extreme illness and hunger,” Wicker posted. “I am also grateful for the effect that increased public health has on our national security. Reducing these needs abroad has proven to be a cost-effective way to help protect Americans at home.”
 
IN THE ADMINISTRATION
U.S.  Global Health Agencies Honor the Legacy of President Carter
The CDC and USAID published several pieces highlighting the indispensable contributions of former President Jimmy Carter to global health. At USAID, Administrator Samantha Power shared an op-ed in The New York Times, The Conscience of Jimmy Carter, and the agency published a separate piece, He Fought the “Fiery Serpent,” which highlighted President Carter and The Carter Center’s herculean efforts to eliminate Guinea worm disease during his post-presidential years. Similarly, the CDC published an article spotlighting President Carter and The Carter Center’s work in combating other NTDs beyond Guinea worm, including lymphatic filariasis, onchocerciasis, schistosomiasis, trachoma, Mycetoma, chromoblastomycosis and sporotrichosis.
 
27^th PACCARB Meeting Scheduled for Late January
The 27^th Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria meeting will be held in person January 28-29. The focus of the meeting will be on the next update to the U.S. National Action Plan on Combating Antibiotic-Resistant Bacteria. More information can be found here.
 
Biden Administration Releases Global Health Security Report
The White House published the 2024 report on U.S. Government Support for Global Health Security: Protecting Lives and Safeguarding Economies. The report highlights the progress and achievements of the Biden-Harris administration across three core goals: 1) strengthen global health security capacities through bilateral partnerships; 2) catalyze political commitment, financing and leadership to achieve health security; and 3) increase linkages between health security and complementary programs to maximize impact. The full report can be found here.
 
GLOBALLY
WHO Director Honors President Carter’s Legacy
WHO Director-General Tedros Adhanom Ghebreyesus published an op-ed in STAT highlighting forming President Carter’s contributions to health and humanity, including his role in Guinea worm eradication. “The divide between rich and poor has never been wider, nor has wealth been so concentrated in the hands of so few. And the perils we collectively face — wars, outbreaks and climate change — have never felt more pressing. But President Carter’s example, as a leader, a humanitarian and a human, can guide us through these unclear times. I urge us all to follow his lead.”
 
Pandemic Fund Announces Third Calls for Proposals
In December, the Pandemic Fund announced its third round of funding, with a grant envelope of $500 million for projects focused on advancing core capacities in one or more of the following areas: early warning and disease surveillance systems, laboratory systems and strengthening human resources/public health and community workforce capacity. Proposals should incorporate four underlying themes: One Health, community engagement, gender equality and health equity. More information can be found here.