IDSA: President's FY 2011 Budget Falls Far Short on Infectious Diseases Programs

The Infectious Diseases Society of America (IDSA) says it is disappointed that President Obama's fiscal year (FY) 2011 budget fails to strengthen key U.S. public health and research initiatives, and adds that the nation's ability to prevent, diagnose and treat an ever-increasing number of infectious diseases threats will be severely diminished under the President's budget. The IDSA calls upon Congress to reshape the President's proposal and craft a budget that instead bolsters funding for U.S. and global infectious diseases research and public health activities through the nation's leading federal health agencies. 

"As the recent outbreak of the 2009 H1N1 influenza virus has shown, federal agencies such as the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) are our nation's first line of defense against infectious diseases," said Richard Whitley, MD, FIDSA, IDSA's president. "Unfortunately, the President's proposal does little to move the nation forward in its battle to reduce the terrible toll of many preventable and treatable infectious diseases that claim too many lives around the world."

Especially hard-hit in this year's budget is CDC, which would have its budget cut by $135 million. Of particular concern to IDSA are:

-- The slashing of CDC's Infectious Diseases program budget, which would be cut by almost $100 million, a 5 percent decline

-- A cut of more than 50 percent to the already strapped budget for the vital Antimicrobial Resistance program, which would force CDC to cut in half its support for state and local surveillance, prevention and control efforts, and end all grants to states for the successful Get Smart in the Community program to combat improper antibiotic use

-- A 21 percent reduction in grants for the Section 317 immunization program compared to the current fiscal year, in light of the end of additional funding provided though the stimulus bill; these cuts will reduce access to immunizations, which save lives and millions of dollars in preventable medical spending

While infectious diseases research at the National Institutes of Health (NIH) would grow by $150 million in FY2011 under the proposed budget, this represents just over 3 percent above current funding levels.  With biomedical research inflation increasing about 3.6 percent per year, this budget will actually result in fewer grants awarded and fewer new research projects, at a time when the need for this research is so critical.

The $476 million proposed for the Biomedical Advanced Research and Development Authority (BARDA) is grossly insufficient and will fail to achieve Congress' stated national security and emerging infection goals for this new program. BARDA was established to support the development of countermeasures against biological agents and naturally occurring emerging infections that could threaten national security. We are grateful that the President has identified BARDA as a priority and recommended an increase in its funding, but this agency has been severely underfunded since its inception. BARDA needs $1.7 billion in the upcoming fiscal year to fund research and development of therapeutics, including new antibacterial drugs to treat gram negative bacterial infections, diagnostics, vaccines, and other technologies.  Such funding would help ensure the availability of resources throughout the advanced stages of development and give needed flexibility for BARDA to partner effectively with industry.

Given the influenza outbreak of the past year, the IDSA says it is distressing that the President's budget would call for a cut of nearly $300 million in pandemic influenza preparedness and response funding at HHS. The 2009 wave of the pandemic was relatively mild, but the next wave-or the next pandemic-may not be.

Proposed increases in funding for key domestic HIV/AIDS programs, including CDC's HIV prevention and surveillance efforts and the Ryan White program, are steps in the right direction. But these minimal additions will leave HIV prevention and medical programs and clinics struggling to meet a growing demand for care. The same can be said of modest increases in funding to address HIV/AIDS and tuberculosis around the world, through the President's Emergency Plan for AIDS Relief (PEPFAR) and other programs, which fall short when matched against the scope of these twin global health threats.

Given these serious concerns, the IDSA urges Congress to develop a budget that will invest wisely in the prevention, diagnosis, and treatment of life-threatening infectious diseases.