Federal and state budget cuts continue to threaten the ability of states to detect and respond to bioterrorism, disease outbreaks, and other disasters, a new study from the Trust for America's Health and Robert Wood Johnson Foundation finds.
According to the ninth annual edition of Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism (92 pages, PDF), forty states and Washington, D.C., have cut public health funding in the past year, with twenty-nine of those states slashing their budgets for the second year in a row and fifteen for the third consecutive year. At the same time, inflation-adjusted federal funds for state and local preparedness have fallen by 38 percent since fiscal year 2005 and additional cuts are expected.
Indeed, fifty-one of the seventy-two cities in the federal Cities Readiness Initiative, which enables the rapid distribution and administration of vaccines and medications during emergencies, are at risk of being eliminated from the program. Moreover, all ten state labs with "level 1" chemical testing status are in danger of losing their top-level capabilities, which would leave the U.S. Centers for Disease Control and Prevention with the only public health lab in the country with the full ability to test for chemical terrorism and accidents. In addition, twenty-four states are at risk of losing the support of career epidemiology field officers — CDC experts who help fill state and local gaps in preventing and responding quickly to outbreaks and disasters — while the ability for CDC to mount a comprehensive response to nuclear, radiologic, and chemical threats as well as natural disasters is in jeopardy due to potential cuts to the National Center for Environmental Health.
The report provides a series of recommendations designed to improve the country's ability to respond to bioterrorism and health emergencies, including a federal government commitment to strengthening public health preparedness core capabilities and assurances of dedicated funding; improving biosurveillance to detect and track outbreaks or attacks rapidly; stepping up the development and manufacture of vaccines and medications; enhancing the ability to provide care for a mass influx of patients during an emergency; providing better support to help communities cope with and recover from disasters; and coordinating food safety with other preparedness efforts through the strategic implementation of the new FDA Food Safety Modernization Act.
"During the anthrax attacks and Hurricane Katrina, we witnessed what happens when public health doesn't have the technology, resources, workforce, or training needed to respond to emergencies," said James S. Marks, senior vice president and director of the RWJF Health Group. "The old adage is that it's better to be safe than sorry. Unfortunately if we ignore preparedness now, we'll be sorry later when the next emergency strikes."