Lab Matters Winter 2017 - Page 9

feature impacts on awardees ’ public health laboratories include new constraints on equipment purchase , equipment maintenance , laboratory staffing and staff training . ( Between FY 2012 and FY 2014 , PHEP awardees dedicated a combined average of $ 77 million each fiscal year to biological and chemical laboratory preparedness .)
• The 61 PHEP awardees reported the combined loss of over 200 full time equivalents ( FTEs ), and 60 % reported a negative impact on Zika preparedness and response in their jurisdictions .
Even though the $ 44.25 million in PHEP funds was later restored , the cuts will have a lasting effect . Said Rich Hamburg , MPA , executive vice president of TFAH , “ You lose capacity when there ’ s unpredictability . You just can ’ t rehire staff .”
As one NACCHO survey respondent commented , “ Public health depends on grants to sustain activities . If grants are cut , that activity goes away . ... This puts our entire population at risk .”
Though these efforts represent a step forward , they fail to deliver support for the full range of public health threats . And public health threats are unpredictable .
Early Intervention : More Effective — and Less Costly
The importance of immediately accessible , comprehensive surge funding cannot be overstated . As the last three big public health events demonstrate , responders cannot count on the ready availability of emergency appropriations : the time between activation of CDC ’ s Emergency Operations Center and Congressional appropriation of supplemental funding was just over 60 days for H1N1 , about 160 days for Ebola and roughly 220 days for Zika virus .
In contrast , public health interventions tend to be more effective — and less costly — when they occur swiftly . In the absence of “ bridge funding ” and easily scalable procurement systems , public health officials are left to fend for their communities the best they can when crises arise .
Already , Pentella , who until recently headed the Massachusetts Public Health Laboratory , said his staff has developed eight new Zika-related assays and tested over 4,000 potential Zika specimens .
He said , “ It ’ s a lot of work , really a lot of work . ... We could use some additional people and we can ’ t hire them because we don ’ t have the money , so it ’ s just added to everyone ’ s workload . ... Maybe we were [ going to ] do some test development or something else beneficial to public health , but we can ’ t — you have to attend to the outbreak , always . We have felt really pushed and very concerned about where the dollars are coming from .”
Public health leaders agree that funding for their work should be nonpartisan and based on a three-tier system :
( 1 ) predictable , long-term funding to sustain and enhance the public health infrastructure via discretionary dollars and vehicles like PHEP grants and the Prevention and Public Health Fund
( 2 ) mechanisms to surge public health capacity quickly when serious threats arise , and
( 3 ) emergency supplemental funding to sustain surge capacity until it is no longer needed .
Senator Roy Blunt ( R-MO ) asked during the Zika appropriations hearings if there were a way to enable authorities to “ prevent some emergencies and be even better positioned to respond to others .” All of those interviewed for this article agree that a rapid response funding mechanism is a key part of the answer .
Said Blumenstock , “ We are having the exact same conversation and challenges today as Congress tried to address 35 years ago . The need never waned , and I would argue the demand is much greater now .”
PublicHealthLabs @ APHL APHL . org
Winter 2017 LAB MATTERS 77