On 22 March, the U.S. Congress approved a budget for Fiscal Year (FY) 2018, which includes a $1.35 billion contribution for the Global Fund, equal to what the U.S. contributed in FY 2017. In so doing, Congress ignored a proposed budget from President Donald Trump which would have resulted in $225 million less funding for the Global Fund. In the U.S., FY 2018 runs from 1 October 2017 to 30 September 2018. The $1.35 billion for the Fund is the first contribution by the U.S. towards its pledge of $4.3 billion for the period 2017–2019. For 2014–2016, the U.S. contributed $4.1 billion. U.S. Senator Rand Paul holding up what he said were the 2,232 pages of the budget bill. (We didn’t count.) The photo is from a Twitter post he sent. The Congress also resisted President Trump’s call for steep budget cuts in other areas, including other global health programs and the State Department. The FY 2018 budget allocated funding for three important U.S. bilateral programs: $4.65 billion for PEPFAR (President Trump wanted a $1 billion cut); $755 million for the U.S. President’s Malaria Initiative; and $261 million for USAID’s TB program. The FY 2018 budget provides $54 billion for “state and foreign operations.” This is down about 6% from the FY 2017 budget because the latter included some one-time costs. President Trump had sought a 30% cut. The FY 2018 budget also allocated $37 billion to the National Institutes of Health (NIH), up $3 billion from FY 2017 (President Trump had sought a $7 billion cut). The NIH funds clinical and biomedical research, including for HIV, TB and malaria. On 23 March, the advocacy organization Friends of the Global Fight Against AIDS, Tuberculosis and Malaria (Friends) published a statement expressing its gratitude to “global health champions on Capitol Hill for sustaining funding for the Global Fund and other global health accounts in the FY 2018 appropriations bill.” But Friends was already focusing on the FY 2019 budget. On 16 March, two members of the House of Representatives sent a letter to the leadership of the House Appropriations Subcommittee on State Foreign Operations and Related Programs calling for continued, robust funding in FY 2019 for PEPFAR and the Global Fund. Friends worked with several other members of the Global AIDS Policy Partnership to successfully increase the number of Representatives’ signatures on the letter (compared to the previous year). This year’s letter included 162 House Members, and more than doubled last year’s number of Republican signatures (from eight to 17).

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