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The Global Health Technologies Coalition (GHTC) commends Congress for its bipartisan work to advance and approve a fiscal year 2026 spending package, which sustains and strengthens critical US investments in global health research and development (R&D)—including the creation of a first-of-its kind health R&D initiative at the Department of State. We applaud the Appropriations Committees for their steadfast leadership and bipartisan, bicameral collaboration in crafting legislation that reinforces a long-term, forward-looking vision for advancing high-impact global health innovation.  “This bipartisan minibus represents a meaningful reaffirmation of the United States’ commitment to advance lifesaving global health innovation,” said Dr. Kristie Mikus, Executive Director of GHTC. “These investments will help ensure the United States remains a global leader in developing the tools needed to prevent, detect, and respond to emerging health challenges, while also addressing long‑standing health challenges that continue to impact millions of people worldwide.” GHTC is particularly encouraged by the creation of a new “Prevention, Treatment, and Response Initiative” at the State Department. This initiative establishes and funds a disease-agnostic R&D mechanism within US global health programs—a concept GHTC has long championed through its Supporting Innovative Global Health Technologies (SIGHT) Fund proposal and one that has received broad support from the global health community. We look forward to working with congressional policymakers and the administration to ensure this new initiative accelerates the development and delivery of lifesaving innovations to the people and communities that need them most. GHTC also welcomes the bill’s funding increase for our nation’s biomedical innovation engine at the National Institutes of Health, including sustained investments in the National Institute of Allergy and Infectious Diseases and the Fogarty International Center. Continued support for basic research and scientific discovery is vital to maintaining US leadership in biomedical science and advancing innovation that benefits patients and public health and ensures the nation remains at the forefront of innovation and preparedness. These institutions form the indispensable backbone of our global health security apparatus and underpin the domestic biotechnology ecosystem. Finally, GHTC celebrates sustained investments in the Centers for Disease Control and Prevention’s Global Health Center and National Center for Emerging and Infectious Zoonotic Diseases, the Advanced Research Projects Agency for Health, the Biomedical Advanced Research and Development Authority, and other key offices driving R&D progress against the world’s most pressing health challenges. GHTC stands ready to support the effective implementation of these investments to advance a healthier, more secure future for all. 

The Global Health Technologies Coalition (GHTC) welcomes the strong research and development (R&D) focus in South Africa’s draft health ministerial declaration, which recognizes the vital role of science and innovation in strengthening health systems, advancing equitable access to medical countermeasures, and supporting sustainable economic growth. However, much of the R&D language in the text lacks clear commitments, specific targets, or actionable measures needed to translate these ambitions into tangible outcomes.We commend the draft declaration’s explicit call to “foster scientific collaboration to accelerate the development of safe and effective vaccines, therapeutics, and diagnostics” and to “develop resilient and sustainable health R&D ecosystems.” The emphasis on building regional manufacturing capacity, reinforcing supply chains, and investing in a skilled health workforce reflects a welcome commitment to a more distributed and equitable innovation ecosystem capable of responding rapidly to future outbreaks. We also welcome the declaration’s endorsement of sustained domestic investment lines for R&D to promote self-reliant science ecosystems.We applaud the recognition that “international collaboration and efforts to accelerate end-to-end development of therapeutics” are vital to address persistent gaps across the R&D pipeline, including through partnerships between research institutions in low- and middle-income and high-income countries. Specifically, the draft’s focus on strengthening regional science hubs and building “transparent, inclusive, and responsive science advisory mechanisms” echo GHTC’s long-standing advocacy for collaborative and equitable R&D models that leverage regional expertise and ensure innovations are designed for—and accessible to—all populations.GHTC also notes South Africa’s elevation of antimicrobial resistance (AMR) in its health agenda. This inclusion in the ministerial text reflects a growing recognition of the threat of AMR and the need for novel health technologies to address it, marking an important step forward during South Africa’s presidency.While this robust language across the document reflects the progress our community has made in ensuring R&D is recognized as a key pillar of health progress, we are disappointed to see that G20 leaders failed to rally around a clear set of commitments or targets and failed to build on deliverables promised by South Africa’s original health agenda.For example, while advocates have praised South Africa’s efforts this year to mobilize a coalition for the development of therapeutics, the text lacks the operational details needed to establish the group. It also omits reference to South Africa’s proposed Commission on Science and Innovation for Health and Economic Growth, underscoring the gap between the ambitions that had been outlined and the tangible outcomes that were delivered through this year’s G20 process.The draft only briefly touches on the Coalition for Local and Regional Production, Innovation, and Equitable Access that emerged from Brazil’s G20 presidency last year. While this was an exciting R&D development to stem from the G20, momentum to carry it forward continues to stall.Finally, while the text underscores the importance of long-term investments in R&D and domestic resource mobilization, it falls short of offering concrete funding targets or commitments, highlighting a lack of political will among leaders to advance new investments.As the G20 finalizes the declaration, we call on health ministers to not only preserve the R&D language in the text but to strengthen it with concrete, actionable measures that advance innovation, ensuring that the G20 remains a forum where global health, particularly lifesaving R&D, remains a top priority.

123September 29, 2025   The Honorable Shelley Moore Capito  Chair Senate Committee on Appropriations  Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies Washington, DC 20510  The Honorable Tammy Baldwin  Vice Chair Senate Committee on Appropriations  Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies Washington, DC 20510   The Honorable Robert Aderholt Chair House Committee on Appropriations  Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies Washington. DC 20515  The Honorable Rosa DeLauro  Ranking Member House Committee on Appropriations  Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies Washington, DC 20515  Dear Chair Capito, Chair Aderholt, Ranking Member Baldwin, and Ranking Member DeLauro:  On behalf of the TB Roundtable, a group of organizations that advocates for robust domestic and global federal tuberculosis (TB) funding, legislation, and policies that support eradicating the disease, and the undersigned fourteen organizations, we thank you for your continued work on Fiscal Year (FY) 2026 appropriations and your commitment to fighting TB around the world, including efforts to fight the disease here in the United States.  As the House and Senate committees move to conference their FY 2026 Labor, Health and Human Services, and Education, and Related Agencies bills, we respectfully ask that you protect funding for the Global Tuberculosis CDC program. Additionally, we urge you to refrain from consolidating Sexually Transmitted Disease and Tuberculosis Prevention grants under the CDC’s Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention program in a final FY 2026 appropriations bill.  Globally, TB has resurged as the deadliest infectious disease, infecting 10.8 million people and killing 1.25 million people in 2023 alone. Since TB is the world’s leading infectious disease killer, the TB community of health experts, researchers, implementers, and advocates emphasizes the urgent need for increased resources to outpace this disease to decrease preventable deaths and infection rates. TB continues to disproportionately affect people in poor and vulnerable communities around the world and domestically in the U.S. Further, cuts to programs that help identify and treat TB alongside under-resourced programs over the past two decades have led to harder-to-treat and deadlier strains of drug-resistant TB (DR-TB), multi drug-resistant TB (MDR-TB), and in rare cases extensively drug resistant TB (XDR-TB). Drug-resistant forms of TB continue to drive rising rates of antimicrobial resistance globally.  Recent funding disruptions to global TB programs have resulted in people sick with TB going undiagnosed and, in some cases, losing access to lifesaving treatment. These disruptions are projected to lead to about a 30 percent increase in TB incidence, which includes new multi-drug resistant (MDR-TB) cases in the U.S. in the next year. Additionally, because of the failure to control the global TB epidemic, experts estimate that it will cost the U.S. health system an additional $40 million next year to treat and manage TB in the U.S. As cases continue to rise across the globe, it is imperative to continue the CDC’s Global Tuberculosis work to coordinate with countries to prevent, diagnose, and treat TB. The CDC’s Global TB program is uniquely positioned and skilled to strengthen laboratory networks and infection control measures. Their efforts enhance surveillance and response systems to prevent outbreaks and monitor TB trends globally, particularly for drug-resistant TB. If these cuts are enacted, a resurgence of TB globally is expected which will lead to additional domestic drug-resistant TB outbreaks despite decades of declining rates of diagnosis in the U.S. With a lean budget, CDC’s global TB program is focused on stretching U.S. investments further and supporting other governments to increase their own investments. CDC’s global TB program partners with countries like the Philippines and India, who invest tens of millions of dollars in their own domestic resources against TB every year, to strengthen their programs. TB programs continue to face historic strain as the frontline response against airborne infectious diseases, and as TB rates and deaths continue to rise.  The CDC’s domestic TB programming keeps Americans safer and healthier. TB continues to be detected in every U.S. state and territory and the highest number of TB cases in over ten years. The CDC estimates up to 13 million people in the U.S. live with latent TB infection–of which 1 in 10 will get sick with active TB. Recent large outbreaks in Kansas have highlighted the need for robust TB monitoring and funding to preserve core public health infrastructure. Our previous success in reducing TB numbers in the U.S. can be directly attributed to the dedicated funding provided to CDC's Division of TB Elimination.  Prior to receiving directly appropriated funding, states and local health departments received funding for TB control in communicable disease block grants. As TB cases declined after a surge of the disease in the early 20th century, categorical federal funding ended and local funding was shifted to other priorities. However, this de-prioritization resulted in a deadly resurgence of the disease in the 1990s, with over 25,000 TB cases being reported per year. Following a significant federal investment in TB control activities in 1993, with a return to designated funding for TB control activities, TB cases began to decline nationwide. Currently, the House FY 2026 LHHS report proposes taking the country back to the block grant structure we know will lead to higher TB cases and consolidating funding for the CDC’s Sexually Transmitted Disease and Tuberculosis Prevention grants. In order to continue our current success, Congress must not block grant STD and TB funding, but rather should maintain currently dedicated funding for TB prevention and control programs that have been vital to keeping domestic TB cases in check.  TB is a national health security issue—but one that can be course corrected with adequate resources. Robust funding both globally and domestically is needed to recover momentum against the disease and save lives. The current proposals in the House FY 2026 LHHS report to cut vital TB elimination programs put progress achieved over the last few years at risk. Any program cuts or efforts to create block grants will create more room for this disease to spread and the development of drug resistance, which we cannot afford to risk. We therefore urge you to protect the CDC’s Global Tuberculosis program funding and refrain from consolidating Sexually Transmitted Disease and Tuberculosis Prevention grants under the CDC’s Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention program in a final appropriations bill.  Sincerely,   American Thoracic Society Association of Asian Pacific Community Health Organizations (AAPCHO) AVAC Georgia AIDS Coalition Global Health Technologies Coalition National Tuberculosis Coalition of America (NTCA) North East Medical Services (NEMS) Partners in Health RESULTS Scene Health Stop TB USA TB Alliance TB Elimination Alliance Treatment Action Group (TAG)   CC: The Honorable Tom Cole, The Honorable Susan Collins, The Honorable Patty Murray

GHTC delivered the below statement at the second official meeting of the negotiators of the Intergovernmental Working Group on the Pathogen Access and Benefit Sharing system annex to the Pandemic Agreement.We welcome the start of negotiations for a Pathogen Access and Benefit Sharing (PABS) system. Your work together in the months to come will be essential to making the world safer for everyone. Given the short timeline for finalizing negotiations, we propose the following actions to ensure successful deliberations: First, we call for a process that systematically and meaningfully engages civil society and relevant stakeholders as experts to reflect an inclusive, whole-of-society approach. We welcome the strategy of hosting informal sessions with experts, member states, and civil society ahead of each meeting of the Intergovernmental Working Group to help advance shared understanding and agreement.  We also call on member states to work with all relevant stakeholders to define the scope of "materials and sequence information on pathogens with pandemic potential." Negotiations to date have focused on human samples and information, even though the majority of emerging infectious diseases are zoonoses.Lastly, greater clarity is also still needed about how the World Health Organization will distribute benefits. The current draft agreement states that "the distribution of these vaccines, therapeutics, and diagnostics shall be on the basis of public health risk and need, with particular attention to the needs of developing countries."  But "public health risk and need" is a subjective categorization and could necessarily be affected by political imperatives. We therefore urge member states to outline decision-making criteria and make these publicly available for scrutiny. We know the coming months will present a challenging test for member states to find breakthroughs, and we encourage all parties to underscore their political commitment to the process. Success can only be achieved through a strong emphasis on equity and transparency, enshrined through robust and meaningful provisions in the PABS framework. We look forward to our continued participation in these forums to advance a meaningful outcome.