Threat to global health not over, just delayed

What does “sequestration” mean, and how might it be dangerous for global health? Sequestration legislation threatens across-the-board cuts to encourage Congress to work out a balanced budget on its own. If they can’t, sequestration authorizes the treasury to withhold funds previously allocated in the appropriations process from government agencies. If Congress exceeds the time allotted to reach a budget agreement this year, there will be an automatic 5.1 percent cut in funding to most non-defense discretionary programs.

The end of 2012 was characterized by months of efforts by the global health community to prevent disproportionate sequestration cuts from hurting the Global Health account the most, with Congress postponing a decision on sequestration just before the early 2013 deadline. The resultant American Taxpayer Relief Act
(H.R.8) bought two additional months of negotiation time—or $24 billion in spending—through an increase in taxation and cuts to discretionary spending for fiscal years 2013 and 2014. H.R. 8 will delay automatic sequestration spending cuts from kicking in until March 1. In addition to educating members of Congress on the danger of disproportionate cuts to global health in March, the global health community will begin making the rounds to request fiscal year 2014 budget appropriations starting in early February.

Despite the policy jargon, the ultimate decisions that arise from these complex budget discussions resonate far beyond the walls of the Capitol building; lives hang in the balance. According to estimates from amfAR, the Foundation for AIDS Research, real effects of sequestration to global health accounts include* (based on the previous estimates of a 5.1 percent cut):

  • 165,400 fewer people will receive HIV/AIDS treatment, potentially leading to 37,700 more AIDS-related deaths and 74,300 more children becoming orphans.
  • 64,700 fewer HIV-positive pregnant women will receive services to prevent mother-to-child HIV/AIDS transmission, leading to more than 12,300 infants being infected with HIV.
  • 656,000 fewer children annually will have access to quality primary school education.
  • 1.2 million fewer insecticide-treated nets will be available under the Global Fund to Fight AIDS, Tuberculosis and Malaria, leading to 3,100 deaths from malaria.
  • 54,800 fewer people with tuberculosis will receive treatment, leading to 6,600 more deaths due to TB.
  • 805,200 fewer vaccines for children will be available through the Global Alliance for Vaccines and Immunizations, leading to 8,500more deaths from diphtheria, tetanus, pertussis, Haemophilus influenza type B, and hepatitis B.

Global health advocates are doing everything in their power to give a voice to those who will be affected by these budget cuts. To protect global health funding, help us share stories of success to send a message to policymakers that our investments in global health are paying off. Stay in touch with us on Twitter at @macepa_tweets and on Facebook at Malaria Control and Evaluation Partnership in Africa for the latest.


*Estimates from the Center on Budget and Policy Priorities and amfAR, the Foundation for AIDS Research,

Photo: Laura Newman/PATH

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