Proposed Budgets for Global Health and Foreign Aid
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

Photo: Flickr

How to Help People in BulgariaUSAID classifies Bulgaria as a nation of upper-middle income, with a GNI of over $53 billion and a GNI per capita of over $7,000. Despite these statistics, learning how to help people in Bulgaria from a U.S. standpoint might begin with funding.

U.S. disbursements to the nation for fiscal year 2015 totaled over $18 million. Unlike many other nations needing assistance in health or emergency services, the top two activities were:

  • International Materials Protection and Cooperation (Department of Energy)
  • Foreign Military Financing Program, Payment Waived (Department of Defense)

Unsurprisingly, those departments are also listed as the top partners for Bulgaria, with the Department of Defense leading over Energy. Furthermore, the top sector involved conflict, peace and security, and over half of the financial assistance for Bulgaria fell under the “military” (rather than the “economic”) category.

However, these focuses may not be the best ways of how to help people in Bulgaria, as the World Bank estimated the percentage of people living under the country’s poverty line in 2014 at around 22 percent.

Furthermore, while HealthGrove statistics estimated the life expectancy in the country at about 74 years, it maintained one of the highest mortality rates in comparison to other nations in Europe. It ranked above only Belarus, Moldova, Ukraine and Russia. Healthgrove breaks down the risk of mortality between communicable, maternal, neonatal and nutritional diseases, injuries and non-communicable diseases.

Of these, non-communicable diseases (such as cardiovascular problems and cancer) ranked much higher than the other two in terms of mortality rates. Consequently, making arguments for funds to treat diseases that can be transferred—like HIV, malaria and tuberculosis—might seem pointless. However, that does not mean that funding cannot go toward health in general when determining how to help people in Bulgaria.

A report from the United Kingdom providing tips on those traveling to Bulgaria explained that, relative to the United Kingdom, “facilities in most Bulgarian hospitals are basic and old-fashioned.” It did, however, make note of hospitals and clinics that are private as “generally well equipped and not expensive in comparison with the U.K.”

Although this measure is dependent on comparing and contrasting with the United Kingdom, it does not change the fact that funding from the United States could be reallocated toward health initiatives, instead of focusing so heavily on the Departments of Defense/Energy.

While the Global Health Innovation Act seems to highlight the importance of addressing communicable diseases in other countries, it may still be influential on the healthcare of Bulgarian citizens. Additionally, the International Affairs Budget is another important piece of legislation addressing U.S. funding to other nations.

Implementing effective practices when figuring out how to help people in Bulgaria can often be as simple as supporting bills and acts that relate to the U.S. budget.

Maleeha Syed

Photo: Flickr

This short video release by the ONE Campaign in late 2012 reveals some interesting things about the average American’s knowledge of foreign aid. The video compiles a series of brief interviews into a cohesive narrative on the American people’s perception of this critical aspect of U.S. foreign policy. The video asks provocative questions such as, “What percentage of the U.S. budget do you think is spent on foreign aid?”,  “How many people do you think are receiving lifesaving AIDS treatment”, and “Do you think it’s part of American core values to have a humanitarian agenda?”  The answers are initially disconcerting but turn hopeful and informative.  Many of those interviewed were grossly misinformed about the U.S. foreign aid budget and the successes of USAID abroad. However, the majority of respondents featured in the video were very open minded to the prospect of increasing foreign aid after learning some basic facts. Videos like this are essential to informing the American public about the importance and effectiveness of U.S. foreign aid.

–  Josh Forgét