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June 20, 2019


House FY 2020 Appropriations Respond to Most Infectious Disease and HIV Realities


With increased funds for important federal programs and interventions responding to infectious diseases and HIV, the health, foreign operations, and defense spending bill for fiscal year 2020 passed by the House of Representatives Wednesday reflects an understanding of a broad scope of public health threats at home and around the world, and of the resources needed to address them.

At the same time, as an association of infectious disease and HIV specialists, care providers and researchers, IDSA will continue to highlight gaps in resources that will be needed in the year ahead to confront global outbreaks, including the continuing spread of Ebola in the Democratic Republic of Congo and Uganda, as well as the growing and worldwide threat of antimicrobial resistant infections.

The bill responds to immediate and critical domestic needs with:

  • $173 million for the agency’s Antibiotic Resistance Initiative, that will help states and local communities track treatment-resistant infections and prevent their spread;
  • $20 million for a CDC initiative focusing on links between substance use and infections that include hepatitis, HIV and endocarditis;
  • $32.5 million for the Advanced Molecular Detection program to more rapidly determine if emerging diseases are resistant to first-line treatments;
  • $22.75 million for the National Healthcare Safety Network to increase the number of healthcare facilities reporting antibiotic use and reporting data;
  • $5 million in new funding to support student loan repayment to medical professionals enrolling in the CDC’s Epidemic Intelligence Service;
  • $567 million for the Biomedical Advanced Research and Development Authority to support development of urgently needed new antibiotics;
  • $1.350 billion in funding for the CDC National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, to confront the rising rates of sexually transmitted diseases more effectively respond to tuberculosis, and expand efforts against HIV and hepatitis C, including with an additional $15 million opioid epidemic-related funding.
  • And a provision blocking the recently announced ban on funding for extramural research using fetal tissue, allowing pivotal research to continue.

The spending bill also recognizes the value of continued U.S. leadership against worldwide infectious diseases and the HIV pandemic, with:

  • $513 million allocated in the bill for the U.S. Centers for Disease Control and Prevention’s Center for Global Health;
  • $5.808 billion for the National Institute of Allergy and Infectious Diseases and $84.9 million for the Fogarty International Center;
  • $1.56 billion for the Global Fund to Fight AIDS, TB and Malaria, including $210 million in increases over FY 19 funding to support epidemic control of the three biggest infectious disease killers globally.
  • $310 million for USAID’s global tuberculosis program, including an increase of $8 million over FY 19 funding;
  • $4.37 billion for the President’s Emergency Plan for AIDS Relief, maintaining level for the program
  • $33.476 billion for the DOD’s Defense Health Program/Research, Development, Test & Evaluation including $40 million for the DOD Joint War Fighter Medical Research Program, supporting research and development of medical solutions to improve military health, including infectious disease prevention, screening, diagnosis and treatment;
  • The bill’s repeal of the expanded Mexico City Policy, which has harmfully withheld U.S. support from overseas programs providing pregnancy termination services or information, also will optimize the value, and standing of U.S. global health efforts.

Still, the spread of Ebola from the Democratic Republic of Congo to Uganda earlier this month underscores urgent need to sustain investments in global health security efforts across multiple agencies, including USAID and the Department of Defense. With funding for the Global Health Security Agenda set to expire at the end of the fiscal year in September, full funding for efforts to control the current Ebola outbreak and to prevent, detect and respond to other infectious disease threats at their source before international spread will be essential.

While the bill also increases funding to $123.4 million for CDC Global Health Security efforts and provides level funding for USAID’s efforts, additional resources will be necessary to build international capacities to detect, prevent and respond to infectious diseases. Finally, with flat funding for antimicrobial resistance programs at the NIH, the House bill does not adequately support the work needed to confront a growing crisis at home and abroad, and IDSA will continue to urge a deeper investment.

As the appropriations process moves forward, IDSA will continue to urge the Senate to provide robust, sustained funding for infectious disease and HIV priorities.

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