As President Bush released his proposed budget for fiscal year 2006, the Infectious Diseases Society of America (IDSA) today urged Congress and the Administration not to allow federal infectious disease programs that are vital to the nation's health to stagnate due to lack of funding.
"Although we recognize that fiscal constraint is necessary during a time of war and significant federal budget deficit, we urge the Administration and Congress to acknowledge the need for a sufficient investment to protect Americans against infectious diseases," said IDSA president Walter E. Stamm, MD.
Stamm noted that policymakers have already recognized that preventing, controlling, and treating infectious diseases is an integral component of homeland security. Topping the health care agenda of the Senate leadership is a broad "biopreparedness" bill (S. 3) that is aimed at protecting the nation against bioterrorism, antimicrobial resistance, pandemic influenza, and other emerging infectious threats. "We urge Congress and the Administration to show the same commitment and leadership as they move forward with the budget and appropriations process," he said.
The IDSA, which represents the nation's infectious disease physicians and scientists, is encouraged by increases in funding for the Food and Drug Administration, and for bioterrorism and pandemic influenza preparedness. However, IDSA is disappointed by steep cuts in funding at the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA). Also, the small increase granted to the National Institutes of Health (NIH) will not keep pace with inflation. IDSA is urging Congress to increase funding for federal programs on biodefense preparedness, pandemic influenza, antimicrobial resistance, emerging infections, HIV/AIDS, and childhood and adult immunization.
Naturally occurring infectious diseases are the second leading cause of death worldwide and are the third leading cause of death in the United States "Infectious diseases don't respect borders and, in the current era of high-speed global travel, can move easily from one part of the world to another," said Stamm. "We saw this with SARS (severe acute respiratory syndrome), and many experts fear we may see it with avian influenza. Add to this threat the risk that microbes resistant to existing antibiotics could be developed by terrorists or by mother nature, and the value offered by strong public health prevention and control and infectious diseases research programs is crystal clear."
The influenza pandemic of 1918 resulted in more than 500,000 fatalities in the United States and nearly 21 million deaths worldwide. Should even a modest influenza pandemic occur in the U.S. today, CDC estimates up to 200,000 deaths could result. The president's budget increases funding for pandemic influenza preparedness by $21 million, to $120 million. IDSA urges Congress to approve at least this level of spending. "The pressing question about the next pandemic is not whether it will occur, but when, and will we be ready," said Stamm. "The challenges of this past influenza season clearly demonstrate the need to strengthen pandemic influenza and other immunization programs."
Equally challenging is the threat posed by antimicrobial resistance. About 2 million people acquire bacterial infections in U.S. hospitals each year, and 90,000 die as a result. About 70 percent of these infections are resistant to at least one drug, according to CDC. The total cost of antimicrobial resistance to U.S. society is nearly $5 billion annually, according to the Institute of Medicine (IOM). Although drug resistance is on the rise, very few new antibiotics are being developed. "We must reinvigorate the anti-infectives market so that infectious disease doctors have the drugs we need to take care of our patients," said Stamm.
The HIV/AIDS pandemic continues to grow, but in recent years there have been virtually no funding increases for AIDS prevention and care services in the United States. Under this year's budget proposal, HIV care and treatment under the Ryan White CARE Act again receives almost no additional funding, and Medicare is cut deeply. IDSA and the HIV Medicine Association call on Congress to increase federal funding for care and treatment initiatives such as Ryan White, Medicaid, research at NIH, and prevention initiatives at CDC.
"These federal programs are critically needed," said Stamm. "We urge policymakers to become advocates for increased funding for infectious diseases."