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March 14, 2023

The Biden administration’s fiscal year 2024 (FY24) budget request is a mixed bag for global health research. The request includes a few bright spots, especially for global health security, but overall fails to address the significant gaps and recent setbacks for global health.

For the State Department and the US Agency for International Development (USAID), the request includes increases to global health security—including to the Coalition for Epidemic Preparedness Innovations—but otherwise proposes cuts to bilateral HIV, tuberculosis, and malaria programs.

  • These proposed cuts to the President’s Emergency Plan for AIDS Relief, and tuberculosis and malaria programs at USAID are especially disappointing at a time when these programs face lingering setbacks from COVID-19.
  • GHTC was especially disappointed that the request did not include additive funding under USAID for a new global health research and development line, a proposal supported by more than 100 global health organizations and former senior USAID officials.

In the Department of Health and Human Services, GHTC was disappointed that the budget proposes flat funding to the National Institute of Allergy and Infectious Diseases and the Fogarty International Center.

  • The Fogarty International Center trains infectious disease researchers, invests in health systems, and improves pandemic preparedness around the world. It is a best buy for global health.

GHTC applauds the proposed increases to the US Centers for Disease Control and Prevention’s National Center for Emerging and Zoonotic Infectious Diseases and Global Health Center, including to Global Public Health Protection and the Division for Parasitic Diseases and Malaria.

  • These centers track infectious diseases globally, support the development of new technologies, and provide technical expertise to many partners in the United States and globally.

In addition to an increase for the Biomedical Advanced Research and Development Authority (BARDA), GHTC applauds the Biden administration for including a longstanding priority for our community: proposing a new line of funding at US$400 million for emerging infectious diseases (titled Pandemic Preparedness and Biodefense) under the Administration for Strategic Preparedness and Response.

  • Nearly all BARDA’s support for emerging infectious disease (EID) medical countermeasures to date has been funded through emergency supplemental appropriations. This new line will enable the agency to be proactive, rather than reactive, to future pandemic threats.
  • Beyond EIDs, however, GHTC is disappointed that the request deprioritizes antimicrobial resistance research, proposing $155 million in support for the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator, or CARB-X, and the advanced development of new antimicrobial therapeutics at BARDA—$30 million less than for fiscal year 2023, despite a topline increase.

GHTC urges Congress to build upon the Biden administration’s request and to pass a spending package for FY24 that recognizes how far we are from achieving our goals for global health research and development. Achieving these research milestones is critical for achieving our national and global health objectives.