Kenneth Glad
Money approved for malaria, tuberculosis, HIV and other overseas health programs could be used to help pay for the dismantling of a major U.S. aid agency. The dispute centers on whether congressionally approved funds will reach disease, nutrition and maternal health programs as intended.
A congressional notification reviewed by CNN says the Trump administration wants to redirect about $2 billion from global health accounts to expenses tied to closing the U.S. Agency for International Development.
The notification, according to the network, involves accounts that support infectious-disease work, nutrition, maternal and child health and global health security programs.
The report said another $1.2 billion in foreign development assistance would also be moved.
The money would instead help pay USAID closeout expenses, including legal costs, unpaid invoices, asset sales and other wind-down costs.
More than $19.1 billion has been reserved for the shutdown process, much of it linked to canceled contracts.
Democrats object to funding shift
The proposal has become a fight over whether the administration is effectively blocking money that Congress already approved for foreign aid and health work.
Because Congress controls federal spending, lawmakers are arguing that the administration is sidestepping the purpose of funds already approved for health programs.
Seventeen Senate Democrats urged officials to reverse the move. In a letter cited by CNN, they said the funds should be used “to save lives and advance U.S. interests as directed by Congress last year.”
Analysts cited in the story warned that the shift could have severe consequences. The Health Security Policy Academy estimated that a $2 billion reduction could contribute to 121,000 preventable tuberculosis deaths and at least 47,600 preventable malaria deaths.
HIV program spending pace questioned
The USAID funding dispute comes as advocates are also questioning the pace of spending for PEPFAR, the landmark HIV/AIDS program launched by President George W. Bush in 2003.
Analysts believe that roughly $1.7 billion already approved for the program is being spent or transferred to implementing agencies much more slowly than in previous years.
Jennifer Kates, a global health policy expert at KFF, a U.S. nonprofit that researches health care and public health policy, told CNN: “When you see the number of people being tested going down… it suggests that people are being missed. They’re not being diagnosed.”
Charles Kenny of the Center for Global Development said disruptions had likely damaged care: “Some people will have dropped off permanently from getting meds.”
For aid advocates, the central question is whether money Congress approved for health programs will reach clinics, workers and patients before services are disrupted further.
Source: CNN, Health Security Policy Academy, Center for Global Development
