Public health advocates say if the president’s budget proposal is approved as is, Americans’ health and safety would be at risk.
On Monday, the Centers for Disease Control and Prevention (CDC) confirmed the 13th case of coronavirus in the U.S. after an already-quarantined patient in California tested positive for the disease. The news came hours after President Trump announced he wanted to slash the CDC’s funding.
Amidst an array of cuts to several federal agencies, the president’s budget plan for fiscal year 2021 included a 9% reduction for the agency responsible for protecting public health in the U.S. Trump’s proposal to do so comes in the middle of a global pandemic, which has not gone unnoticed.
“Cutting the CDC in the middle of a pandemic is not viable in a functioning republic,” wrote Charles Pierce for Esquire. “We do not currently have one.”
Pierce wasn’t alone in his criticism.
“I look at today’s coronavirus leading the global news and the news in Washington, D.C., and scratch my head wondering how building our efforts to fight infectious disease continue to get short shrift,” said Karen A. Goraleski, CEO of the American Society of Tropical Medicine and Hygiene.
American Public Health Association Executive Director Georges Benjamin called the president’s budget “a disinvestment in the health of Americans.”
Others, including Sen. Elizabeth Warren, took to Twitter to express their concerns.
The coronavirus outbreak has sickened more than 43,000 people in Asia and killed at least 1,018 individuals, all but two in mainland China. Trump administration officials said funding aimed at fighting the coronavirus would be protected, but that did not ease the criticism of his budget proposal.
“Public health is battling threats on multiple fronts, from coronavirus, to natural disasters, to opioids to chronic diseases like diabetes. Every year, public health is asked to do more with less, often fighting a growing number of 21st century problems with an insufficient set of 20th century tools,” said John Auerbach, the president and CEO of Trust for America’s Health, a nonpartisan public health advocacy group.
“We are concerned that this budget request, if adopted by Congress, would cut public health funding amid multiple outbreaks and epidemics that threaten the health and safety of the American people,” Auerbach added.
The good news for critics of Trump’s proposal, however, is that these cuts are unlikely to be implemented as is. The president proposed similar cuts in 2019, but was met with steadfast opposition from the Democratic-led House of Representatives.
In its justification for reducing CDC funding, the Trump administration wrote that it wants to “refocus the Center for Disease Control (CDC) on its core mission of preventing and controlling infectious diseases and other emerging public health issues, such as opioids.”
In keeping with that strategy, the administration has proposed spending cuts for programs aimed at preventing chronic diseases, such as diabetes, heart disease, and stroke. The administration also wants to combine the funding streams for those efforts into a single block grant to states.
“These chronic diseases all share common risk factors such as tobacco use, poor nutrition, and lack of physical activity, so consolidating funding for these prevention activities can help magnify the public health impact of these funds,” the budget reads.
The budget takes a similar approach to programs intended to fight specific cancers, including prostate and ovarian cancer, again consolidating them and reducing funding.
The CDC isn’t the only agency being targeted with spending cuts. The National Institutes of Health, which is the largest biomedical research agency in the world, also stands to lose $3 billion (7%) of its funding. According to a Washington Post analysis, the Department of Health and Human Services, which is the parent agency of both the CDC and NIH, stands to suffer an overall budget cut of 9%.
The administration also proposed budget cuts for the U.S. Agency for International Development, or USAID, and wants to reduce funding to the World Health Organization by 53% and to the Pan American Health Organization by 75%, ABC News reported.
All told, the administration’s proposal seeks $3 billion in cuts to global health programs.
Many experts believe that public health actually needs far more funding.
“To be clear, these programs are already underfunded,” tweeted Nicolette Louissaint, executive director of Healthcare Ready, a nonprofit that works to strengthen health care supply chains.
A 2019 report from the Trust for America’s Health concluded that the nation’s public health efforts are underfunded by $4.5 billion. The report found that over the past decade, funding for the CDC—more than half of which goes to states, localities, and other nonfederal partners—decreased by 10%, after adjusting for inflation.
The report found that these cuts have taken a toll on state health departments who depend on CDC funds for about half of their budgets, as well as local health departments who in turn rely on both federal and state funding.
“When CDC funding is cut,” Auerbach said in 2019, “state and local governments are often forced to reduce funding for critical programs including those to prevent chronic and infectious diseases, to protect environmental health and to provide vaccinations for children, among many others. These are programs Americans need and support. They shouldn’t be constantly on the chopping-block.”
The overall impact of these cuts could be staggering, Auerbach told COURIER on Tuesday. “We urge Congress and the administration to work to ensure public health has the tools and resources it needs to prevent disease and safeguard the health of all communities.”
While much of the immediate reaction to Monday’s budget cuts focused on coronavirus, Goraleski also emphasized the harm such cuts could cause in the long run.
“A new disease threat is literally a plane ride away,” Goraleski said. “Cuts to global health programs and research and development at the CDC, NIH and USAID are short-sighted. These programs work together to form a web that helps to protect Americans. Cuts to any part of that web leave us all vulnerable.”