Infectious Diseases Experts Concerned with President’s Budget Request

The Society for Healthcare Epidemiology of America (SHEA) says it is alarmed by the proposed funding for critical programs needed to prevent, treat, and contain infectious diseases included in the President’s Budget Request. The recommended funding levels suggest an under-appreciation for the wide-ranging and life-saving programs coordinated by the Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ).

“The President’s Budget Request signals shifting priorities in public health, but these tradeoffs come with substantial consequences to the quality and safety of healthcare in the United States,” said Keith Kaye, MD, MPH, president of SHEA. “Proposed cuts and consolidations will substantially limit our ability to monitor trends in healthcare-associated infections and antibiotic resistance, and to prevent and respond to infectious diseases outbreaks, as well as improve the delivery of healthcare.”

The PBR outlines several reductions in funding that affect healthcare and public health programs:
• The CDC’s total budget would be reduced by 12 percent, to $5.6 billion, compared to the 2017 level.
• The CDC’s Public Health Emergency Preparedness and Response Program would have its funding reduced by 43 percent, or $1.4 billion.
• Antibiotic Resistance Solutions Initiative, a CDC program that drives coordinated and aggressive action to tackle the threat of antibiotic resistance, would be reduced by $22 million.
• The CDC’s Global Health Security Agenda, a program that helps track and respond to emerging infectious outbreaks throughout the world would be cut from $180 million each year to about $60 million each year.
• AHRQ would see a 21 percent reduction in spending. Additionally, the budget request proposes folding the vital work of AHRQ under the National Institutes of Health, a move that would dilute the agency’s work to address waste and inefficiencies in our healthcare system.

Additionally, the budget request does not include funds for vital work supported by the Prevention and Public Health Fund, including efforts on healthcare-associated infections, outbreak response and laboratory capacity. The elimination of these resources will end funding for public health department communication systems and staff support to communicate among healthcare facilities in the event of an outbreak. Public health departments’ ability to collect and analyze data specific for outbreak detection and response will be seriously hindered.

“If implemented, this proposal would abandon critical efforts by states and hospitals to coordinate and manage detection of and response to infectious diseases outbreaks,” said Kaye. “Patient outcomes could suffer as a result, and recent progress in reducing healthcare and community-associated infections would be difficult to maintain.”

SHEA says it will look to Congressional leaders to temper the magnitude of these reductions and maintain their commitment to strengthening investments in healthcare, research and innovation. Over the past several years, the House and Senate have demonstrated persistent support for these health programs. It is important that Congressional leadership recognize that spending on efforts to prevent infections is less costly than efforts to contain infections, that efforts to stem the tide of antibiotic resistance will save numerous American lives, and that the CDC and AHRQ are critical to the success of protecting and improving the health of our nation.

Source: Society for Healthcare Epidemiology of America (SHEA)