See below for a guest post from Christopher J. Elias, MD, MPH, President and CEO of MFAN Partner PATH on the severity of House-proposed cuts to the 150 account, particularly looking at the impact such cuts would have on global health programs worldwide.
As the president and CEO of PATH, a nonprofit organization that helps to improve the health of some of the world’s poorest people, I am deeply concerned about the drastic cuts to global health funding proposed by the U.S. House of Representatives for the fiscal year 2012 budget. In the 70 countries where PATH works, we see firsthand the benefits of the leadership role that the U.S. government plays in global health not only in terms of lives saved abroad, but also in relation to U.S. diplomacy efforts and the U.S. economy. We recognize that the success of global health, as well as every other development sector, depends on the stability of the international affairs budget overall.
The U.S. House of Representatives’ proposal reduces the so-called “150 account,” which contains spending on global economic, diplomatic, and humanitarian programs by the U.S. Department of State, the U.S. Agency for International Development (USAID), and the Millennium Challenge Corporation, among others, by a total of 18 percent. Global health funding, which is part of this account, would be cut by roughly 9 percent, and more cuts are possible down the line. If this funding is not protected, we face the risk of reversing many of the impressive, lifesaving gains our community has made over the years.
No one would disagree with the premise that the United States needs to get its fiscal house in order. At the same time, we need to be smart about what programs are cut. Taking a hatchet to this very small piece of the fiscal pie, which accounts for less than 1 percent of the U.S. federal budget, would do much more harm than good to the American economy.
Today, 50 percent of our exports go to countries in the developing world, and that trend is expected to accelerate at the same time that our trade with other industrialized nations slows. Choosing to cut investment now to countries that have the potential to become America’s next big trading partner is not only myopic, but fiscally imprudent.
In a similar vein, American jobs depend on the business we do abroad. In fact, more than 20 percent of our jobs rely on international trade, particularly trade with the developing world where markets are growing faster than anywhere else. In a letter to Representatives Nita Lowey and Kay Granger, chairs of the House Subcommittee on State and Foreign Operations, the U.S. Chamber of Commerce wrote, “The international affairs budget play[s] a vital enabling role for U.S. companies to tap foreign markets and create jobs and prosperity at home.”
In addition to benefiting our economy, international aid programs have been proven to strengthen our national security. The military’s top brass have lauded development as a cornerstone of America’s overall foreign policy. As Defense Secretary Robert Gates succinctly put it, “Development is a lot cheaper than sending soldiers.”
Our development efforts are not only cost-effective, they promote a positive image abroad. Rajiv Shah, administrator of USAID, has spoken at length about the “values” that our civilian forces express overseas. This is evident in much of the work USAID does: the agency’s quick response to last year’s natural disaster in Haiti; the distribution of insecticide-treated bed nets in malaria-prone countries; and the educational opportunities it has helped to provide to girls and women throughout the world. The return on investment for these initiatives is not always easy to quantify, but without them, the costs both at home and abroad would be tremendous. The “soft power” that we exert through our international affairs programs plays a key role in staving off the very conflict and instability that puts our national security at risk.
The appropriations decisions that Congress has before it are not easy, but indiscriminately cutting programs, especially programs that are working, is hardly the solution. Reducing funding for malaria control, for instance, would be “a foolish waste of a historic opportunity,” according to Awa Marie Coll-Seck, executive director of Roll Back Malaria. In the last ten years alone, the lives of nearly 750,000 children were saved across 34 African countries, the equivalent of about 485 children every day. Much of this success is due to the efforts of the U.S. government, particularly the President’s Malaria Initiative. To suddenly slash investment in malaria-control programs would severely hurt our chances of winning the war against this age-old disease and leave millions of children vulnerable.
There are many more examples of how U.S.-funded global health programs have made substantial progress against devastating diseases that exacerbate poverty. And there are many more examples in the other areas of the 150 account. With less than 1 percent of the U.S. federal budget, we have managed to accomplish some amazing feats, not only in the global health context, but throughout the development sector, and this is cause for celebration. If these dollars are cut any further, though, it is hard to say what we’ll have left to celebrate.