Public Health Critical Care Programs and Funding Priorities

After decades of under-investment, our public health system lacks the resources it needs to tackle the full range of health threats, from potential chemical or biological attacks, to serious chronic disease epidemics, or emerging infectious diseases like avian influenza. As the lead federal agency for protecting the public's health, the Centers for Disease Control and Prevention's (CDC) budget must reflect the vital role it plays in the lives of every individual, every day, and its increasing responsibilities for homeland security.

Correspondence to Policymakers

Letter in Support of BARDA funds (March 2008)
Read the letter

Working Group on Pandemic Influenza Preparedness Letter Urges Congress to Fund Pandemic Preparedness in FY 2009 (March 2008)
Read the letter

Letter in Support of Environmental Health Tracking and Biomonitoring Funds (March 2008)
Read the letter

Working Group on Pandemic Influenza Preparedness letter urges Congress to fund pandemic preparedness in the FY07 Emergency Supplemental (April 2007)
Read the letter

Letter Urging Senate and House to Increase Funding for Environmental Health Programs (March 2007)
Read the letter

Cuts Proposed in the President's Budget to Disease Prevention and Bioterrorism Preparedness Programs Jeopardize the Health of Americans, TFAH Warns (February 2007)
Read the press release

Letters in Support of Flu Preparedness Funding in FY 2006 Emergency Supplemental Appropriations Bill (May 2006)
TFAH Letter
Working Group on Pandemic Influenza Preparedness Letter

Letter in Opposition to Cuts to Discretionary Public Health Programs (April 2006)
Read the Letter

Testimony

Testimony of David Fleming, MD, Director of Public Health for Seattle-King County, Washington & Member, Board of Directors, Trust for America's Health, before to United States House of Representatives, Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education and Related Agencies (March 2008)
TFAH Testimony on FY09 Budget

The Fiscal Year 2009 Budget

America faces a major health crisis. Tens of millions of Americans suffer every day from chronic diseases like cancer, diabetes, and Alzheimer's that rob them of health and quality of life. And, our nation is not adequately prepared to respond to large-scale health emergencies or bioterrorist attacks. Quality, affordable health care is essential, but a strong public health system focused on prevention must also be part of the equation.

Congress must make strategic investments in preventing and combating threats to our health. Keeping America healthier will require increased upfront and sustained funding for prevention programs which pay off in better health outcomes and in keeping treatment costs down.

However, instead of increasing funds for prevention, the President's proposed budget would cut funds for important public health programs. The U.S. Centers for Disease Control and Prevention (CDC) faces a 7 percent cut in discretionary programs from Fiscal Year (FY) 2008 levels. Over the last 5 years, CDC's budget has remained essentially flat-lined, not even increasing with the rate of inflation.

Trust for America's Health (TFAH) has developed its annual "Critical Care" list to identify key programs at the U.S. Department of Health and Human Services (HHS) and across other federal agencies that are vital to protecting America's health and preventing disease. Increased support for these programs is needed to help improve the health of all Americans.

Pandemic Influenza Preparedness:

Ensure full funding to implement the Administration's $7.1 billion National Strategy for Pandemic Influenza, which is intended to identify, contain and treat pandemic flu. This includes funding for vaccines; stockpiling antiviral medications, diagnostics, and medical supplies; contingency planning; risk communication; developing surge capacity; and enhancing global and domestic health surveillance. For the Department of Health and Human Services, TFAH supports:

• $870 million to complete the final phase of preparedness activities outlined in the National Strategy for Pandemic Influenza in November 2005, to be used for expanding vaccine capacity, purchasing antivirals, and accelerating research and development of rapid diagnostics (ASPR)


• $350 million for state and local pandemic preparedness activities (CDC)


• $313 million for annual, recurring pandemic preparedness activities (CDC, Food and Drug Administration, National Institutes of Health and the Office of the Secretary)

Bioterrorism and Emergency Preparedness:

Provide funding to upgrade state and local public health departments' capacity to respond to terrorism and improve the nation's ability to respond to mass casualty events by enhancing programs at the CDC and the Office of the Assistant Secretary for Preparedness and Response (ASPR). Congress must restore cuts to these programs to continue much-needed public health infrastructure improvements across the country. TFAH recommends:

• $919 million for upgrading state and local preparedness (CDC)


• $474 million for the Hospital Preparedness Program (ASPR)


• $500 million for the procurement and advanced development of medical countermeasures through the Biomedical Advanced Research and Development Authority (ASPR)

Strengthen the public health workforce to help prepare for and respond to public health emergencies. TFAH recommends a funding level of:

• $15 million for the Office of the Civilian Medical Reserve Corps (Office of the Surgeon General)


• $6 million for the Emergency System for the Advanced Registration of Volunteer Health Professionals (ASPR)


• $5 million for public health epidemiology fellowships (CDC)
  Chronic Diseases and Environmental Health

Provide funding to augment programs to combat obesity through evidence-based interventions to improve nutrition and increase physical activity. A February 2008 public opinion survey conducted for TFAH found that seven-in-ten Americans want the federal government to invest more in disease prevention and healthy living, with 46 percent saying they want "much more" spending. To help fight chronic diseases, TFAH recommends these funding levels:

• $65 million for the Division of Nutrition, Physical Activity and Obesity (CDC)


• $74 million for the Division of Adolescent School Health (DASH) (CDC)


• $34 million for School Health under DASH

In addition, TFAH supports the following initiatives at the Department of Education and the Department of the Interior:

• $100 million for the Department of Education's Carol M. White Physical Education Program


• $125 million for the Department of the Interior's Land and Water Conservation Fund state-side assistance program


• $12 million for the Department of the Interior's Rivers, Trails and Conservation Assistance Program.

Provide the resources necessary to modernize and integrate health information sources to better track the health of Americans and research causes and cures of disease. Expand health tracking which is essential to prevention efforts and to fostering a better knowledge of health trends. Specifically:

• $50 million for the Environment and Health Outcome Tracking Network to allow federal, state, and local agencies to better develop and evaluate prevention and control efforts for chronic and acute diseases linked to hazards in the environment.


• $53 million for CDC's Environmental Health Laboratory to conduct testing for potentially dangerous environmental chemicals.

View a funding chart of TFAH's priorities.

Budget-Related Links

The President's FY 2009 Budget

The Department of Health and Human Services' FY 2009 Budget

The Centers for Disease Control and Prevention's FY 2009 Budget