Posted by: blog4globalhealth | 02/14/2012


GHC Senior Policy Manager Craig Moscetti breaks down the President’s global health budget numbers

President Obama released his Fiscal Year 2013 budget request yesterday, showing an essential flat-line in international affairs funding, but a $300 million cut to U.S. global health programs, a 4% decrease from levels enacted last year. Most global health issues were requested at levels 3-5% lower than FY2012 enacted levels, though several accounts received much deeper cuts, notably bilateral funding for HIV/AIDS and neglected tropical diseases. There were exceptions, including a continued emphasis to support women and girls through family planning and reproductive health, which received a modest 1.1% increase. A more detailed breakdown of accounts under Global Health Programs (which replaces the Global Health and Child Survival Account) is below.


A closer look at the numbers reveals potentially dramatic implications for how the U.S. approaches global health specifically and aid effectiveness generally. The President, including in the GHI, has embraced a much stronger multilateral approach to foreign affairs. Within the GHI, this means a commitment to supporting partnerships like the Global Fund and GAVI. To achieve multi-year pledge to both – which are both positive steps from an aid effectiveness perspective – the FY2013 request includes significant increases for both – the Global Fund received a 27% increase from FY2012 levels, and 12% for GAVI.

The concerning part is a possible classic instance of robbing Peter to pay Paul. In the case of the Global Fund, the offset appears to come from bilateral HIV/AIDS funding. But does this move fail to recognize the complementary elements of U.S. bilateral HIV/AIDS programs and the Global Fund? The Global Fund and GAVI are recognized as two of the most efficient and effective global health institutions, but will this type of significant resource shift effect the balance between Global Fund and PEPFAR in the field?

In stepping back, however, the largest concern is with progression towards stated goals of the GHI, particularly the funding goal. Despite assurances that the President’s budget request supports a comprehensive approach to global health, funding for the Global Health Initiative is severely lagging behind its stated funding goal of $63 billion between FY2009 and FY2013. This year’s request still leaves a $20 billion gap for the GHI heading into its final year. Many in the global health community support the Administration’s strong embrace of efficiency and innovation, but will the huge funding gap prove too great to overcome for the Administration to achieve its stated global health goals?


  1. Global health issues are a concern in health care professional practice. Many of the citizens in the United States are more concerned with the issues surrounding local or national concerns and do not recognize the positive impact of global health initiatives. How can we help to support the initiative set forth by the GHC? As a nurse educator, I work to keep students informed of opportunities for involvement (both locally, nationally, and internationally) but the scope of students is often limited during their educational program. The GHC is setting forth initiatives that are worthy of support as world citizens. How can nurse educators be more involved and pro-active in supporting these world initiatives?

  2. While many diseases and illness plague our global community, funding for their treatment has become an increasing burden. No one denies the benefits of global health care. However, given the current economy budget cuts must be made to many, if not all, public programs to sustain government viability. These programs include those funding global health care such as the Global Alliance for Vaccines and Immunizations (GAVI) and the Global Health Council (GHC). This does not, however, mean that assistance should cease. Organizations must strive to increase efficiency in their operations, in order to provide the same or improved care for less money. In addition, organizations must have a primary focus of providing care to populations which truly require it. I believe that education regarding the impact of these illnesses on the local, national and global community may be the single most effective way to secure assistance. Additionally, innovation (Takepart, 2010), technology application (Smith, 2004) and volunteerism can assist with organizational health care efforts on a budget.
    Illness is not confined to a single country or population; it affects us all. Therefore, we must all strive to tighten our belts, lace up our boots, and get to work to find improved ways to combat these illnesses with the money that is available. Only with a collective and collaborative effort can we continue toward the realization of our Global Health Initiatives and a healthier global community.
    Smith, Coy. (2004). New technology continues to invade healthcare; What are the strategic
    implications/outcomes? Nursing Administration Quarterly 28(2), pp. 92-98. Retrieved from

    Takepart. (2010). Five improvised medical gadgets that save money and lives. Retrieved from

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