Centers for Disease Control and Prevention Global Health Programs: FY2001-FY2010
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A number of U.S. agencies and departments implement U.S. government global health interventions. Overall, U.S. global health assistance is not always coordinated. Exceptions to this include U.S. international responses to key infectious diseases. For example, U.S. programs to address HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR), malaria through the President's Malaria Initiative (PMI), and avian and pandemic influenza through the Avian Flu Task Force. Although several U.S. agencies and departments implement global health programs, this report focuses on funding for global health programs conducted by the U.S. Centers for Disease Control and Prevention (CDC), a key recipient of U.S. global health funding. Congress appropriates funds to CDC for its global health efforts through five main budget lines: Global HIV/AIDS, Global Immunization, Global Disease Detection, Malaria, and Other Global Health. Although Congress provides funds for some of CDC's global health efforts through the above-mentioned budget lines, CDC does not, in practice, treat its domestic and global programs separately. Instead, the same experts are used in domestic and global responses to health issues. As such, CDC often leverages its own resources in response to global requests for technical assistance in a number of areas that also have domestic components, such as outbreak response; the prevention and control of injuries and chronic diseases; emergency assistance and disaster response; environmental health; reproductive health; and safe water, hygiene, and sanitation. From FY2001 to FY2009, Congress provided about $3.3 billion to CDC for global health programs. In addition, CDC received transfers from the Office of the Global AIDS Coordinator (OGAC) as an implementing partner of PEPFAR, and transfers from the U.S. Agency for International Development (USAID) for PMI. Including these transfers, CDC's spending on global health activities from FY2004 to FY2008 totaled $5.2 billion, of which 78% was targeted at HIV/AIDS programs. Data on FY2009 transfers have not yet been provided to CRS. President Barack Obama has indicated early in his Administration that global health is a priority and that his Administration would continue to focus global health efforts on addressing HIV/AIDS. When releasing his FY2010 budget request, President Obama indicated that his Administration would increase investments in global health programs and, through his Global Health Initiative, improve the coordination of all global health programs. The President requested that in FY2010, Congress approve $9.1 billion for all global health programs, including $479.8 million to CDC for global health programs--an estimated 3.4% increase over FY2009 enacted levels for CDC global health activities. In the House (H.Rept. 111-220) and Senate Appropriations Committee (S.Rept. 111-66) reports accompanying the FY2010 Labor, HHS, Education Appropriations (H.R. 3293), funds for CDC's global health activities exceed the President's request by some $4 million and $14 million, respectively. There is a growing consensus that U.S. global health assistance needs to become more efficient and effective. There is some debate, however, on the best strategies. This report explains the role CDC plays in U.S. global health assistance, highlights how much the agency has spent on global health efforts from FY2001 to FY2010, and discusses how funding to each of its programs has changed during this period. For more information on U.S. funding for other global health efforts, including those implemented by USAID, the Department of Defense (DOD), and the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) and debates about making U.S. global health assistance more efficient, see CRS Report R40740, U.S. Global Health Assistance: Background, Priorities, and Issues for the 111th Congress.
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