Zika virus exposes need for greater public health funding, experts say

Government funding cuts are helping to fuel wide variations in states’ ability to detect and respond to public health threats such as the Zika virus.

That was the overriding conclusion of a panel of experts who gathered on Capitol Hill on Wednesday to discuss how to prevent and respond to infectious disease outbreaks.

The event was sponsored by the Trust for America’s Health, a nonprofit, nonpartisan organization dedicated to disease prevention.

In recent years, public health threats such as bird flu, anthrax, Ebola and MERS have focused attention on the nation’s spotty ability to detect and address public health scares.

Each crisis typically brings temporary laser focus from lawmakers, who usually provide emergency funds as needed. Consider that President Barack Obama has requested $1.8 billion in emergency funding in his fiscal year 2017 budget plan to address the Zika virus. And Congress is weighing a number of funding proposals as well.

But that tendency to react to the “disease of the day” is shortsighted, said Umair A. Shah, executive director of the Harris County (Texas) Public Health & Environmental Services.

“We’re doing that similar thing related to Zika,” Shah said, “instead of really investing in a proactive fashion with a broad-based platform of public health emergency funding.”

In the recent National Health Security Preparedness Index compiled by the Robert Wood Johnson Foundation, the United States scored a 6.7 out of 10 on its preparedness level.

The score is based on more than 100 measures, including flu vaccination rates, the share of the population covered by wireless 911 and the number of hospitals.

But those measurements varied significantly by state. While 18 states logged preparedness index levels that were significantly higher than the national score, 16 others scored significantly below the national average.

Generally, states along the Eastern Seaboard, in the upper Midwest and in the Southwest scored above the national score.

But states in the deep South – Alabama, Arkansas, Georgia, Louisiana, Mississippi, Oklahoma – scored significantly below the national average. As did states in the mountain West region – South Dakota, Wyoming, Montana, Idaho.

The low-scoring Southern states are “particularly concerning when you look at the issue of Zika,” said Paul Kuehnert, assistant vice president for programming at the Robert Wood Johnson Foundation.

That’s because projections from the U.S. Centers for Disease Control and Prevention show that Zika-carrying mosquitos are likely to be prevalent in the Southern half of the U.S.

“Many of the states that are potentially the home for these mosquitoes are the states that are scoring below the national average on the preparedness index,” Kuenhert said.

The Zika-infected mosquitoes also are expected to reach Indiana, West Virginia, Arizona and parts of Nevada – all states that also scored significantly below the national average on the preparedness index.

A December report by the Trust for America’s Health and Robert Wood Johnson Foundation also found that 28 states scored five out of a possible 10 on key measurements of a state’s ability to prevent, detect, diagnose and respond to an infectious outbreak.

Part of the problem has been a slashing of state and federal funding for public health services.

Sixteen states cut their public health budgets from fiscal year 2013 to 2015, according to a separate report released last month by the Trust for America’s Health.

Federal Public Health Emergency Preparedness funding, which helps states and local governments respond to all types of emergencies, has fallen to $651 million this year from a high of $940 million in 2002, the report said.

Federal Hospital Preparedness Program funding has been cut by more than 50 percent, from $515 million in 2004 to $255 million in 2016, the Trust for America’s Health report said.

Similar cuts have occurred at the state level. Median per-capita state spending for public health in fiscal year 2015 is about $33.71, the report said. That’s roughly the same rate as in fiscal year 2008. But when adjusted for inflation, it amounts to a $1.2 billion cut.

The funding cuts reflect a “misperception that we no longer needed public health,” said Dr. Margaret Fisher, medical director at the Unterberg Children’s Hospital at Monmouth Medical Center.

“We’ve really crippled ourselves,” said Fisher, a member of the American Academy of Pediatrics’ Disaster Preparedness Council. “We’ve gotten ourselves in a situation where I think we’re undervaluing the things that could help us the most.”