Public Health Funding Policy Activities

After decades of under-investment, our public health system lacks the resources it needs to tackle the full range of health threats, from potential chemical or biological attacks, to serious chronic disease epidemics, or emerging infectious diseases like avian influenza. As the lead federal agency for protecting the public's health, the Centers for Disease Control and Prevention's (CDC) budget must reflect the vital role it plays in the lives of every individual, every day, and its increasing responsibilities for homeland security.

Position Statements and Letters

Group Letter in Support of Increased Funding for Health Tracking and Biomonitoring (August 2011)
Read the Letter

Working Group on Pandemic Influenza Preparedness Letter in Support of Preparedness Funding (March 2010)
Read the Letter

Group Letter in Support of Increased Funding for Health Tracking and Biomonitoring (March 2010)
Read the Letter

Testimony

Testimony of Jeffrey Levi, PhD, Executive Director of Trust for America's Health Before House Appropriations Subcommittee on Labor, Health & Human Services, Education and Related Agencies (April 2011)
TFAH Testimony

Testimony of Jeffrey Levi, PhD, Executive Director of Trust for America's Health Before House Energy & Commerce Subcommittee on Health (March 2009)
TFAH Testimony in Support of Reliable Funding for Public Health

Testimony of David Fleming, MD, Director of Public Health for Seattle-King County, Washington & Member, Board of Directors, Trust for America's Health, before to United States House of Representatives, Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education and Related Agencies (March 2008)
TFAH Testimony on FY09 Budget

Critical Care List - Fiscal Year 2012 Budget

Federal spending for Fiscal Year 2011 contained devastating cuts for public health. The Centers for Disease Control and Prevention (CDC) alone saw an 11 percent cut ($740 million) from Fiscal Year 2010 levels. These cuts come at a time when tens of millions of Americans continue to suffer from chronic diseases like cancer, diabetes, respiratory and cardiovascular illness, and others and spend billions seeking treatment in our health care system. And, our country is still not adequately protected from bioterrorist or other large-scale public health emergencies.

Fiscal Year 2012 affords us an opportunity to put us back on the right track. Congress and the President should work together to restore funding for critical public health programs so that we can begin to move the needle on chronic disease and ensure we are safe and responsive in the event of a bioterrorist or public health emergency. The Prevention and Public Health Fund, guided by the release of the new National Prevention Strategy, also creates a historic opportunity to invest in new and innovative approaches to disease prevention.

Trust for America's Health has developed its annual "Critical Care" list in an effort to identify key programs within the U.S. Department of Health and Human Services (HHS) that are vital to our efforts as a nation to protect health and prevent disease.

The Prevention and Public Health Fund:
The Prevention and Public Health Fund affords us an historic opportunity to make a sustainable investment in activities to protect chronic disease and ensure preparedness against public health emergencies. TFAH recommends that the Fund be fully allocated in 2012 in the spirit of its authorization, and should be used to support the long-term transformation of the nation's public health system. Investments from the Fund should be used in a manner that leverages change throughout the public health system - moving away from the current disease-by-disease approach to one that prioritizes and targets funds so there is alignment between available resources and desired outcomes. The overaching goal should be to optimize the health of everyone by creating healthier, more resilient communities, through policy, systems, organizational, and environmental change. It should not be used to supplant or replace existing critical public health activities that are currently funded by federal discretionary dollars.

Combating Chronic Disease:
Rates of obesity in this country have reached epidemic proportions. This is just one of many conditions that contribute to the heavy burden of chronic disease on growing national and private health care spending, reduced military readiness and national security, and human quality of life and mortality. We need a strong and sustained investment in new community-based and clinical approaches to combating chronic disease. TFAH recommends:

$221 million for the CDC's Community Transformation Grant program to empower communities to transform places where citizens live, work, learn, and play to promote prevention and improve health by lowering rates of chronic disease.
Strong federal investment in the CDC’s National Center for Chronic Disease Prevention and Health Promotion to ensure that we are able at the national, state, territorial, tribal, and local levels to effectively combat chronic disease. Consolidated funding for CDC chronic disease activities has merit in principle but should be designed and implemented in a way that will improve, not hamper, current efforts.

Responding to Environmental Health Hazards:
Beyond visits to the doctor and the choices we make, much of our health is determined by the environment in which we live and work. We must continue to support research, translation, and implementation of knowledge and practices into creating safe, healthy environments that are free of environmental toxics, chemicals, and other hazards and enable citizens to make healthy choices that are not possible in many communities across America today. TFAH recommends:

$50 million for the CDC’s National Environmental Public Health Tracking Network to permit new states to track the impact of environmental hazards on rates of asthma, cardiovascular disease, carbon monoxide poisoning, and other chronic and acute disease and illness.
$43.425 million for the CDC’s Environmental Health Laboratory to ensure that states continue to test for human exposure to potentially dangerous chemicals like arsenic, perchlorate, and many others.
$15 million for the CDC’s Climate and Health Program to support the Climate-Ready States and Cities Initiatives and enable more states to respond to the health impacts of climate change, including heart attacks, stroke, and respiratory illness.
$4 million for CDC’s Healthy Community Design Initiative to help train and support states make changes to the built environment of their communities and enable citizens to make healthier choices.

Bioterrorism and Emergency Preparedness:
Significant progress in preparedness has been made since September 11th and the anthrax tragedies, but the economic situation is putting a decade of gains at risk, with funding cuts at federal, state and local levels. More than any other source, federal dollars are used to fund states and local areas to ensure they have the critical public health infrastructure and capacity to prepare and respond to acts of terrorism, natural disasters, and infectious disease outbreaks. The CDC and the HHS Assistant Secretary for Preparedness Response (ASPR) work to ensure that public health and health systems can respond adequately and effectively in the event of a disaster. TFAH recommends:

$761 million for CDC to adequately fund 50 states, eight territories, and four metropolitan areas through the Public Health Emergency Preparedness (PHEP) cooperative agreement.
$417 million for ASPR’s Hospital Preparedness Program to ensure all 50 states and major cities and territories are funded to maintain communications, equipment, personnel, and other resources needed in crisis scenario.
$665 million to continue investment in the ASPR’s Biomedical Advanced Research and Development Authority (BARDA) to spur development of new vaccines and technologies and manage Project BioShield. TFAH also recommends an additional $100 million be used to support creating a Medical Countermeasure Strategic Investor to spur private equity interest in this market.

Pandemic Influenza Preparedness:
Another influenza pandemic is unavoidable, but we can continue our long-term investments to prepare for and respond to future outbreaks by supporting vaccine production and continuing surveillance and planning efforts. Today, several different agencies across HHS conduct federal efforts to respond to influenza. To ensure we are adequately prepared to the next pandemic, TFAH recommends:

$160 million for CDC’s seasonal and pandemic influenza activities.
$51 million for the Food and Drug Administration.
$33 million for the National Institutes on Health.
$65 million for the HHS Office of the Secretary.

Global Disease Detection:
In a global world, infectious diseases know no boundaries. Maintaining and expanding our work with international partners is critical to detecting and responding to outbreaks and epidemics before they reach our borders. TFAH recommends:

$64 million for CDC’s Global Disease Detection program to incrementally expand our efforts to establish regional centers abroad and avoid closing existing centers.