Bioterrorism Preparedness Needs are Draining Funds from Essential Public Health Resources, Say Speakers at Annual Stern Forum

NEW YORK CITY, May 29 ??? Cities and counties in New York and the rest of the nation are having an increasingly difficult time developing and maintaining critical public health functions while dealing with escalating bioterrorism preparedness demands and dwindling funds, according to panelists speaking at the A. Richard Stern Memorial Health Policy Forum at The New York Academy of Medicine.

The audience at the Stern lecture on "The Price of Bioterrorism Preparedness"

The U.S. Centers for Disease Control and Prevention awarded $918 million to states in 2002 to upgrade health departments??? preparedness for bioterrorism, infectious disease outbreaks and other public health threats. These funds, however, were hardly sufficient to respond to the anthrax scares and to the rapid spread of West Nile Virus, said Roz Lasker, M.D., Director of the Academy???s Division of Public Health and organizer of the May 28 event. Widespread state and local budget deficits are placing an increasing number of health departments in a fiscal crisis.

???To carry out the initial phase of the President???s smallpox vaccination plan, many local health departments have had to divert resources away from core public health programs and other terrorism preparedness efforts,??? said Lasker, who also directs the Academy???s Center for the Advancement of Collaborative Strategies in Health.

The health forum featured presentations by four public health experts and was attended by 65 people. Lloyd Novick, M.D., M.P.H., President of the New York State Association of County Health Officials (NYSACHO), told the audience that the federal government has directed local health departments to prioritize bioterrorism preparedness but has not provided ample funding. Traditional public health functions will be shortchanged as a result, said Novick, who is also Health Commissioner for Onondaga County in upstate New York. His department received $450,000 in federal bioterrorism preparedness dollars yet had to spend an additional $485,000 from its own coffers to cover the costs, he said. Conditions would have been even worse if NYSACHO and others had not blocked Gov. Pataki???s plan to cut matching funds to health departments in the new fiscal year.

Speaker Patrick Libbey, Executive Director of the National Association of County and City Health Officials Most health departments are not receiving additional staff to handle the new bioterrorism preparedness tasks, Novick said. During the height of the anthrax scare, for example, his staff had to test every suspicious substance, including traces of powder found in a pizza box (it proved not to be anthrax). ???When situations like this occur, new staff is not added,??? Novick said. In fact, 30 percent of health departments nationwide say that smallpox vaccination requirements are diverting resources from ongoing public health programs such as STD prevention, according to a recent survey shared by speaker Patrick Libbey, Executive Director of the National Association of County and City Health Officials. The national survey also found that half of local health departments??? time in the past year was spent on emergency preparedness activities, Libbey said. The surveys won???t be enough to prove that bioterrorism preparedness is actually diverting resources from essential public health functions, Libbey said. Data is needed so that something can be done to address the crisis. Too many reports of diverted funding are anecdotal, he said, and anecdotes will not be enough to force funding changes.

Commissioner Thomas Frieden, M.D., M.P.H., of the New York City Department of Health and Mental Hygiene told the audience that bioterrorism preparedness requirements are stretching his resources but not undermining the city???s public health services. In fact, Frieden said that some initiatives labeled ???bioterrorism preparedness??????like the city???s new Syndromic Surveillance system???are dually serving public health needs. The electronic surveillance system tracks non-specific disease indicators, such as whether hospital emergency room visits are suddenly on the rise or whether pharmacy sales of a certain drug are suddenly skyrocketing. This system can provide early warning of both bioterror outbreaks and other health trends, such as flu epidemics and SARS clusters. ???Every day we sift through about 50,000 pieces of data looking for trends,??? Frieden said at the Stern forum. ???It???s helping us know more about the health status of New Yorkers than we???ve ever known before.??? Still, Frieden is dissatisfied with the way the federal government is allocating federal funds for bioterrorism preparedness. He testified this spring to the U.S. Senate that New York City isn???t receiving its fair share. Alaska is receiving four times more in federal dollars than New York City, he said, and Washington, D.C. is receiving six times more.

Speaker Jo Ivey Boufford, M.D., Co-Chair of an Institute of Medicine committee on public health Jo Ivey Boufford, M.D., a Professor of Health Policy and Public Service at New York University???s Robert F. Wagner Graduate School of Public Service, said that only 1 percent of the nation???s total health spending is being used for prevention initiatives. This is a gross underfunding since so many deaths are preventable, she said, including those related to tobacco, diet and exercise, firearms, microbial agents and illicit drugs. Boufford, who is Co-Chair of the Institute of Medicine???s Committee on Assuring the Health of the Public in the 21st Century, said there is a real message problem when it comes to heralding the importance of public health, in part because preventive undertakings are far less visible than treatment and health care delivery.

A panel of health experts at the Stern forum offered feedback on whether public health efforts were truly being sacrificed to meet bioterrorism preparedness demands. Eileen Salinsky, M.B.A., Senior Research Associate with the National Health Policy Forum, said that even if health departments aren???t financially suffering now, they will if the federal spigot is turned off. ???There???s no guarantee the federal money will continue,??? Salinsky said. ???I think there???s going to be a real debate in the next session of Congress for fiscal year 2005.??? With the current elevated interest in public health and prevention due to bioterror threats, now is the time for the public health community to unite and spread the word about the critical funding needs, concluded Michael McGinnis, M.D., M.P.P., Senior Vice President and Director of the Health Group for The Robert Wood Johnson Foundation.

???Because of bioterrorism and emerging diseases, the interest in public health is probably stronger now than any time in the last 50 years,??? McGinnis said.

The health policy forum was made possible by the Dr. A. Richard Stern Memorial Fund, established by the Academy in1943 at the request of Dr. Stern???s widow to support lectures and addresses. Dr. Stern was an Academy Fellow who practiced medicine in New York for 39 years. The New York Academy of Medicine is a non-profit institution founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on urban populations, especially the disadvantaged.

Posted on May 29, 2003

 Print   Subscribe

 

Contact:
Andrew J. Martin
Director of Communications
The New York Academy of Medicine
1216 Fifth Avenue
New York, New York 10029
212-822-7285
amartin@nyam.org

Press Release Archive