In a time of very tight fiscal constraints - including a freeze on overall domestic non-defense/security discretionary spending - in the budget released today, the Obama Administration demonstrated its commitment to supporting a strong public health system that focuses on prevention. Obviously, we would prefer to see larger increases, however, this budget, combined with large investments about to be released under the American Recovery and Reinvestment Act (ARRA), will significantly increase the capacity of communities to respond to our pressing prevention needs.
However, without a long-term commitment of resources, we'll be unable to maintain the short-term gains we were able to achieve with the ARRA funds, and as efforts to balance the budget continue, we could easily fall back into an annual cycle of chronic underfunding of public health prevention and preparedness programs. This is why we call for the establishment of a dedicated funding mechanism for prevention and public health through a Prevention and Public Health Fund and a Community Health Center Fund in the Senate health reform bill, and a Public Health Investment Fund in the House bill. We also regret to see a small decrease in funding for CDC preparedness and response capability (about $9 million) down to $183 million and a $3 million cut for state and local preparedness programs (down to $758 million). As the past year's effort around H1N1 has demonstrated, we need continued and increased investment in public health preparedness or we will be caught off stride again at the next crisis. This is especially hard at a time when state and local budgets are so hard hit.
Overall, these are modest increases. To really turn the tide on the health challenges facing our nation - to turn to a culture of prevention rather than treatment - we will need the level of investment found in the prevention, wellness, and public health Trust Funds that have been proposed as an essential component of health reform.
Some public health highlights in the budget include:
• A 30 percent increase (to $1.4 billion) for food safety;
• A new $20 million Big Cities Initiative (using funds from cuts in other programs) at the U.S. Centers for Disease Control and Prevention (CDC) to target chronic diseases in up to 10 large cities;
• $10 million for a new Health Prevention Corps, to provide new support for state and local health departments;
• A major increase in support for public health emergency preparedness, including a $136 million increase to $476 million (from $341 million) for Office of the Biomedical Advance Research and Development Authority (BARDA) to support the next generation of medical countermeasures;
• $421 million to support the new Center for Tobacco Products at the FDA (from user fees) to ramp up the public health effort to regulate tobacco products;
• $10 million for a Federal Employee Health and Wellness Initiative to create a culture of wellness, improve employee health, and reduce health care costs through programs at Federal worksites;
• $4 million to support Safe Routes to School Programs to encourage healthy community design;
• $16 million increase for global health initiatives;
• $10 billion over 10 years for a strong Child Nutrition and WIC reauthorization; and
• $50 million for a new Healthy Food Financing Initiative to bring grocery stores and other healthy food retailers to underserved communities.
• $17 million boost for the Section 317 child immunization program.