After months of threatening to make serious cuts in the proposed budgets for global health and foreign aid, the Trump administration and Congress signed a budget deal on March 21, 2018 indicating increases to nearly all government-allocated scientific research agencies, many of which contribute to global health research. For instance, the National Institues of Health received a $3 billion increase in federal budget allocations, a reversal of the 22 percent reduction in the budget proposed by the White House earlier this year.

These developments fall in line with press releases published on the White House website. The White House explains that the Trump administration champions the Global Health Security Agenda (GHSA), funded by the Centers for Disease Control and Prevention (CDC), which helps to prevent the spread of diseases through increases in disease prevention provisions in countries prone to an outbreak.

President Trump himself has expressed that “the world cannot have prosperity unless it is healthy”. His administration’s reports detail the GHSA and clearly show the impact that this specific global health advancement has had on outbreaks of dengue fever in Burkina Faso, as well as the Marburg virus in Uganda.

This viewpoint on global health security and the recently approved 2018 budget contrast with the Trump administration’s 2019 proposed budgets for global health and foreign aid. The 2019 budget proposes 30 percent cuts to the Senate Foreign Affairs Budget as well as the Department of Health and Human Services.

While the recently approved 2018 budget increased the funding to agencies vital to public health, it is still important to understand the impact these proposed budgets for global health and foreign aid could have on agencies internally. Budget cuts to United States government institutions materialize in a slowdown of impactful research and operations that occur within the agency. Decreases in budgets inevitably reduce the number of grants that are approved and also limit the number of researchers institutions are allowed to hire.

The less money an agency receives, the fewer projects it is able to complete. As of right now, the deepest cut in the proposed budget for global health and foreign aid are to the State Department, with a primary focus on the United States Agency for International Development (USAID). Cuts to USAID will reduce the number of programs and limit the amount of personnel and projects carrying out USAID work.

As of right now, USAID is in a hiring freeze and only seeking out critical personal on an as-needed basis through specialized waivers. Despite this challenge, current USAID administrator Mark Green claims that the tightening of the USAID budget causes the agency to operate as efficiently as possible. Green explained that even with budget restrictions, he is working with the president to show how development is a necessary soft approach to national security and global health.

While some global health programs are proposed to receive equal or additional funding through presidential and Congressional support of the CDC’s GHSA program, USAID looks to remain under tight restrictions. Overall, advocates of global health and USAID will continue to emphasize the institution’s importance to foreign policy, but it is ultimately up to President Trump and Congress to approve the organization’s desired funding.

– Daniel Levy

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