How Does the World’s Leading Economy and the Rest of the World Prepare for Disease Outbreaks, Epidemics, and Pandemics?

The CDC

invisible hand “As demonstrated in the PHEP funding chart above, CDC continues to work with reduced financial resources, which similarly affects state, local, and insular area public health departments. These and other funding decreases have resulted in more than 45,700 job losses at state and local health departments since 2008. These losses make it difficult for state and local health departments to continue to expand their preparedness capabilities, instead forcing them to focus on maintaining their current capabilities.”

The NIH

invisible hand “NIH has been working on Ebola vaccines since 2001. It’s not like we suddenly woke up and thought, ‘Oh my gosh, we should have something ready here,'” Collins told The Huffington Post on Friday. “Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would’ve gone through clinical trials and would have been ready.”

It’s not just the production of a vaccine that has been hampered by money shortfalls. Collins also said that some therapeutics to fight Ebola “were on a slower track than would’ve been ideal, or that would have happened if we had been on a stable research support trajectory.”

The PPACA

invisible hand “The health law initially funded the Prevention Fund at $2 billion annually, with slightly smaller appropriations in the first few years as the program scaled up. This would be the only federal budget item dedicated to prevention and public health activities. The deficit reduction package that passed in February 2012 cut $6.5 billion from the Prevention and Public Health Fund, leaving it with the budget you see in green. The cut eliminated just over a third — 37 percent — of the Prevention Fund’s budget. Congress used these funds as part of a “doc-fix” package to keep Medicare provider payments stable.

Congressional gridlock has stopped Republican plans to eliminate the fund altogether from becoming law. But that doesn’t mean it’s safe: The Obama administration plans to use $454 million in Prevention Fund dollars to help pay for the federal health insurance exchange. That’s 45 percent of the $1 billion in Prevention Fund spending available this year — and what’s represented in the graph above, in yellow.”

The WHO

Peter Piot, the discoverer of Ebola responded: “On the one hand, it was because their African regional office isn’t staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for hemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard…I think it is what people call a perfect storm: when every individual circumstance is a bit worse than normal and they then combine to create a disaster. And with this epidemic there were many factors that were disadvantageous from the very beginning.”

How did austerity, starving the beast, and politics get us ready for world disasters? It didn’t and I believe it is pretty plain to see we were unprepared to meet Ebola head-on due a lack of foresight, planning, and funds.

Notes and References:

Republican budget cutting nearly halved CDC’s emergency preparedness since 2006 Huffington Post, October 13, 2014

CDC Preparedness Report – Background “2013-2014 National Snapshot of Public Health Preparedness,” USHH CDC

Ebola in the U.S.—Politics and Public Health Don’t Mix Scientific American October 6, 2014

The Incredible Shrinking Prevention Fund Washington Post, Health Reform Watch blog, April 13, 2013

Ebola and WHO Budgets Controversies in Hospital Infection Prevention blog, October 5, 2014

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