Last Friday, the Office of Management and Budget (OMB) delivered to congressional appropriators the Trump administration’s proposal for negotiating a final fiscal year 2017 spending package before the current continuing resolution (CR) keeping the federal government operating expires on April 28th. In a table leaked to the media, OMB proposes “reduction options”—otherwise known as funding cuts—for non-defense discretionary programs totaling $18 billion—the amount necessary to offset supplemental funding the Trump administration is requesting for the Department of Defense and for a down-payment on construction of the Mexican border wall.
Like the Trump administration’s FY 2018 “skinny” budget blueprint, released on March 16th, the FY 2017 proposed cuts are being dismissed out of hand on Capitol Hill. Nevertheless, the proposal does bring into clearer focus the administration’s spending priorities, which clearly do not fall in the international affairs arena.
Tucked into the “reduction options” table are a proposed cut to bilateral funding for international family planning and reproductive health (FP/RH) programs of $114 million below the FY 2017 CR level (a nearly 19 percent reduction), and zeroing out the U.S. contribution to the United Nations Population Fund (UNFPA). Taken together, the recommended cut to USAID bilateral FP/RH programs and elimination of the UNFPA contribution of $32.5 million would total $146.5 million or a reduction of nearly one-quarter (24 percent).
The magnitude of the proposed cut to FP/RH programs was not surprising. In fact, it represents perhaps the best case scenario one might hope for coming out of this administration. Nevertheless, the low level is another disheartening signal after the imposition of an expanded Global Gag Rule of the administration’s anti-family planning antipathy. When the detailed FY 2018 budget request is released in May, family planning advocates might be elated if the proposed FP/RH funding level is anywhere close to this amount.
OMB is proposing $461 million for bilateral FP/RH for a final FY 2017 appropriation. This is misleadingly described in the table as a $62 million cut from FY 2017 CR level of $523 million. In reality, the comparable figure is a statutory earmark of $575 million for FP/RH in all bilateral accounts, including $523.95 million specified in report language from the Global Health Programs (GHP) account and the remaining $51 million from the Economic Support Fund (ESF) for FP/RH activities in three countries—so in fact, a $114 million slashing.
The size of the proposed cut is described as reducing the “level for this program to the FY17 House committee ceiling.” The table does note the considerably larger FY 2017 Senate committee-approved level of $544 million, but again understates the size of the reduction by ignoring the statutory earmark of $585 million for FP/RH programs in all bilateral accounts. (This earmark is accompanied by report language specifying $544 million from the GHP account and $41 million from ESF.) In fairness, the cuts to FP/RH paid for with ESF could be contained within the overall $290 million cut proposed for ESF. However, FP/RH is not specifically named in the accompanying justification, unlike climate change, education, democracy and governance, and economic growth programs which are pointedly called-out.
The International Organizations and Programs account (IO&P), which contains the voluntary contributions to UN agencies, would suffer a cut of $169 million, including zeroing out UNFPA, earmarked at $32.5 million in the FY 2017 CR. The justification in the table states, “This reduction would eliminate such contributions to most organizations funded through this account including the UN Population Fund and some climate change programs but preserve flexibility to make contributions to some organizations such as UNICEF as well as those supporting global security functions.”
Given the unrelenting assault that international family planning programs have been under since the inauguration, there are perhaps opportunities for increased solidarity with global health advocates in other sectors to be found in this disastrous, albeit doomed, administration proposal. With the apparent exceptions of malaria and maternal and child health programs, no other global health sector is spared from the budget axe, including George W. Bush’s signature initiative, the President’s Emergency Plan for AIDS Relief (PEPFAR). State Department PEPFAR funds are slated for a $242 million cut, a large amount of money but less than a six percent hit. Among the activities to be reduced to achieve the proposed savings are “lower-priority prevention programs.” Based on Vice President Pence’s voting record in Congress and tenure as Indiana governor, it is probably safe to speculate that of these programs, condom promotion to high-risk groups will be on the chopping block—versus abstinence and “be faithful” education.
In addition to the recommended cut to PEPFAR, funding for global health security programs of $72 million, which help protect U.S. citizens from overseas epidemics reaching American shores, is proposed for elimination, which OMB seeks to justify by the use of pipeline funding and a reprogramming of unspent Ebola funds. Other specified USAID global health programs targeted for $90 million in cuts or about 17 percent from current levels include: tuberculosis ($45 million), polio ($8 million), nutrition ($16 million), vulnerable children ($8 million), and neglected tropical diseases ($13 million).
The appropriations committees have been diligently negotiating and appear close to finalizing an omnibus spending package for FY 2017. Funding levels are largely settled. Some policy “riders” remain outstanding, but there is reportedly progress on that front as well. Appropriators are suggesting that the administration’s supplemental funding requests may need to be deferred, despite OMB’s pitch last Friday for “reduction options” to fund defense increases and the border wall. If all goes according to plan, a final conference agreement would be attached by the Senate to the House-passed defense appropriations bill after the Easter recess and a government shutdown or a year-long CR will be avoided.