Bills
| 3.23.22

Should Congress Express Continuing Support for the Global Fund’s Critical Work Fighting AIDS, Tuberculosis & Malaria? (H. Res. 517)

Do you support or oppose this bill?

What is H. Res. 517?

(Updated December 8, 2019)

This resolution would express the House’s recognition of the critical gains that the Global Fund has made in fighting AIDS, malaria, and tuberculosis around the world. It would also support ongoing efforts by other donors to increase their financial commitments to the Global Fund and encourage continued buy-in to the Global Fund as it enters its sixth replenishment. Finally, it would affirm the historical U.S. commitment to financing 33% of the Global Fund.

As a simple resolution, this legislation is non-binding and wouldn’t advance beyond the House if passed.

Argument in favor

The Global Fund is an important international effort to fight AIDS, tuberculosis, and malaria. The U.S. — which provides 33% of the Fund’s funding — is critical to the Fund’s continued existence, and the Trump administration’s attempts to reduce funding for the Global Fund need to be staunchly resisted by Congress through measures like this one that expresses America’s commitment to the Global Fund.

Argument opposed

While it’s important for the U.S. to lead in the global fight against AIDS, tuberculosis, and malaria, it doesn’t make sense for the U.S. to contribute a full third of the Global Fund’s funding. Other nations should pull their weight, as the Trump administration has suggested. This resolution would absolve other countries of their obligation to also contribute to the Global Fund.

Impact

Congress; Congressional support for the Global Fund; the Global Fund; AIDS; tuberculosis; and malaria.

Cost of H. Res. 517

A CBO cost estimate is unavailable.

Additional Info

In-Depth: House Foreign Affairs Committee Chairman Eliot Engel (D-NY) introduced this resolution to express Congress’ bipartisan support for the Global Fund to fight AIDS, tuberculosis, and malaria. In floor remarks when the House Foreign Affairs Committee marked this resolution up on September 25, 2019, Rep. Engel said: 

“[M]y resolution with Mr. McCaul… demonstrates Congress’s bipartisan support for the Global Fund to fight AIDS, tuberculosis, and malaria. The Global Fund has contributed to incredible achievements in the fight against some of the world’s most terrible diseases. We cannot accept the Trump Administration’s drastic cut to this life-saving program. So, I’m pleased we are moving this forward and hope all members will join me in supporting it.”

Lead Republican sponsor Rep. Michael McCaul (R-TX) adds: 

“I am proud to lead this resolution demonstrating the United States’ longstanding commitment to the Global Fund, which has saved millions of lives and prevented the spread of the world’ most life-threatening diseases. Over the years, the Global Fund has made critical gains in fighting AIDS, tuberculosis, and malaria by increasing access to treatment, preventing new cases, and ultimately supporting people around the globe to lead healthy lives. I look forward to working with Chairman Engel and my colleagues in Congress to pledge our continued support for this vital and life-saving program.”

Former Global Fund executive director Mark Dybul is confident that the Global Fund will meet its replenishment target of $14 billion in 2019. In a June 2019 interview, he expressed optimism about the future of the Fund’s funding despite attempts from the Trump administration to reduce its funding: 

“What it will take is for people to recognize the links between health and economic growth, which are rock solid… The U.S. Congress has been rock solid. In fact, the budget committee just asked for an increase for the Global Fund so they basically ignored bad budgets.”

Dybul added that pulling back on support for the Global Fund would be “really stupid,” as “[i]t’s necessary for [the U.S.] to stay in the game for a while longer … It's not forever, but it's for a little bit. It's enlightened self-interest.” He added that funding the Global Fund is important as a means of addressing the global refugee crisis: 

“If you’re worried about migration refugees, if you have the population of Africa doubling — which we are projecting, even with decreased birth rates by 2050 — if you have 50-75% of populations 25, 35, and younger without health, education, economic growth, and opportunity, what do you think it’s going to look like?”

RESULTS, Inc. a nonprofit grassroots advocacy organization that champions specific policies and legislation to address poverty, supports this resolution. In a fact sheet, it says: 

“Just twenty years ago, HIV/AIDS, tuberculosis, and malaria were wreaking havoc on populations across the globe, killing millions in a worldwide crisis that disproportionately affected people in poor countries and communities. But the world came together to change the future. Countries pooled their resources and created the Global Fund to Fight AIDS, Tuberculosis and Malaria. Now almost two decades later, that international partnership has helped save 27 million lives. The progress in the fight against HIV/AIDS, tuberculosis, and malaria has been nothing short of remarkable, but key challenges remain…  It’s clear that more must be done and that without increased action, our progress to date is at risk. Renewed global commitment, including U.S. Congressional leadership, is critical for driving down these diseases of poverty.”

The Trump administration has proposed reduced U.S. contributions to the Global Fund and a reduced pledge amount. In its 2020 budget proposal, the Trump administration wrote, “The budget supports America’s reliable allies, but reflects a new approach toward countries that have taken unfair advantage of the United States’ generosity.” However, these proposals have been rejected by Congress. 

Anti-AIDS activists in particular took umbrage with the Trump budget proposal, arguing that the proposed global cuts are at cross-purposes with the administration’s request for $291 million in additional spending to “virtually eliminate” new HIV infections in the U.S.

More broadly, skeptics of the Global Fund have raised questions about the appropriate balance of U.S. spending between the Global Fund and U.S. bilateral programs, the role of multilateralism in U.S. global health policy, and the Global Fund’s sustainability given a shortfall in the availability of resources to meet country demand.

This legislation unanimously passed the House Foreign Affairs Committee with the support of 158 bipartisan House cosponsors, including 128 Democrats and 30 Republicans.


Of Note: The U.S. helped establish the Global Fund in 2002 to support the global fight against AIDS, tuberculosis, and malaria. Over the years, U.S. contributions to the global fund have leveraged billions in additional investments, saving 32 million lives as of the end of 2018. Overall, deaths caused by AIDS, tuberculosis, and malaria have fallen by 40% since 2002 in countries where the Global Fund invests. 

In 2018, key results of the Global Fund in the countries that it invests in were:

  • 18.9 million people on antiretroviral therapy for HIV;
  • 5.3 million people treated for tuberculosis; and
  • 131 million mosquito nets distributed.

The Global Fund’s work has led to a 50% reduction in AIDS-related deaths since 2005; contributed to a 37% decline in tuberculosis deaths over the period 2000-2016; and facilitated a 60% decline in the number of malaria deaths since 2000.

However, despite the Global Fund’s successes thus far, work remains to be done. RESULTS, Inc. a nonprofit grassroots advocacy organization that champions specific policies and legislation to address poverty, reports that tuberculosis is now the leading infectious killer, and health systems still miss 40% of cases each year. Meanwhile, progress in fighting malaria has stalled, and gains are at risk due to resistance to insecticides to stop mosquitos and drugs to treat the disease. While deaths from HIV/AIDS have been cut in half since their peak in 2004, poverty, stigma, and gender disparity still fuel the disease, and nearly 1,000 adolescent girls and young women are newly infected each day. Altogether, these three diseases continue to claim over three million lives each year.


Media:

Summary by Lorelei Yang

(Photo Credit: iStockphoto.com / Bulat Silvia)