FEATURE
The Virginia facility—which has provided
surge capacity testing for the National
Capital Area—once routinely tested a
portion of all non-influenza respiratory
outbreak specimens for a slate of other
respiratory viruses, “so we could at
least identify a causative agent for an
outbreak.” But with less federal funding
that is no longer feasible.
For public health laboratories struggling
to, as Toney puts it, “provide the support
we know we can provide,” the fiscal year
2020 (FY2020) budget enacted this past
December will be neither a disaster nor a
game changer.
According to data published by
TFAH, there is a $4.5 billion gap
between current funding levels
and what is needed to achieve
“an adequate level of public
health protection” nationwide.
Said APHL Policy Director Peter
Kyriacopoulos, the budget “does not
represent the kind of increases we
would get excited about. It also does not
represent the kind of decreases that had
been proposed. Congress, again, kept us
going at a modest level.”
CDC got a $637 million boost over the
agency’s FY2019 budget, almost a 9%
increase, discounting inflation. Just over a
third of this will go to building projects on
the CDC campus.
Among the good news items for public
health are funds for an urgently needed
data initiative (see sidebar), $140 million
for a new Ending HIV/AIDS Initiative,
an additional $75 million for the Global
Health Security Agenda (totaling $183
million for GHSA) and an extra $35 million
for the Infectious Disease Rapid Response
Reserve Fund, which was established
in FY2019 with an initial $50 million in
funding.
There were no new funds for influenza
planning and response, vector-borne
diseases, CDC’s Advanced Molecular
Detection program, opioid overdose
surveillance, laboratory training,
laboratory safety and quality, public
health workforce development or the
Public Health Emergency Preparedness
(PHEP) Cooperative Agreement,
the main source of federal support
for state and local public health
emergency preparedness and response.
(Kyriacopoulos guesstimates that about
10% of overall PHEP funding goes to public
health laboratories.)
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LAB MATTERS Winter 2020
Other CDC programs, such as emerging
infectious diseases, food safety and the
Antibiotic Resistance Initiative, got a two
or three million dollar bump each—a
negligible gain after factoring in inflation.
At the same time, the FY2020 CDC budget
includes no supplemental funding
for Ebola, which had provided around
$120 million/year on average for GHSA
activities from FY2015 through FY2019.
Although the budget news could have
been worse, it continues a worrying, long-
term trend of public health underfunding.
According to data published by the
advocacy group Trust for America’s Health
(TFAH), there is a $4.5 billion gap between
current funding levels and what is needed
to achieve “an adequate level of public
health protection” nationwide.
TFAH reports that between FY2010 and
FY2019, CDC’s budget actually fell by 10%,
after adjusting for inflation.
One measure of the funding shortfall
for public health laboratories is the CDC
Epidemiology and Laboratory Capacity
(ELC) cooperative agreement, which
builds capacity for emerging infectious
disease control in the 50 states, District
of Columbia, eight US territories and six
US cities. In 2019, CDC received over $400
million in qualified ELC funding requests,
but had only $231 million to award.
Team Lead Dr. Bethany Bolling sets up a PCR plate to test
mosquitoes for vector borne diseases. Photo: TX DSHS
Arbovirus Lab
PublicHealthLabs
@APHL
APHL.org