Health directors say HHS flu cuts are for the birds

Harkin amendent to 2006 Senate DOD Bill

As state and local health departments gear up to battle a possible avian flu outbreak, they face a sharp cut in funding from the Department of Health and Human Services. However, the loss could be fixed through funds intended to cover the costs of controlling a pandemic, added as an amendment to the 2006 Defense Department Appropriations bill.

“Critical funding is shrinking just as public health agencies are being required to expand their work in pandemic influenza preparation and response," said Dr. Rex Archer, health director of Kansas City, Mo., and president of the National Association of County and City Health Officials (NACCHO).

The Bush administration, in its proposed 2006 HHS budget, slashed funding for public health preparedness by $129 million -- from $926 million in 2005 to $797 million. The House version of the 2006 HHS bill appropriates $853 million while the Senate bill sticks with the$797 million requested by the administration.

Donna Brown, government affairs counsel at NACCHO, said those state and local preparedness funds provided by the Centers for Disease Control and Prevention (CDC), an HHS agency, are used for a wide range of activities by local health departments, including information technology and disease surveillance systems.

“We need robust electronic information systems to detect disease outbreaks," Brown said, including surveillance systems that can alert local public health officials to potential flu symptoms. Those would be critical to helping combat a pandemic.

Congress should not be cutting preparedness funds as “we face a potential health emergency," Brown said. He believes Congress should reverse any cuts proposed by the administration. The Senate and House HHS bills are still in conference and need to be passed by Nov. 15, when a continuing resolution to fund government operations in fiscal 2006 expires.

The Senate version of the 2006 Defense Appropriations bill contains an amendment proposed by Sen. Tom Harkin (D-Iowa) which would make up for the shortfall in HHS funding to deal with a potential avian flu pandemic, Brown said. That amendment provides $3.9 billion in finding for the CDC, including an extra $600 million for state and local public health preparedness.

The amendment also provides $3.1 billion to stockpile antiviral medication and $33 million in for global avian flu surveillance systems. The Harkin amendment and the Senate DOD appropriations bill also have to go through conference in the next month before they become law.

The administration is in the process of putting the final touches on its pandemic flu plan, which it expects to release by the end of this month. The Council of State and Territorial Epidemiologists said in a recent newsletter that the plan could be accompanied by a budget amendment of between $6 billion to $10 billion to cover the cost of using it.