On Thursday, the second anniversary of 9/11, HHS reported a 17-fold boost in funding for public health emergency preparedness, comparing budgeted spending in 2001 against proposed spending for 2004.
In a fact sheet posted on its Web site, the department listed the total amount allocated for bioterrorism preparedness in 2001 was $305 million, compared with almost $4.4 billion in 2003.
In his budget request for 2004, President Bush proposed $5.2 billion, which includes $890 million for the establishment of BioShield, a new program to expand medical countermeasures to potential terrorist threats.
"This federal investment--combined with the efforts of states, local government and private sector entities--is bringing about rapidly increasing capacity in our nation's public health system, both for confronting possible bioterrorism incidents as well as other health threats," the HHS fact sheet said.
Georges Benjamin, M.D., executive director of the American Public Health Association, agrees.
"The monies for public health preparedness that have gone out through HHS, have gone out faster than any money in history," Benjamin says, noting some first responders who were to receive funds from other agencies, such as the Department of Justice, have not seen any money yet.
"The fundamental question is, is it enough?" Benjamin asks. "We need sustained investment over a long period of time in order for it to be meaningful."
He says he is concerned that a lag in bookkeeping from the local to federal level may lead Congress to see money they perceive to be unspent and to consider reducing future spending.
"The truth of the matter is, the money was spent," Benjamin says.
The HHS fact sheet says $2.5 billion in 2002 and 2003 was allocated for cooperative agreements between the Centers for Disease Control and Prevention and the states to expand their public health systems, and for hospital preparedness funding provided by the Health Resources and Services Administration. An additional $1.4 billion for these measures has been proposed for 2004.
About 75% of the funding for public health agencies and hospitals is intended to support local-level efforts, with the remaining 25% used to build state systems.
"States are drawing these funds as quickly as they ramp up their preparedness structures," HHS says.
Also, spending on bioterrorism research at the National Institutes of Health represents the largest single increase for any NIH initiative in history, according to HHS. Funding grew from $53 million in 2001 to $291 million in 2002 to $1.5 billion in 2003. Bush has proposed bioterrorism research spending at $1.6 billion for 2004.