President’s Budget Proposal Takes Important Steps Toward Renewed Global Health Leadership, Leaves Challenging Gaps

With significant increases and meaningful investments in U.S. Centers for Disease Control and State Department global health programs, President Biden’s proposed budget for the coming fiscal year offers the promise of renewing our country’s role as a leader of infectious disease responses that can detect, prevent and contain public health threats where they emerge. In addition, the proposal reinforces commitment to the federal initiative to end HIV as an epidemic in America.

The proposal, however, leaves gaps, including in needed resources to address the growing crisis of antimicrobial resistance, that compromise our ability to confront immediate threats both at home and abroad. Without significantly increased investments in new infection fighting drugs, protection of existing ones and surveillance of pathogens and disease that do not respond to treatment, our defenses against current and future challenges to individual and public health will be gravely compromised. In addition, the proposal’s flat funding for global HIV and tuberculosis programs in the face of growing needs leaves the future of hard-won progress and ambitious goals in question.

Specifically, and commendably, the White House budget plan for FY2022 would provide:

The U.S. Centers for Disease Control and Prevention:

A $1.6 billion increase in funding for CDC over the 2021 enacted level, providing $9.497 billion in funding for improved data collection, training and disease detection efforts;
$698 million in overall funding for CDC Global Health, a $105 million increase over FY2021 funding;
$303.2 million for global health protection, a $100 million increase over FY2021 funding;
$400 million for improving public health infrastructure and capacity at CDC, which was not funded in FY2021;
$460.6 million for expanding Surveillance, Epidemiology, and Informatics at CDC, a $100,000 increase over FY2021 funding. This includes $150 million for the Public Health Data Modernization Initiative, a $100,000 increase over FY2021 funding;
$106 million for bolstering the public health workforce, a $50 million increase over FY2021.

The State Department and USAID:

$10 billion for global health programs;
$1 billion in foreign assistance to expand global health security activities, including to establish Global Health Security Agenda capacity-building programs, representing more than an $800 million increase in funding over 2021 enacted levels;
$995 million for global health security, with $745 million for USAID and $250 million for the State Department.

The National Institutes of Health:

A$9 billion increase over the 2021 enacted level for NIH for a total request of $51 billion;
$6.245 billion for the National Institute of Allergy and Infectious Diseases, a $179 million increase over FY2021 funding;
$96.322 million for the Fogarty International Center, a $12 million increase over FY2021 funding.

With significant gaps, though, the proposal leaves needed growth for critical endeavors stagnant with:

$172 million for CDC’s Antibiotic Resistance Solutions Initiative, level with FY2021 funding;
$30 million for CDC’s Advanced Molecular Detection Program, level with FY2021 funding;
$21 million for CDC’s National Healthcare Safety Network, level with FY2021 funding;
$128 million for Global HIV/AIDS, level with FY2021 funding.

The proposal recognizes critical needs with the allocations that follow, but more robust support is needed to meet the challenges ahead:

$714 million for the Immunization Program, a $100 million increase over FY2021 funding
$1.421 billion for the Divisions for Viral Hepatitis, STI Prevention, and TB Elimination, a $106.5 million increase over FY2021 funding, including a $100 million increase for the Ending the HIV Epidemic initiative and a $6.5 million increase for the ID and Opioids program;
- $2.555 billion for the Ryan White HIV/AIDS Program, a $131 million increase including $85 million for the Ending the HIV Epidemic initiative.

IDSA will continue to call on Congress to build a healthier world and a safer nation, with support for the vision exemplified by this budget proposal, and by filling the gaps it leaves, with the funding our global and domestic health security and progress will require.