HHS budget proposal cuts state preparedness, boosts food safety

Feb 4, 2008 (CIDRAP News) – The Bush administration today unveiled a $3.1 trillion budget for the 2009 fiscal year that cuts a number of public health initiatives but includes an increase for the Food and Drug Adminstration's (FDA's) food safety efforts.

The proposed spending plan would take effect in October 2008, the start of the next fiscal year. Details of the US Department of Health and Human Services (HHS) component of the budget were announced at a press conference today by HHS Secretary Mike Leavitt. "We have crafted a fiscally responsible budget at a very challenging time," he said.

The HHS share of the budget is $737 billion, an increase of $29 billion from 2008, HHS said in press release today. However, the amount decreases discretionary spending by $2.2 billion.

Proposed cuts for CDC
Trust for America's Health, a nonprofit health advocacy group based in Washington, DC, expressed concern over what it described as an overall 7% cut for the Centers for Disease Control and Prevention (CDC). The cutback, TFAH said in a press release today, represents a 6-year low for discretionary funding for the agency.

"At a time when healthcare costs are skyrocketing, we should be investing more to keep Americans healthy instead of cutting funds for disease prevention," said Jeff Levi, PhD, executive director of TFAH, in the press release.

The cuts would impair state and local preparedness efforts, TFAH said. Cuts of $97.2 million from the Prevention Health and Health Services Block Grant program would dry up funding that states use to run disease prevention programs, the group said. The new budget would cut $136.7 million from state and local bioterrorism and emergency preparedness efforts and reduce hospital emergency preparedness programs by $61.9 million, according to TFAH.

"The administration has cut these programs over the past 5 years, reducing the funding level by one-third," said TAFH in its press release.

More for FDA food monitoring
The budget proposal includes a $42 million increase for food safety initiatives announced by the FDA in November 2007, raising total FDA food safety spending to $662 million, according to HHS. The initiatives were spurred by recent cases of tainted imports as well as contamination in domestic food products, such as Salmonella in peanut butter and Escherichia coli in fresh produce. The funding would expand staffing and resources at food production and handling sites, the FDA said today in a press release. The budget provisions would increase the total number of full-time FDA staff by 526.

At a press conference today, budget officials from the FDA said the proposal would establish an FDA food safety office in China.

The proposed budget provides $29.5 billion for the National Institutes of Health (NIH) to support research. But TFAH said the administration's plan would "flat-fund" biomedical research at the NIH.

The National Institute of Allergy and Infectious Diseases (NIAID), in a 29-page budget briefing today, reported that funds for biodefense and emerging infectious disease research would drop by $7.5 million. The agency said it would move funds in those research areas from research and development contracts to the intramural research program to partially offset projected increased operating costs for new biodefense containment facilities that will be opening in Ft Detrick, Md., and Hamilton, Mont.

For bioterrorism preparedness, the budget allocation of $4.3 billion includes $250 million for developing medical countermeasures for the national stockpile. It also sets aside $53 million to establish five new international quarantine stations and fully staff all 20 domestic stations, according to the HHS press release. Also, the budget includes $30 million to expand, train, exercise, and coordinate medical emergency teams, including two Commissioned Corps Health and Medical Response (HAMR) teams designed to respond to real or potential threats, HHS said.

Pandemic preparedness funds
The budget contains $507 million for the next phase of the administration's influenza pandemic preparedness plan, including funds to expand egg-based vaccine capacity and buy medical countermeasures and supplies for HHS employees and patients, according to HHS. In addition, $313 million is proposed for ongoing pandemic preparedness efforts at the CDC, FDA, NIH, and the Office of the HHS Secretary.

In a 120-page budget briefing today, HHS said Congress did not appropriate $870 million requested by the president last year to implement the nation's pandemic preparedness plan. "The Administration is still considering options regarding this funding, and will reach out to Congress soon," HHS said.

The 2008 omnibus spending bill passed by Congress in December earmarked only $76 million for influenza pandemic preparedness funding, far below the Bush administration's $870 million request. The House and Senate appropriations committees had said their reason for cutting the 2008 pandemic budget was that $1.2 billion was left over from previous appropriations, according to previous media reports. However, Rich Hamburg, director of governmental relations for TFAH, said at the time that the $1.2 billion represented one-time funding that was mostly intended for buying vaccines and antiviral medications.

At the press conference, Leavitt said the budget proposal provides for an initiative to improve the nation's inadequate supply of ventilators, which he said cost from $8,000 to $10,000 apiece and require highly trained operators. He said the budget includes $25 million to develop a new generation of ventilator that will be portable, will cost 90% less, and will not require specialized training to operate.

"This effort will help fill the gap to ensure our nation has an adequate number of ventilators in the event of a public health emergency," HHS said in its press release.

See also:

Feb 4 HHS press release

Feb 4 TFAH press release

Dec 20, 2007, CIDRAP News story "Congress slashes pandemic preparedness funding"

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