Courtney Carson, MA

Representative Tom Price. Photo: Flickr/Mark TaylorThe Senate continues to consider the nomination of Representative Tom Price (R-GA) to serve as Secretary of Health and Human Services (HHS), following his nomination hearings before the Senate Health, Education, Labor and Pensions Committee and the Senate Finance Committee, which concluded yesterday. If confirmed, Price will assume leadership of a department that plays a critical role in advancing the development of new global health innovations through its sub-agencies including the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Food and Drug Administration. As head, Representative Price will play an influential role in strategy and decision-making at these agencies.Price did not directly discuss HHS’s engagement in global health research at either hearing, but he did address global health and infectious diseases; innovation for rare diseases; support for health innovation, NIH, and priority setting for NIH-funded research. Here’s what he said: Global health and infectious diseases Senator Ben Cardin (D-MD) questioned Representative Price on how the reinstatement and expansion of the Global Gag Rule under the Trump administration will affect HHS operations and active participation in international global health bodies. This rule restricts all US global health funding from being used to support international organizations that provide abortion services, counseling, or referrals; or advocate for the liberalization of abortion laws, even if they do so without US funds. Senator Cardin asked Representative Price how he will ensure the United States can “fully participate” in global health efforts to address “maternal health, to help stopping the spread and ending HIV and AIDS […] to make sure that the next Zika virus, that we [are] able to contain it so it doesn't cause the catastrophic effects if the Global Gag Rule is enforced in a way that prevents us from participating in international health organizations?While Representative Price didn’t address the impact of the Global Gag Rule on HHS’s international engagement in response, he did stress the importance    of active engagement in the global response to infectious diseases, calling the question “really important,” and noting that his goal if confirmed    is to “gather the best minds and the best talent that we have within the department and without and determine what is wisest policy for this nation    to have [as] it relates to […] infectious disease.” He further elaborated on his support for ongoing infectious disease work saying, “germs    know no geographic boundaries. And we do incredible work, the work that the CDC does and the work that's done by others in our nation that try to prevent    infectious disease, work to detect the spread of infectious disease and then provide a logical and methodical and aggressive response to the outbreak    of any infectious disease is absolutely vital to protect the American people, and we're committed to doing so.” SSenator Cardin expressed his agreement and hope that Representative Price “will look at perhaps unintended consequences from […] executive orders that could compromise our ability to be as effective as we need to, using all tools at our disposal.”While under previous administrations, the Global Gag Rule only applied to organizations receiving family planning–specific funds—which account for about US$600 million in federal funding—the expanded version of the rule applies to organizations that receive any global health money. This means that approximately $9.5 billion in US funding for global health programs administered by the US Agency for International Development, the State Department, and HHS—which address a range of issues including maternal and child health, nutrition, HIV and AIDS (including the President’s Emergency Plan for AIDS Relief), malaria, tuberculosis (TB), and other infectious diseases—is subject to the rule. This could have a dramatic impact on the ability of organizations funded by US global health accounts to team with international partners to develop, test, roll out, and monitor new global health technologies around the world. Rare diseases and the Orphan Drug ActCDC research. Photo: CDC/Dr. Scott SmithSenator Orrin Hatch (R-UT) discussed rare diseases, attesting that the Affordable Care Act prevents “investments and innovative therapies that can cure and save lives.” He asked Representative Price what steps he believes “will improve the pipeline for rare disease therapies to bring treatments and cures to patients in desperate need of hope.” Price replied that the Orphan Drug Act has “revolutionized the ability to treat rare diseases” and that it made “the United States the leader in coming forward with treatments for rare diseases.” He highlighted that there are actions the government can take “in terms of patent protection, in terms of liability, in terms of incentivization [of] resources to be able to encourage the discovery of cures for rare diseases” but stopped short of providing details about specific reforms or new policies he proposes. Price also said that the Orphan Drug Act, which Senator Hatch cited as creating “an explosion” of drugs for rare diseases is “one of the success stories truly for public policy in the country.” Rare diseases are defined as diseases that affect less than 200,000 people in the United States, or those for which investment in a new product is not expected to yield financial return. The Orphan Drug Act, and other provisions to incentivize the development of tools for rare diseases, can also be used to support the development of new technologies for neglected diseases, which affect millions of people around the world, yet few in the United States. Continued support for vehicles that advance the development of tools for orphan and rare diseases—in addition to new steps to ensure that these programs work to support neglected disease research and development (R&D)—is critical to advancing US support for global health R&D. Health innovation, NIH, and the prioritization of research funding Discussing Representative Price’s commitment to public service, Senator Rand Paul (R-KY) asked, “What are your motives? [...] What are your goals? [...] Do you want more people to have health care? Or do you think we disagree on just how we do it and not necessarily on the motives?” In listing principles that he believes are “absolutely imperative for a health care system,” Representative Price said that the system must incentivize innovation “because it is innovation that drives high-quality health care.”Senator Susan Collins (R-ME) cited biomedical research as a “passion,” noting that “if we invest in biomedical research, we have the possibility of not only improving lives for Americans and curing or coming up with effective treatments for devastating diseases, but also lowering health care costs.”When asked by Senator Collins if he supports “increases for the NIH” passed last year and under consideration this year, Price replied, “NIH is a treasure for our country, and the kind of thing we should be doing to find cures for those diseases. One of the core avenues to be able to make that happen is through NIH, and I supported the increase [as a member of Congress].”Senator Patrick Toomey (R-PA) also questioned Representative Price on his views on NIH research and allocation of resources. Citing 5.2 million Americans with Alzheimer’s—a disease for which there is no cure or treatment—Senator Toomey noted that NIH spending on the disease is $168 per diagnosed patient and asked if Representative Price would commit to “ensure that we have a better proportionality in terms of the allocation of resources and the breadth and severity of illnesses.” Representative Price responded, “I think it's absolutely imperative, Senator, and I look forward to working with you.”NIH is the largest financial supporter of global health R&D in the world. Its work to advance basic research on infectious diseases like HIV and AIDS, TB, malaria, neglected tropical diseases, and emerging diseases like Ebola and Zika—as well as research in maternal and child health—has led to important scientific breakthroughs that have transformed treatment in the United States and around the world. Continued and robust support for these research areas is critical to ongoing progress in global health.At GHTC, we will continue to monitor Price’s views on US support for global health and medical innovation and urge strong support for programs that further the development and rollout of urgently needed global health technologies.

Donald Trump. Photo: Flickr/Gage SkidmoreAs eyes turn to the inauguration of President-elect Donald Trump this Friday, we still have only limited insight into the incoming administration’s vision for global health and medical research. At GHTC we have long championed a strong role for the US government in developing new vaccines, drugs, and diagnostics to address the world’s most pressing diseases and health conditions and have celebrated America’s historic leadership in global health research and development (R&D). We urge the Trump administration and the 115th Congress to continue to prioritize global health and medical research and will be watching the following issues in 2017:Budgets and fundingOne of the first ways the Trump administration can demonstrate commitment to global health, international development, and medical research is through the president’s fiscal year 2018 budget request. Traditionally, the Executive Office of the President uses the first budget of a new administration to articulate priorities and set the stage for the following years. We expect President-elect Trump to release a preliminary budget request in February, with a more detailed budget proposal released by May. These two policy proposals will provide the most comprehensive picture to-date of the Trump administration’s views on global health, development, and medical research, and whether the new president will continue to prioritize these areas of American leadership.As Congress ultimately sets the budget and appropriates funds, it will also be critical to watch this body. As a check on executive power, Congress has the power to accept, reject, or find middle ground with the president’s proposal. Importantly, while there have been shifts in the makeup of Congress, strong global health and medical research champions remain—and we can look to these members to support continued and robust investments in these areas.GHTC will be closely following the budget and appropriations process to ensure US leadership in global health and medical research continues to be prioritized. The United States leads the world in investment in global health R&D, so any changes to US funding—positive or negative—can have a significant effect on global health research projects worldwide.Key nomineesWhile President-elect Trump has nominated cabinet-level officials, many of those who will assume leadership posts with a more direct role in global health, international development, and medical research have yet to be named. Who Trump picks to lead the US Agency for International Development (USAID), USAID’s Bureau of Global Health, the National Institutes of Health (NIH), and the Centers for Disease Control and Prevention (CDC) will provide insight into the administration’s plans for global health R&D.Key questions for these future nominees will include how a Trump Administration USAID will advance innovation to further development efforts, how new leadership of NIH will prioritize research that benefits the health of Americans and the global community—including research for both emerging and long-standing disease threats—and how the CDC will continue leadership in critical work to prevent, detect, and respond to emerging health threats around the world, including investments in new technologies.Commitment to US leadership in global health and international developmentPresident-elect Trump has not yet articulated a policy direction on global health and international development. On the campaign trail, Mr. Trump promisingly expressed support for signature US global health programs like President Bush’s President’s Emergency Plan for AIDS Relief (PEPFAR), and his nominee to lead the State Department, Rex Tillerson, stated in his nomination hearing that PEPFAR is a “remarkable success” and model we should look to in the future. However, recent reports cite potential skepticism toward health, development, and aid programs. Members of the Trump transmission team have asked “Is PEPFAR worth the massive investment when there are so many security concerns in Africa?” and “Is PEPFAR becoming a massive, international entitlement program?” The team is also cited as questioning US engagement in Africa more broadly, including whether corruption in African governments means US aid to certain countries is “stolen.”Photo: CDC/James GathanyWhile worrisome, our hope is that this line of questioning leads to a better understanding of the value of US investments in regions such as Africa. GHTC will continue to champion the United States’ history of leadership in global health and development, as well as highlight the dramatic number of lives saved and other returns to economic growth and national security from US investment in global health and development. Prioritization of global health securityRecent outbreaks of Ebola and Zika have demonstrated that America is not immune to diseases and health conditions that have traditionally only threatened other geographies. Global health is American health, and recent efforts to strengthen health security and infrastructure around the world through initiatives such as the Global Health Security Agenda, are beginning to show impact.Given the increasing threat of diseases with potential to impact American health, it is likely that global health security could rise to the top of the Trump Administration’s global health agenda. In order to address this urgent need, Mr. Trump will need to support robust and expanded activities to prevent, detect, and respond to emerging diseases that threaten American and global health. This must include establishing dedicated funding for both emergency response to threats as they occur and ongoing investments to strengthen health systems and bolster capacity to prevent, detect, and respond to emerging diseases, including investments in the development of new technologies.Engagement with key multilateral bodiesMultilateral partnerships are essential to global health policy that works for the United States. In an interconnected world, we can’t stop the spread of new, emerging diseases or eradicate long-standing heath challenges like polio without countries working together in partnership. Strong participation in bodies like the United Nations (UN), the World Health Organization (WHO), and the Global Fund to Fight AIDS, Tuberculosis and Malaria is key to advancing American leadership, as well as to ensuring that those organizations function as effectively as possible. While the Trump administration has offered general statements implying more inward-facing policy, several of his nominees to defense and diplomatic positions have stressed the value of strong international and multilateral engagement as a “force multiplier” for the United States GHTC will also be monitoring efforts in Congress to restrict funds to the UN. Political tensions around passage of a UN Security Council Resolution on Israeli settlements have prompted several US legislators to introduce bills and resolutions to defund the UN, with some proposing a fifty percent reduction in funding to all UN agencies—including WHO, the UN Development Programme, and other specialized agencies. While these measures do not currently have bipartisan support, any cuts to the UN and UN agencies would have significant effects on global health programming and achieving global goals for health and development.GHTC is committed to maintaining a strong, coordinated voice to champion policy that advances US leadership in global health R&D in 2017 and beyond. Global health, development, and medical research are historic areas of bipartisan agreement, and we look forward to maintaining this legacy and driving progress in the years ahead.

Secretary of State–designee Rex Tillerson. Photo: Center for Strategic and International StudiesWednesday’s nomination hearing for Secretary of State–designee Rex Tillerson provided an opportunity for the global health community to learn more about his views on the United States’ role in international development and global health.While the majority of the hearing highlighted policy toward Russia, human rights, global terrorism, and how Tillerson’s professional experience in the oil industry will impact his role as chief foreign policy advisor to the President, Tillerson was also questioned on women’s empowerment, family planning, development aid, and the President’s Emergency Plan for AIDS Relief (PEPFAR).Here’s what he said:Gender equity and women’s empowermentIn response to Senator Shaheen’s (D-NH) question on whether he would support programming to increase women’s empowerment, Tillerson described how these types of programs had been a priority for the Exxon Foundation and cited a program Exxon supported in Papua New Guinea. He committed to continuing these programs, noting “I think it’s an important part of our foreign aid assistance efforts, whether it’s through the USAID [US Agency for International Development] or whether it’s through other opportunities we have in more structured ways.”Family planning and reproductive health Senator Shaheen also pushed Tillerson on family planning and reproductive health, asking if he would pledge to “continue to prioritize quality family planning and reproductive health services for women worldwide, and ensure that resources and access to these programs are not conflated with support for abortion.” Tillerson responded that he was aware that the United States spends roughly a half a billion dollars per year on family planning aid, and he thinks this level of funding is “an important level of support.” Asked whether his answer represented a pledge to continue this commitment, Tillerson deferred, and said he would examine these programs further, if confirmed.Development aid and disaster assistanceSenator Flake (R-AZ) discussed the role of soft diplomacy with Africa and USAID programs, questioning what works and what doesn’t. Tillerson replied that it is important that US assistance be used to nudge countries toward diplomacy, punish countries when required, and encourage cooperation. He noted that USAID has two important streams of assistance: disaster relief, to address immediate suffering, and development assistance, which is important for achieving lasting change. He said that recently the proportion of disaster assistance relative to development assistance has been growing, which constrains the government’s ability to use aid as a tool for change. He suggested when possible, the United States should tie assistance to behavior change and then follow up. He also said that assistance should be targeted, designed to support American values, and help countries continue their own development. He noted that tying aid to governments meeting obligations is hard to do with disaster relief, and that he understands and appreciates this difference.PEPFARWhen questioned about PEPFAR by Senator Flake, Tillerson called it “one of the most extraordinarily successful programs in Africa.” He described how he saw the success of global health programs up close through Exxon’s work to eradicate malaria in central Africa. He noted that PEPFAR broadly has generated much goodwill from Africa and “recognition of the goodwill and compassionate nature of American people,” calling PEPFAR one of the best projections of America to the African people.Questioned by Senator Markey (D-MA) on his views of PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria, and his commitment to strengthening these programs in the years ahead, Tillerson replied: “PEPFAR is one of the remarkable successes of the past decade or more…I think what’s notable about PEPFAR is that there are measurable results…I think it serves as a model for us to look to as we’re thinking about other ways in which to project America’s values, project our compassion to want to solve these threats that are in other parts of the world that by and large we’re not threatened by a lot of this here in this country. Malaria was eradicated decades ago, TB well under control, AIDS—great treatment programs are available to people. Projecting that into other parts of the world is a marvelous way to send a message of the compassion of the American people that we care about people’s lives all over the world. So PEPFAR is a terrific model to look at in the future as we look at other areas that may be useful for us to put additional programs in place.”At GHTC, we will continue to monitor Tillerson’s views on US support for global health and development aid and urge strong support for programs that further the development and rollout of urgently needed global health technologies.

US Navy Lt. Kimberly Edgel, left, and Christian Baldeviano examine a positive malaria blood smear at Naval Medical Research Unit (NAMRU) 6 in Callao, Peru.This afternoon, the US Senate voted to protect critical medical research programs at the Department of Defense (DoD). In a vote of 66 to 32, the Senate approved Senator Durbin’s (D-IL) Amendment 4369 to the Fiscal Year 2017 National Defense Authorization Act (FY17 NDAA), which strikes sections 898 and 756 in the underlying bill, designed to enact enough restrictions and red tape on DoD medical research to effectively end all existing programs. With this vote, the majority of the Senate signified that medical research is a critical function of the DoD, and must continue to be a priority. Infectious disease and other medical research at DoD plays a vital role in serving the Department’s overarching mission: supporting our military men and women. Not only does DoD infectious disease research directly benefit service members overseas—who experience neglected infectious diseases alongside local communities—but it also plays a key role in domestic health preparedness initiatives that prevent, detect, and respond to infectious diseases that threaten the health of American civilians at home. Beyond threat reduction to Americans, DoD research can often be translated for other contexts, and serves as an important component of US global health efforts to address HIV and AIDS, tuberculosis, malaria, and neglected tropical diseases in low-income countries.For example, malaria, which threatens the lives of nearly 3.2 billion people in tropical and poor regions of the world, is also a significant threat to the operational readiness of the US military. More person-days were lost among US military personnel due to malaria than to bullets during every military campaign fought in malaria-endemic regions during the 20th century. Thanks to ongoing research at DoD, nearly all of the most effective and widely used antimalarials—used to protect our service members overseas and adapted for widespread use in endemic regions—were developed in part by US military researchers. DoD medical research is also critical to medical advances that directly benefit US civilians at home: One of every four vaccines approved by the US Food and Drug Administration in the last century was developed with the participation of DoD. The 2014 Ebola epidemic in West Africa offers yet another example: the Department’s quick work to advance the development of Ebola countermeasures and safety protocols during troop deployment to West Africa was vital to protecting lives of service members and civilians in the region and remains vital to ongoing response efforts.On May 25th, GHTC sent a letter to members of the Senate, urging them to uphold the DoD’s critical medical research programs and oppose provisions in Sections 756 and 898 of the FY17 NDAA, which would limit our nation’s ability to develop medical countermeasures necessary to protect our troops and save lives around the world.GHTC commends Senator Durbin’s leadership on a bipartisan effort to remove these troubling provisions and extend our thanks to the co-sponsors of Amendment 4369: Cochran (R-MS), Reid (D-NV), Blunt (R-MO), Mikulski (R-AK), Murkowski (D-MD), Murray (D-WA), Collins (R-ME), Feinstein (D-CA), Shelby (R-AL), Casey (D-PA), Gillibrand (D-NY), Baldwin (D-WI), Bennet (D-CO), Markey (D-MA), Brown (D-OH), Leahy (D-VT), Hirono (D-HI), Reed (D-RI), Menendez (D-NJ), Tester (D-MT), Coons (D-DE), Kirk (R-IL), Klobuchar (D-MN), Udall (D-NM), Boxer (D-CA), Schatz (D-HI), Moran (R-KS), Sanders (D-VT), Warren (D-MA), Cardin (D-MD), Schumer (D-NY).

Aedes Aegypti mosquito which carries the Zika virus. Photo: CDC/James GathanyOn Tuesday, the Obama administration announced that it will transfer nearly US$600 million in remaining Ebola funds to fight the growing threat of Zika virus. But many questions remain. Where is the money going? From what accounts will it come? And what does this mean for the Global Health Security Agenda (GHSA) programming which is supposed to help protect against these threats in the future?In February, the President requested $1.9 billion in emergency appropriations to combat the Zika virus outbreak, but authorization was stalled by members of Congress who suggested the Administration reallocate existing funds instead. The Administration continues to stress that the full request is still needed to fight both Zika and complete the Ebola response. With the announcement of the transfer of funds, the Administration is signaling that the risk of waiting for Congress to act on a supplemental funding is too great, and deploying additional funding to address Zika is essential in the short-term—before the summer weather leads to a broader spread of the mosquito-carried virus.Reallocating Ebola funding to address Zika carries consequences. While the Administration acknowledges that some Ebola funds remained unspent, much of this money has been allocated to implement the GHSA—a commitment to help at least 30 countries prevent, detect, and respond to emerging disease threats. GHSA has not received any direct appropriations, largely due to sentiment that remaining Ebola balances should cover the cost. Additionally, as the Ebola response remains unfinished—health systems in West Africa remain fragile and we have not yet developed approved Ebola vaccines or treatments—diverting funding before we have finished the job remains risky.Where is the money going? From where will it come? Vaccine researcher. Photo: NIAID, NIH Because the US Centers for Disease Control and Prevention (CDC) is focused on research and development (R&D) for Zika vaccines, treating those infected, and combating the mosquitoes that spread the virus, many expect the bulk of the $600 million transfer to be directed to CDC Zika efforts. The Washington Post reports that 75 percent of the transfer will go to CDC and the rest to foreign aid accounts. It remains uncertain from what accounts the Ebola transfers will come—and subsequently the impact on programs currently funded through the Ebola supplemental. It seems likely that much of the transfer may come from accounts at the US Agency for International Development and State Department, which as of December 31, 2015, had $400 million in programmed Ebola funds that will expire at the end of fiscal year 2016. Other accounts with remaining funds include: $1.031 billion at CDC for domestic, international, and global health security $363 million at Public Health and Social Services Emergency Fund, which houses the Biomedical Advanced Research and Development Authority $45 million at the US National Institutes of Health $14 million at the US Food and Drug Administration Funds in these accounts do not appear to have expiration dates. As we do not yet know for certain which accounts will fund the $600 million transfer, the impact of this decision on implementation of the GHSA is also uncertain.If funds are transferred from CDC accounts, GHSA efforts could be delayed or stalled. It also remains to be seen whether the Administration will receive additional funding to supplement the Zika response. While Congress has not acted on a request for a stand-alone supplemental funding, members have suggested they are open to providing additional funding in the future should the reallocation of existing funds prove insufficient to both addressing Zika and completing the Ebola response. The possibility remains that we could see additional funding for Zika as part of the regular appropriations process, which is likely to progress in the coming months. 

On Monday, President Obama released his proposed budget for fiscal year 2017 (FY17). For global health advocates the budget was a mixed bag. GHTC was pleased to see many critical global health accounts receive proposed funding boosts, but there also worrisome cuts or flat-lined funding proposed in other important areas. New tools and technologies are critical for advancing global health, and robust funding for US global health accounts is key to bolstering US leadership in global health research and development (R&D). USAID and Department of State For the first time in several years, the President’s request for global health programs at the United States Agency for International Development (USAID) and the Department of State is higher than the level of funding enacted the previous year: the White House requested US$2.906 billion, which is $73.1 million (2.6 percent) higher than the $2.834 billion appropriated for global health programs at the two agencies in the fiscal year 2016 (FY16) Omnibus. This funding increase reflects sustained commitment to USAID’s global health goals—ending preventable maternal and child deaths, preventing infectious disease epidemics, and achieving an AIDS-free generation—all of which require emphasis on R&D. Specific programs proposed to receive increases include: $64.5 million increase for USAID’s maternal and child health programs, including a $40 million increase to Gavi, the Vaccine Alliance; $20.1 million increase for family planning and reproductive health; and a $71 million increase for malaria programs. These increases are critical to US engagement in global health R&D: New funding for the maternal and child health and family planning and reproductive health accounts will bolster USAID’s work to develop new innovations to help women and infants during pregnancy and childbirth, a strong component of the Saving Lives at Birth Grand Challenge. Increased contributions to Gavi to advance international efforts to deliver new and underused vaccines to children living in the world’s poorest countries. Increased funding for malaria—including the President’s Malaria Initiative—will accelerate US efforts to eradicate malaria through the development of new vaccines, drugs, diagnostics, and vector-control innovations. Despite these welcome increases, the President’s FY17 proposal cuts funding to several key accounts, including a $16.5 million cut for nutrition, $7.5 million for vulnerable children, and $13.5 million in cuts to neglected tropical disease (NTD) programs at USAID. The proposal also decreases funding for tuberculosis (TB) programs by $19.1 million, which comes in sharp contrast to the Administration’s National Action Plan for Combating Multidrug-Resistant Tuberculosis (MDR-TB), released in December 2015. These cuts could stifle promising work in global health R&D: Since 2014, the USAID NTD Program has been investing in R&D to ensure that promising new breakthrough medicines for filarial diseases can be rapidly evaluated, registered, and made available to patients. Limited funding could hamper these burgeoning efforts. The Administration’s MDR-TB Action Plan includes a strong research component. Limited funding for TB will hamper efforts to implement the plan and achieve its goals to accelerate R&D for new TB drugs, diagnostics, and vaccines to address the growing threat of drug resistance. Centers for Disease Control and Prevention Photo: CDC/Dr. Scott Smith Key accounts at the Centers for Disease Control and Prevention (CDC) received modest increases. The CDC Center for Global Health received a $15 million increase (3.5 percent) to $442.1 million, which bolstered funding for the Global Immunization ($224 million from $219 million) and Global Public Health Protection ($65.2 million from $55.2 million) programs. These accounts are critical for accelerating CDC’s role in developing and implementing novel vaccines and immunization programs, as well as for bolstering the agency’s role in capacity building for global health research and disease detection in partner countries. CDC’s Center for Emerging and Zoonotic Infectious Diseases (NCEZID) received a $49.6 million increase (8.6 percent), to $629.49 million. This increase will bolster NCEZID’s important work to develop new diagnostics, countermeasures, and innovative technologies for diseases like Ebola, rabies, and chikungunya. The additional funding will also help accelerate implementation of the National Strategy for Combatting Antibiotic-Resistant Bacteria. National Institutes of Health Funding for the National Institutes of Health—which conducts the bulk of the United States’ global health R&D—is also critical. For several key offices and institutes, the President’s FY17 budget proposes nearly flat funding: The National Institute of Allergy and Infectious Diseases (NIAID) received a $71.55 million increase (1.5 percent) to $4.7 billion. NIAID conducts vital R&D to accelerate the development of novel vaccines and other countermeasures to respond to public health emergencies—including the recent Ebola and Zika epidemics. The Office of AIDS Research (OAR) received level funding at $3.1 billion. Research conducted through OAR has been vital to the development of new tools and technologies to treat, diagnose, and prevent HIV and AIDS, and robust funding for research is critical to achieving an AIDS-free generation. Advancing global health requires a strong commitment to global health R&D. The President’s FY17 budget represents a promising start to advancing US leadership in global health innovation and is just the beginning of negotiations between Congress, US Agencies, and the Administration on final funding levels for FY17. GHTC will continue to monitor global health R&D accounts in the FY17 appropriations process and will support global health funding that facilitates sustained and robust investments in global health innovation. All $millions FY16 Omnibus FY17 President request FY17 President request v. FY16 enacted USAID Global Health Programs $2,834 $2,906.50 2.6% Tuberculosis $236 $191 -19.1% Malaria $674.00 $745 10.5% HIV and AIDS $330 $330 0.0% Maternal & Child Health $750 $814.50 8.6% Of which GAVI $235 $275 17.0% Nutrition $125 $108.50 -13.2% Neglected Tropical Diseases $100 $86.50 -13.5% Vulnerable Children $22 $14.50 -34.1% Global Health Security $72.50 $72.50 0.0% Family Planning & Reproductive Health $524 $544 3.8%     All $Millions FY16 Omnibus FY17 President request FY17 President request v. FY16 enacted CDC Global Health $427.12 $442.12 3.5% Global Immunization Program $219.00 $224.00 2.3% Of which Polio Program $169.00 $174.00 3.0% Of which Global Measles & others $50.00 $50.00 0.0% Global AIDS Program $128.40 $128.42 0.0% Parasitic Diseases and Malaria $24.50 $24.50 0.0% Global Public Health Protection $55.20 $65.20 18.1% CDC NCEZID $579.89 $629.49 8.6%     All $Millions FY16 Omnibus FY17 President request FY17 President request v. FY16 enacted NIAID $4,629.00 $4,700.55 1.5% Of which HIV and AIDS $1,400.05 Of which Biodefense & Emerging Infectious Diseases $1,370.35 Of which Infectious & Immunologic Diseases $1,081.69 Office of AIDS Research $3,100.06 $3,100.06 0% Of which Vaccines $553.91 Of which Therapeutics $645.29 Of which Microbicides $108.88