Proposed US budget boosts pandemic readiness, stalls biodefense capacity

Feb 7, 2007 (CIDRAP News) – The Bush administration's new budget proposes adding funds for pandemic preparedness while cutting some support for bioterrorism and local preparedness, drawing mixed reviews from national public health groups.

The budget, released Monday, proposes a spending plan for the fiscal year that begins October 2008. It proposes $1.2 billion in new funds to improve pandemic preparedness, which includes $870 million to develop a pandemic vaccine, according to a Department of Health and Human Services (HHS) budget report.

For bioterrorism spending, the budget proposes $4.3 billion, an increase in $143 million from 2007 levels. HHS says this total would include $135 million to speed the development of countermeasures for the Strategic National Stockpile and $154 million to expand, train, and coordinate medical emergency response teams.

HHS secretary Mike Leavitt, in comments the department released about the president's budget, said the proposal builds on past successes and continues investing in the future. "It sets out an aggressive, yet responsible, budget that funds our priorities and helps sustain our long-term commitment to seniors and low-income Americans," he said. "We are serving our citizens with compassion while maintaining sensible stewardship of their tax dollars."

Public health groups respond
In a Feb 5 press release, the nonprofit health advocacy group Trust for America's Health (TFAH) commended the Bush administration for the additional pandemic influenza funding. However, it said the president's proposal would cut $185 million from funds earmarked for upgrading state and local capabilities and hospital readiness, which would undermine bioterrorism and public health readiness. The cuts would leave public health preparedness funding more than 25% below 2005 levels, TFAH said.

Richard Hamburg, director of government relations at TFAH, said in the press release, "We are cutting core boots-on-the-ground support for emergency disaster response, leaving the country at unnecessary levels of risk."

The American Public Health Association, the world's largest public health association, also applauded the increased proposed funding for pandemic influenza initiatives, but in a Feb 5 press release called some of the cuts to the Centers for Disease Control and Prevention devastating, particularly the elimination of Preventive Health and Health Services Block Grants.

According to TFAH, absent from the president's budget is $99 million for the block grant program that Congress had included in a continuing resolution for 2007.

Donna Brown, government affairs counsel at the National Association of County and City Health Officials (NACCHO), told CIDRAP News that the budget proposal reflects a disappointing 8% drop in cooperative agreement funds that local health departments need to build capacity. "They justify that by saying localities are already getting pandemic flu money for that, but this budget includes no funds for that, so it's a circular argument," she said.

In recent recommendations to strengthen the nation's preparedness, the Infectious Diseases Society of America (IDSA) addressed a lack of stable funding to build local preparedness capacity. Though IDSA pointed out in its report that Congress has approved more than $6 billion in pandemic influenza preparedness spending over the last several years, much of it has come from one-time emergency funding that has been offset by cuts in other federal emergency preparedness programs.

"One-time infusion funding makes it difficult for health departments to establish permanent capacity and do hiring," Brown said. "This budget proposal continues erosion that began in 2006."

Eliminating the block grants will further strain local public health budgets, Brown said, because communities depend on them for addressing pressing health problems, such as West Nile virus in New York.

Those who think the new Congress will be the key to solving public health funding problems are probably overly optimistic, Brown said. "The Democratic Congress is between a rock and a hard place. They disagree with prior cuts, but they agree they need to balance the federal budget," she said.

Funding for food safety
The Bush administration's budget proposes $325 million for multiagency Food and Agriculture Defense Initiative programs, according to a Feb 5 US Department of Agriculture (USDA) press release. The total includes a $148 million increase to support USDA efforts to improve food safety and security, a $36 million increase to improve response to food emergencies, $35 million for research to improve animal vaccines and facilitate rapid response to agricultural threats, and $77 million to enhance surveillance of pest and disease threats.

The budget proposal includes $82 million for avian influenza programs, including domestic surveillance of poultry and migratory birds for H5N1 avian flu, the USDA said.

A budget increase of $16 million has been requested to design a new Consolidated Poultry Research Center in Athens, Ga., which will become the USDA's primary center for conducting key research on exotic and emerging avian diseases, the agency said in its press release.

Included in the president's budget is a $1.1 billion record level of funding for the Food Safety and Inspection Service. The USDA said the funding would strengthen the Food Emergency Response Network, increasing the USDA's ability to detect and respond to foodborne illness outbreaks.

See also:

HHS budget
http://www.hhs.gov/budget/08budget/2008BudgetInBrief.pdf

HHS news release
http://www.hhs.gov/news/press/2007pres/02/20070205a.html

TAFH news release
http://healthyamericans.org/newsroom/releases/release020507.pdf

TAFH analysis of budget
http://healthyamericans.org/reports/budget07/

USDA news release

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