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Global health advocates eye Ryan budget plan with concern

At a panel discussion on Monday organized by the national research advocacy group Research!America and hosted at the New York Academy of Sciences, speakers aired their concerns about the proposed 2013 US federal budget, which they say threatens to cut both grants for primary research and spending on foreign aid.

“Under Paul Ryan’s plan, the number of grants available for global health research would be reduced dramatically over the next decade,” Nita Lowey, a Democratic congresswoman representing the suburbs of New York City, said at the conference. The plan of Wisconsin Republican Paul Ryan would keep the 2013 budget for the US National Institutes of Health (NIH) flat, and could decrease funding for basic research grants and for foreign aid between 2014 and 2024 by an unknown amount determined by a “review of the long-term budget outlook every 5 years”, as part of a larger goal to reduce federal spending by $261 billion.

Representatives from New York’s Global Alliance for TB Drug Development and the International AIDS Vaccine Initiative and Geneva-based Drugs for Neglected Diseases Initiative, agreed that the success of their initiatives relies on the US Congress passing greater federal funding for global health. “Without federal funding we’d have a lot less of the basic knowledge of disease mechanisms, which we in the pharmaceutical industry apply to develop drugs,” explained Pol Vandenbroucke, vice president of development for emerging markets at New York’s Pfizer, who said even private players in the global health community rely on government spending.

The speakers contrasted the US government’s possible shrinking global health spending with the findings of a poll released by Research!America on Monday that shows 64% of New Yorkers support spending on global health initiatives such as vaccine development and prevention of diseases such as malaria and tuberculosis. And New York is not alone: panelists at Monday’s conference on the future of global health institutions in New York said that national support for and interest in such initiatives has increased steadily over the past decades, as national surveys conducted by the Pew Research Center and the Kaiser Foundation demonstrate. Another indication of such support is that “all over the country, public health masters students overwhelmingly state global health is their number one interest,” as opposed to historically popular fields of epidemiology or health economics, said moderator Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, a New York-based think-tank.

Lawmakers and global health advocates called on researchers, pharmaceutical companies and funding partnerships to actively expand congressional lobbying for their global health initiatives, or risk severe federal budget cuts for such projects in coming years. “Public support is there, but it’s extremely important that those who work in global health publicize what they do,” Mary Woolley, president of the Research!America, a non-profit research advocacy organization based outside Washington, DC, told Nature Medicine. “If we want Congress’ budget to reflect the public support we know exists for global health, we will need to do a better job on outreach and advocacy.”

But not everyone on the panel is looking to Washington as the end all of funding. “I think we’ve got the players in the right position, but we’ve really got a slash and burn Congress,” said Mel Spigelman, president of the Global Alliance for TB Drug Development. In a time of belt-tightening and legislative gridlock, he and others on the panel agreed, private funders such as the Seattle-based Bill & Melinda Gates Foundation and the New York-based Clinton Foundation may be the most reliable resources for funding global health initiatives.


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