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Friday, September 24th, 2021

Biodefense advocates take on U.S. preparedness funding fight

William M. Barnes

With the nation’s signature preparedness law due for reauthorization in 2018, leaders now are readying public health stakeholders across local, state and federal levels for battle on Capitol Hill.

Not only should those in the public health sector be battle-ready to support renewal of the Pandemic and
All-Hazards Preparedness Reauthorization Act next year, but to also wage war against looming budget cuts proposed by President Donald Trump in fiscal years 2017 and 2018 to federal agencies that support national preparedness, officials said Tuesday.

“We in the public health community are living in an era of uncertainty. Our federal policymakers are debating issues that will impact the resilience of our communities for many years to come, whether it’s federal funding for preparedness, changes in federal regulations or access to health insurance,” said William M. Barnes, acting executive director and chief program officer of the National Association of County and City Health Officials (NACCHO).

“We need sustained funding” from Congress that reaches across the spectrum of public health professions, said Barnes, speaking during NACCHO’s 2017 Preparedness Summit opening plenary session Tuesday in Atlanta.

Headlining the session were the co-chairmen of the Blue Ribbon Study Panel on Biodefense, former U.S. Sen. Joe Lieberman of Connecticut and former U.S. Homeland Security Secretary and former Republican Governor of Pennsylvania Tom Ridge, who discussed federal preparedness efforts.

Ridge and Lieberman reiterated some of the 33 recommendations for federal lawmakers contained in the blue ribbon panel’s 2015 report, A National Blueprint for Biodefense: Leadership and Major Reform Needed to Optimize Efforts. Ridge said the panel’s six members want to have the report’s recommendations embedded into U.S. policy to strengthen national biodefense while optimizing resource investments.

“Overall, we’re slipping backward and the threat is getting greater,” said Lieberman, referencing the nation’s preparedness and response efforts to biological and chemical threats.

“You are the front lines. We need to arm you better than you are now and we need to listen to you better than we do,” he told the almost 1,800 summit attendees.

Budget threats ahead
Over the years, Ridge told the attendees, “your resources have been limited, but the demands on you have dramatically increased. The [blue ribbon] panel views public health as a national security issue. And if public health is a national security issue, it should be appropriately funded.”

But there’s concern the funding won’t be there if Trump’s proposed budget cuts to the U.S. Department of Health and Human Services (HHS) and other related federal agencies are approved after the president releases the full budgets next month.

For instance, Trump’s “America First “ Budget Blueprint for FY 2018 would reduce overall discretionary spending at HHS by more than $15 billion over 2017 continuing resolution (CR) monies. The so-called “skinny budget” would reduce the National Institutes of Health’s (NIH) spending relative to the 2017 annualized CR level by $5.8 billion to $25.9 billion and reorganize NIH’s institutes and centers.

Stakeholders worry that such a massive cut to NIH could affect areas like research, particularly for universities and others that are working to develop medical countermeasures for chemical, biological, radiological and nuclear threats, as well as future threats like emerging infectious diseases, synthetic biology and engineered diseases.

Additionally, Trump’s blueprint budget would provide funding to create a new Federal Emergency Response Fund to rapidly respond to public health outbreaks, such as the Zika virus; reform the Centers for Disease Control and Protection (CDC) through a new $500 million block grant; and direct resources to states with the greatest need.

“We’ve stopped adequately funding the preparedness program,” Lieberman told the audience.

“If you start to calculate the costs we would avoid by being better prepared to prevent and respond to a catastrophic outbreak of infectious disease, there’s no comparison,” he said. “The money we spend now would be saved many, many times over.”

Ridge said that the public health community should have more consistent funding on both the preparedness and response sides and the funding should be permanent — just like it is for the U.S. Department of Defense and U.S. Department of Homeland Security.

Suggestions to the crowd
Funding cuts have already provided “real pain” in terms of what can be done at the local level, said Marisa Raphael, deputy commissioner of the New York City Office of Emergency Preparedness and Response, during the question-and-answer portion of the session.

“We are at a crisis point in terms of funding and it’s alarming to see potential future cuts,” Raphael told the speakers. “We haven’t succeeded in convincing policymakers of the value of the work we’re doing. They don’t understand the role public health plays in emergencies and how public health’s role is being compromised and threatened.”

She asked the speakers what messages would be effective to help lawmakers understand that their work is critical and how best to engage the public.

Ridge and Lieberman suggested that stakeholders attend local, state, territorial or tribal meetings and call federal congressional staffers and then “make your story as explicit as possible,” providing details about what happens on the front lines every day and what happens when funding is slashed.

Give examples as to how people are vulnerable to attacks, for instance — “If we’re not prepared to deal with a pandemic … people could be dying on the streets. That’s not a scare tactic, it’s a reality,” Lieberman said. “They need to hear it. The threat is real.”