Domestic TB funds probably still secure

Impact of terrorist attacks on the budget

Last month’s terrorist strikes could actually help prospects for domestic TB funding, as well as other good causes with strong bipartisan support, say policy experts at the American Lung Association (ALA) in Washington, DC.

The $40 billion Congress swiftly approved last month in emergency funding will "almost surely" come from the once-sacrosanct Social Security Trust Fund surplus, says an ALA policy analyst who asks not to be named. "Once the piggy bank is broken," the analyst adds, Congress may be less reluctant to tap into the trust fund money for other causes, including TB control.

Debate on next year’s budget for domestic TB spending had been set to start the week of Sept. 10. As this newsletter went to press, debate had been postponed by last month’s events for at least a week, and perhaps longer.

Budget serves to set tone

The domestic TB bill, called the Omnibus TB Control Act, seeks an increase of $200 million for domestic TB control programs and asks for $240 million for TB research at the National Institutes of Health. In his proposed budget, President Bush had indicated he would seek flat funding for the Centers for Disease Control and Prevention; at that time, ALA experts remained hopeful, pointing out that the proposed presidential budget served only to set a tone, not to establish policy.

As last month drew to a close, the fate of funding for international TB control was looking bleaker. Well before the terrorist attacks, the full House had approved only $90 million for international TB control. An additional $20 million was added as part of $100 million approved by the House for the Global AIDS Fund. (Supplemental funds along with money from a separate bill were expected to raise the total for the Global Fund to about $300 million.)

A comparable Senate bill for international TB spending that was before an appropriations committee would have awarded even less than the House version — only $70 million for international TB control programs and $50 million for the Global AIDS Fund.

The STOP-TB Now Act, the companion bill for international TB spending, had sought $200 million for 2002 international TB control activities. The Global AIDS Fund, according to World Health Organization experts, was seeking at least $1 billion in contributions from the United States.