A Bush administration proposal to redirect $55 million in federal funding for state bioterrorism preparedness programs is creating a furor among public health officials and members of Congress who are concerned that the reallocation may further deprive states of much needed money for such efforts.
Under the proposal, called the Cities Readiness Initiative, $27 million will be used to develop systems in 21 of the largest U.S. cities for distributing medications and medical supplies rapidly during a public health emergency, according to a spokesman at the Centers for Disease Control and Prevention, which is in charge of distributing the money.
Another $12 million would be spent training the U.S. Postal Service to help in the distribution of the treatments.
If approved by Congress, the proposal would go into effect within a few weeks, an HHS spokesman said.
Funding for hospital bioterrorism preparedness will not be affected by the proposal if it is passed. Last week, HHS' Health Resources and Ser-vices Administration said that states, U.S. territories and four cities will receive $498 million for fiscal 2004, which began Oct. 1, 2003, to prepare for such potential attacks.
The money is targeted to hospitals and other healthcare facilities.
Congressional opposition quickly greeted the initiative last week. In a letter written to HHS Secretary Tommy Thompson on behalf of 20 senators from both parties, Sen. Evan Bayh (D-Ind.) said that states had crafted their bioterrorism plans based on the availability of funds for a two-year period, fiscal 2003 and 2004, as directed by the CDC.
"Since states designed their bioterrorism preparedness plans, budgets and courses of action based on the availability of these funds for the full two years, they can ill afford to lose them now," Bayh wrote. The letter did not offer an alternative way of funding the proposal.
The National Governors Association and the American Public Health Association, or APHA, which represents public health professionals, also oppose the proposal.
"Any effort to reduce or redirect already appropriated funds for ongoing state preparedness efforts threatens the existence and fitness of state strategic planning, and with it, a national approach to bioterrorism preparedness," the governors' association said in a news release.
While supportive of the development of a vaccine and antidote distribution system, Georges Benjamin, executive director of the APHA, said the administration's method of funding its proposal is misguided. "It's akin to taking away dollars for smoke detectors to build up your fire department," he said. "Why not ask for (more money) in the budget process" instead of redirecting existing funds.
Bill Hall, an HHS spokesman, said the proposal is the next step in "enhancing the distribution and deployment of " vaccines and treatments for possible bioterrorist attacks. He added that because 2004 funds have not been dispensed and states don't yet know how much money they'll be getting, "They're not losing any money."
He acknowledged, however, that the $55 million in the proposal is not new money being added to the total available for bioterrorism preparedness.
Despite a heightened threat of attacks during the summer, the proposal was not in response to an imminent threat, Hall said.
The cities that would receive the new funding under the proposal are the 20 with the largest populations-Atlanta, Boston, Chicago, Cleveland, Dallas, Denver, Detroit, Houston, Los Angeles, Miami, Minnea-polis, New York, Philadelphia, Phoenix, Pittsburgh, St. Louis, San Diego, San Francisco, Seattle and Washington-and Las Vegas, which was chosen because of its high rate of tourism and large transient population, Hall said.