Dear Colleagues,

My morning wake-up call today was from a reporter requesting a comment about President Trump’s proposal to abolish the Fogarty International Center, the National Institutes of Health (NIH) institute that is dedicated to supporting global health research, developing international partnerships, and training the next generation of scientists to address global health needs. By now, you must have heard the details about the president’s requests for huge cuts to HHS, NIH and AHRQ.  Below this message, I have pasted in an email from ASPPH that provides some details and links.

Here is a summary of my response to the reporter:

These proposed cuts are the antithesis of "making America great." They would be devastating for biomedical research in the United States but, more importantly, for the health of persons in the U.S. and around the world. Abolishing the Fogarty International Center would inhibit the development of life-saving vaccines, programs to lower maternal and child mortality, and innovative research to attack the epidemic of non-communicable diseases (cardiovascular disease, cancer, injuries) that is killing the majority of people around the world. Lastly, it would end productive and strong partnerships between U.S. institutions and those in low- and middle-income countries. Lessons from Fogarty-funded research have informed the work of other NIH institutes and improved health everywhere.

The Fogarty Center's budget is tiny in governmental terms but its impact is mighty. It plays a central role in training people from low- and middle-income countries in research and public health field operations to combat emerging disease epidemics, such as Ebola and Zika. Shuttering the Fogarty Center would have a huge negative impact on the health of Americans as well as on the research capability and public health expertise in low- and middle-income countries.

It is ironic that the United States is the model for the world in regard to public health and biomedical research. For this reason, people from all over the globe come to train at our universities and at NIH. This proposed budget would change that and send a strong signal to young people and trainees not to choose a career in public health research.

Today I am in Washington for the annual ASPPH meeting. The sense from policy makers with whom I have spoken is that the President’s budget proposal is politically untenable, given the strong support in the House and Senate for NIH. The likely outcome is a continuing resolution, a short-term fix that would continue funding federal agencies without approving a new budget. To ensure that the proposal does not become a reality, it is our duty to tell the story of the impact of our work to senators and representatives as well as to the people of America.

Warmest regards,

Klag Signature

Michael J. Klag, MD, MPH ’87
Dean


Original Message

ASPPH Policy & Advocacy

March 16, 2017 -- Budget Special Edition

Trump Releases FY 2018 “Skinny Budget” Proposal

The Trump Administration on Thursday morning released a proposed “skinny budget” for fiscal year 2018. Unlike normal presidential budget proposals, the 62-page document does not include funding recommendations for each agency and account. However, it does make a few specific agency funding and reorganization recommendations. Many of the recommendations appear to be non-starters on Capitol Hill. The entire proposal, which has been titled, “America First: A Budget Blueprint to Make America Great Again,” appears to be a political campaign document and not a realistic budget proposal. Among Trump’s recommendations:

HHS: The FY 2018 budget requests for HHS is $69.0 billion, a $15.1 billion or 17.9 percent decrease from the 2017 annualized CR level.

NIH and AHRQ: The proposal, “Reduces the National Institutes of Health’s (NIH) spending relative to the 2017 annualized CR level by $5.8 billion [about -18%] to $25.9 billion. The Budget includes a major reorganization of NIH’s Institutes and Centers to help focus resources on the highest priority research and training activities, including: eliminating the Fogarty International Center; consolidating the Agency for Healthcare Research and Quality within NIH; and other consolidations and structural changes across NIH organizations and activities. The Budget also reduces administrative costs and rebalance Federal contributions to research funding.”

CDC, Preparedness and Prevention: Per the document, Trump’s budget, “Reforms key public health, emergency preparedness, and prevention programs. For example, the Budget restructures similar HHS preparedness grants to reduce overlap and administrative costs and directs resources to States with the greatest need. The Budget also creates a new Federal Emergency Response Fund to rapidly respond to public health outbreaks, such as Zika Virus Disease. The Budget also reforms the Centers for Disease Control and Prevention through a new $500 million block grant to increase State flexibility and focus on the leading public health challenges specific to each State.”

HRSA: The Trump budget “Eliminates $403 million in health professions and nursing training programs, which lack evidence that they significantly improve the Nation’s health workforce. The Budget continues to fund health workforce activities that provide scholarships and loan repayments in exchange for service in areas of the United States where there is a shortage of health professionals.”

EPA: The President’s 2018 Budget requests $5.7 billion for the Environmental Protection Agency, a reduction of $2.6 billion, or 31 percent, from the 2017 annualized CR level.

State Department and U.S. AID: The Trump proposal, “Eliminates the Global Climate Change Initiative and fulfills the President’s pledge to cease payments to the United Nations’ (UN) climate change programs by eliminating U.S. funding related to the Green Climate Fund and its two precursor Climate Investment Funds.” The proposal also states it, “Provides sufficient resources to maintain current commitments and all current patient levels on HIV/AIDS treatment under the President’s Emergency Plan for AIDS Relief (PEPFAR) and maintains funding for malaria programs. The Budget also meets U.S. commitments to the Global Fund for AIDS, Tuberculosis, and Malaria by providing 33 percent of projected contributions from all donors, consistent with the limit currently in law.”

A more complete budget proposal from the Administration is expected later this spring.

Tony Mazzaschi | Senior Director, Policy and Research
Association of Schools and Programs of Public Health (ASPPH) | www.aspph.org