WASHINGTON -- Less than two months after unveiling a plan to fight multidrug-resistant tuberculosis, President Barack Obama has proposed cutting the U.S. Agency for International Development's funding to combat the world's No. 1 infectious killer -- by 19 percent.
This will be the fourth budget in a row from the Obama administration that calls for a 19 percent cut to tuberculosis funding at USAID. In each of the previous years, Congress rejected that reduction. If lawmakers approve this week's funding proposal -- at $191 million, down from $236 million last year -- it would be the lowest level of spending on tuberculosis since fiscal year 2009.
Dr. Eric Goosby, the United Nations special envoy for tuberculosis, called it "astonishing" that Obama's fiscal year 2017 budget would "severely cut" tuberculosis funding. "To turn the [National Action Plan] into more than words on a page, resources are needed," he said in a statement Tuesday.
The White House's National Action Plan for Combating Multidrug-Resistant Tuberculosis, released in late December, lays out a series of ambitious goals to fight the international spread of the deadliest forms of the disease. Those with multidrug-resistant tuberculosis have about a 50 percent cure rate.
Rep. Eliot Engel (D-N.Y.), a longtime advocate for tuberculosis funding and a member of the Tuberculosis Elimination Caucus, echoed Goosby's words.
"If you don't have money with the plan, we can talk about pie in the sky all you want," Engel said. "But if you don't put your money where your mouth is, it's worthless."
Tuberculosis was identified as the world's No. 1 infectious killer this past fall, infecting over 9 million and killing 1.5 million people a year. Global health experts are increasingly worried over the threat that the drug-resistant forms of TB pose to eliminating what is otherwise a treatable and curable disease.
For more on multidrug-resistant tuberculosis, read this special report from The Huffington Post.
Advocates were heartened by the administration's release of the National Action Plan, as many thought it signaled a new U.S. focus on fighting tuberculosis.
But then came the proposed budget cut.
"President Obama is either getting bad advice on the importance of addressing TB or is not really using good advice that he's getting," said Dr. Randall Reeves, a professor of medicine and public health at the University of Colorado, Denver. "It's hard for me to understand with the burden of TB globally and the way it affects the United States that he could really justify proposing a cut in TB funding for USAID."
Christine Lubinski, the vice president of global health at the Infectious Diseases Society of America, suggested that it seems "kind of bizarre, frankly, that on the heels of putting out a plan, you would actually propose again to cut the overall program."
Most TB advocates contacted by HuffPost suggested that Congress will again maintain the current level of USAID funding for tuberculosis, but that's a best-case scenario.
"Fortunately, Congress has consistently rejected those cuts and restored the TB budget," said John Paul Fawcett, director of global policy and advocacy at the nonprofit Results. "But that's put us in a position and put Congress in a position of basically spinning our wheels while TB is literally evolving to be more deadly."
Sen. Sherrod Brown (D-Ohio), another major voice for greater tuberculosis funding, said he was disappointed in the proposed reduction and promised to push for restoration of funding in the appropriations process.
"Following the comprehensive approach outlined in the National Action Plan, I'd hoped the President's budget would increase funding for our efforts to eliminate this deadly disease and scale up services for drug-resistant TB," Brown said via email. "Every minute we delay this plan, TB continues to kill and won't relent without our attention and resources."
Rep. Chris Smith (R-N.J.), who convened a congressional hearing on the growing global threat of multidrug-resistant TB, was similarly disheartened.
"The administration's habitual short-sightedness exacerbates efforts to address, mitigate and protect from worldwide epidemics -- including TB, the top infectious disease killer worldwide," Smith said in an emailed statement.
If you don't put your money where your mouth is, it's worthless. Rep. Eliot Engel
Under the administration's budget plan, funding for the Centers for Disease Control and Prevention's domestic efforts to fight TB would also remain flat at $142 million. Money for the Global Fund to Fight AIDS, Tuberculosis and Malaria would also stay the same at $1.35 billion.
Ryan Essman, a press officer for USAID, stressed that the U.S. continues to be the largest donor to the Global Fund. In years past, administration officials had pointed to actual increases in money for the Global Fund to justify proposed cuts to USAID funding.
"We, the small number of TB advocates, can't figure it out," Lubinski said of the string of proposed cuts. "We're stepchildren, doesn't matter what the context is."