Biodefense takes hit in budget plan

Medical emergency professionals and public health advocates are expressing alarm over the proposed reductions in emergency preparedness funding outlined in the Obama administration's fiscal 2014 budget.

Funding for programs run by the Centers for Disease Control and Prevention was reduced by $270 million below fiscal 2012 levels. The budget would reduce biodefense and emergency preparedness funding by $48 million to $1.3 billion. It also limited spending on the Strategic National Stockpile of emergency medical supplies to $510 million, down $38 million from the earlier period.

Also cut in the proposed budget was $8 million from the agency's Public Health and Emergency Preparedness grants to states. The agency was allocated $666 million in fiscal 2012.

According to Dr. Georges Benjamin, executive director of the American Public Health Association, a not-for-profit organization of public health professionals, such reductions make it more difficult for state and local government to maintain staffing levels, which in turn undermines the stability of the system throughout the country.

“Preparedness systems throughout the country have already been diminished,” Benjamin said. “These cuts will certainly add to those problems, and we're very concerned that it makes us less prepared over time.”

According to an HHS budget summary (PDF), a total of $6.7 billion has been allocated for programs the CDC described as “mission-critical effort to prevent and control infectious diseases.”

The proposed cuts are part of a continued paring down of government funding toward public emergency preparedness over the past several years, according to an analysis conducted by the group Trust for America's Health.

In a recent report (PDF), the organization found that the amount of public health funding states have received from the CDC fell sharply since its peak in 2005 at $7.3 billion, only to remain relatively flat since 2006.

“Money for the cooperative agreements with the states (PHEP grants) we've seen fall pretty dramatically (since 2005), and over the last seven or eight years has leveled off,” said Trust for America's Health Deputy Director Richard Hamburg.

While the cuts raise concerns among public health worker representatives, Hamburg stressed the need for the CDC to maintain a predictable level of funding each year in order to allow state and local governments to plan their budgets.

“I think the key for emergency funding is to try to obtain a steadier flow of dollars rather than an increase only in a really big emergency,” Hamburg said. “Over time, it's kind of ebbed and flowed a bit.”

The CDC cuts are part of a $3.8 trillion fiscal plan designed to reduce the nation's budget deficit by $1.8 trillion over the next 10 years.

Hamburg said it was difficult to ascertain just how different the 2014 budget was compared with spending for the current fiscal year ending Sept. 30, since the final version of the 2013 budget had yet to be released. He anticipated it would be about the same as the Obama administration's proposal.