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Dear Majority Leader McConnell, Speaker Pelosi, and Minority Leaders Schumer and McCarthy:
As Congress undertakes the next iteration of legislation to speed the response to the COVID-19 pandemic, the undersigned organizations urge you to include a significant, long-term investment in public health infrastructure. This investment is critical to support the public health system as it rebuilds from the COVID-19 response, but also to strengthen it before the next pandemic hits and avoid the loss of life and social and economic disruption we are facing today. The importance of strong, predictable federal investment in this system is even more vital now as the economic impacts of the pandemic are felt nationwide. State and local governmental budgets, and therefore public health budgets, are likely to be devastated. This will leave our nation even more vulnerable to emerging health risks. By building the core public health infrastructure of states, localities, tribal governments and territories, as well as the Centers for Disease Control and Prevention (CDC), the nation will be better prepared for the next threat.
Our groups recommend $4.5 billion in additional annual funding for CDC, state, local, tribal and territorial core public health infrastructure to pay for such essential activities as disease surveillance, epidemiology, laboratory capacity, all-hazards preparedness and response; policy development and support; communications; community partnership development; and organizational competencies.
For too long, the nation has neglected basic public health capacity. More than 56,000 local public health jobs were eliminated between 2008 and 2017—nearly one quarter of the workforce.1 Health departments are still dependent on archaic methods of tracking diseases, including phone,fax and paper.2 CDC’s funding remains just above level with FY2008, when adjusting for inflation,3 and funding specific to state and local public health preparedness has been cut from $939 million in FY2003 to $675 million in FY2020. That means there has been little room to modernize, retain skilled workforce, and address emerging threats. In fact, only 51 percent of the U.S. population is served by a comprehensive public health system, and the estimated gap in funding foundational public health capabilities is about $13 per person per year, yielding the requested $4.5 billion.
The COVID-19 pandemic is illustrating in the direst terms the consequences of underfunding public health. The delays in diagnostic testing are hampering communities’ ability to suppress the virus. Public health departments are attempting to conduct statewide situational awareness and management of medical supply shortages. The response is personnel-heavy – investigating cases, managing supplies and volunteers, conducting risk communications, coordinating with governmental and healthcare partners, and planning for the next phase of response.
The U.S. has followed a pattern of underfunding of vital public health services, followed by a crisis, a quick infusion of cash, and then dwindling investments over time.5 This pattern is placing American lives at risk. We must think not just of the short-term needs of this pandemic, but the long-term readiness of our nation. We applaud Congress for taking quick action to provide $8.3 billion for the initial response, which included $950 million for the state and local public health response. However, short-term, supplemental funding does not allow public health to recruit and retain the expert workforce needed for protecting the nation against emerging threats. We urge you to do act now to prevent and prepare for the next pandemic.
Sincerely,
1,000 Days
317 Coalition
Advocates for Better Children’s Diets
Advocates for Youth
African American Health Alliance
AIDS Alliance for Women, Infants, Children, Youth & Families
The AIDS Institute
AIDS United
Alliance for Aging Research
Alzheimer's Association and Alzheimer's Impact Movement
Alzheimer's Los Angeles
Alzheimer's San Diego
American Academy of Pediatrics
American Association for Clinical Chemistry
American Association for the Study of Liver Diseases
American Association of Colleges of Pharmacy
American Association of Colleges of Osteopathic Medicine
American Association on Health and Disability
American Clinical Laboratory Association
American College of Clinical Pharmacy
American College of Nurse-Midwives
American College of Preventive Medicine
American Dental Education Association
American Dental Hygienists' Association
American Diabetes Association
American Foundation for Suicide Prevention
American Geophysical Union
American Geriatrics Society
American Heart Association
American Immunization Registry Association
American Institute for Medical and Biological Engineering
American Lung Association
American Mosquito Control Association
American Physical Therapy Association
American Podiatric Medical Association
American Public Health Association
American School Health Association
American Sexual Health Association
American Society for Microbiology
American Society for Reproductive Medicine
American Society of Transplantation
American Society of Tropical Medicine & Hygiene
American Therapeutic Recreation Association
American Thoracic Society
America's Blood Centers
Americas TB Coalition
The Arc of the United States
Asian & Pacific Islander American Health Forum
Association for Prevention Teaching and Research
Association for Professionals in Infection Control and Epidemiology
Association for Women's Health, Obstetric and Neonatal Nurses
Association of American Cancer Institutes
Association of American Medical Colleges
Association of Immunization Managers
Association of Maternal & Child Health Programs
Association of Nurses in AIDS Care
Association of Public Health Laboratories
Association of Schools Advancing Health Professions
Association of Schools and Programs of Public Health
Association of State and Territorial Health Officials
Association of University Centers on Disabilities
Autistic Women & Nonbinary Network
Biophysical Society
Bipartisan Policy Center Action
CAEAR Coalition
Campaign for Tobacco-Free Kids
CDC Southeastern Center of Excellence in Vector Borne Diseases
Center for Science in the Public Interest
CenterLink: The Community of LGBT Centers
ChangeLab Solutions
Children's Environmental Health Network
Commissioned Officers Association of the USPHS
CommunicationFIRST
Council of State and Territorial Epidemiologists
Delta Vector Control District
Easterseals
Emergency Nurses Association
End AIDS Now
Endocrine Society
Entomological Society of America
Epilepsy Foundation
Florida Institute for Health Innovation
Foundation for Healthy Generations
The Gerontological Society of America
GLMA: Health Professionals Advancing LGBTQ Equality
Global Health Security Roundtable
Green & Healthy Homes Initiative
Hawaii Health & Harm Reduction Center
Health Resources in Action
Healthy Schools Campaign
Healthy Teen Network
Hepatitis Education Project
Hep Free Hawaii
HIV Medicine Association
Human Rights Campaign
Immunize Nevada
Infectious Diseases Society of America
International Certification & Reciprocity Consortium
Lakeshore Foundation
Let’s Kick AIDS Survivor Syndrome New York
Los Angeles LGBT Center
March of Dimes
NAACP
National Alliance of State and Territorial of AIDS Directors (NASTAD)
National Association for Biomedical Research
National Association of Chronic Disease Directors
National Association of County and City Health Officials
National Association of Nurse Practitioners in Women's Health
National Association of Pediatric Nurse Practitioners
National Association of School Nurses
National Athletic Trainers' Association
National Black Nurses Association
National Center for Healthy Housing
National Coalition of STD Directors
National Environmental Health Association (NEHA)
National Family Planning & Reproductive Health Association
National Forum for Heart Disease & Stroke Prevention
National Foundation for Infectious Diseases
National Health Care for the Homeless Council
National League of Cities
National Network of Public Health Institutes
National Nurse-Led Care Consortium
National Tuberculosis Controllers Association
National Viral Hepatitis Roundtable
National WIC Association
National Women's Health Network
New Jersey Health Care Quality Institute
NMAC
Novavax
OSA, The Optical Society
Partners for Our Children
Peggy Lillis Foundation
PFLAG
National Prevent Blindness
Prevention Institute
Project HOPE
Public Health Accreditation Board
Public Health Institute
Public Health Management Corporation
Redstone Global Center for Prevention and Wellness GWU
Research!America
Ryan White Medical Providers Coalition
Safe States Alliance
Seqirus
SIECUS: Sex Ed for Social Change
Society of General Internal Medicine
The Society for Healthcare Epidemiology of America
Society for Public Health Education
Society for Vector Ecology
Spina Bifida Association
Stop TB USA
Treatment Action Group
Trust for America's Health
USA Patient Network
Vaccinate Your Family
Washington State Association of Local Public Health Officials
Washington State Public Health Association
Welcome Back Initiative
YMCA of the USA