The lower funding levels of recent years translated into reduced training programs and fewer local health workers, according to public health and emergency preparedness experts. Local health departments have lost 44,000 jobs since 2008, according to the National Association of County and City Health Officials (NACCHO).
“We've been making lots of noise about how we thought those were inappropriate cuts,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “This has been the traditional yoyo funding that has occurred in public health.”
“It's definitely alarming,” said Jeff Schlegelmilch, managing director for strategy and operations at Columbia University's National Center for Disaster Preparedness. “It's been very traumatic in terms of impacting the ability of what can be done.”
Those cries have largely fallen on deaf ears, with cuts in funding to the programs supported by the Obama administration and Republican legislators. But that may be changing now as the country becomes increasingly concerned about Ebola spreading across its shores.
On Monday, Sen. Robert Casey (D-Pa.) sent a letter to the chair and ranking member of the Senate Committee on Appropriations calling for additional spending on the Hospital Preparedness Program.
“The news that a nurse who treated the Ebola patient in Texas has now become infected with the virus herself highlights the need for ongoing training and education for healthcare workers and drills and exercises for hospitals,” Casey wrote in the letter to Sens. Barbara Mikulski (D-Md.) and Richard Shelby (R-Ala.). “Without an ongoing commitment to preparing for these events, and the funding to support training activities, we cannot adequately ensure that our health system is ready for Ebola or any other emergency.”
The emergency preparedness grants have fallen victim to the overall climate of fiscal austerity in Washington, with the sequestration cuts taking a chunk out of both programs.
But supporters of the funding streams also point out that awareness about the perils of health emergencies and the need to adequately prepare tend to dissipate until the next crisis surfaces.
“These are relatively easy pots of money for Congress to cut because they're like insurance benefits,” said Jack Herrmann, senior adviser for NACCHO's public health programs. “The longer you drive and you don't have an accident, the more frustrated you feel about funneling money out every month to pay for something you don't really use.”
But Richard Hamburg, deputy director of Trust for America's Health, and other supporters of the programs say the Ebola outbreak provides an opportunity to highlight the need for sustainable funding dedicated to preparing for health emergencies. “When the acute emergency passes, and it will at some point, that's when everyone needs to take a step back to figure out how do we work across party lines to make sure adequate funding is there,” Hamburg said.
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