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Staff and volunteers with Project C.U.R.E hold a drive outside the United Center to collect donations of personal protective equipment from the community which will be used to supply hospitals and clinics that are experiencing shortages due to the Covid-19 pandemic on March 29, 2020 in Chicago. (Photo: Scott Olson via Getty Images)

Staff and volunteers with Project C.U.R.E hold a drive outside the United Center to collect donations of personal protective equipment from the community which will be used to supply hospitals and clinics that are experiencing shortages due to the Covid-19 pandemic on March 29, 2020 in Chicago. (Photo: Scott Olson via Getty Images)

'Stunning': Democrats Considering Major Cuts to Future Pandemic Preparedness

"If there was ever a teachable moment that we need to invest in public health, it is now."

Kenny Stancil

Although President Joe Biden has called for investing $30 billion in pandemic preparedness, congressional Democrats are reportedly considering slashing such proposed funding by $25 billion in forthcoming legislation, alarming public health advocates and prompting critics to ask if lawmakers have learned anything from the ongoing coronavirus disaster.

"Prevention is always better than treatment, and the fact that, after an event as significant as Covid, we have to fight for this $30 billion defies belief."
—Gabriel Bankman-Fried, Guarding Against Pandemics

Covid-19 has killed nearly 614,000 Americans over the course of the past year and a half, and as the rapid spread of the ultra-contagious Delta variant has made clear, the pandemic is not over.

And yet, as Democrats finalize their $3.5 trillion reconciliation bill to authorize federal spending on a range of social welfare measures, they are contemplating devoting just $5 billion to bolstering the nation's defenses against future infectious disease outbreaks, according to The Hill

The Atlantic reported Monday that while the precise amount of funding for pandemic preparedness "is still in flux, it is significantly less than requested," according to an unnamed source familiar with the negotiations. The Senate's bipartisan infrastructure bill, meanwhile, does not include any substantial investments in public health.

"It's so stunning because if there was ever a teachable moment that we need to invest in public health, it is now," Tom Frieden, head of the Centers for Disease Control and Prevention during the Obama administration, told The Hill late last week. "We will not have another moment like this in our lifetimes."

When the White House unveiled its $2.3 trillion American Jobs Plan at the end of March, Biden proposed spending $30 billion over four years to "protect Americans from future pandemics."

Those funds would be used to improve the production of vaccines and therapeutics, train personnel for epidemic response, and build up the Strategic National Stockpile, which is meant to avert potential shortages of lifesaving supplies, medicines, and devices during public health emergencies. Such funding would also make it possible to proactively develop "universal vaccines for pathogens most likely to cause a pandemic (e.g., influenza)" as well as "treatments such as broad spectrum antivirals and rapid monoclonal antibodies."

Eric Levitz of New York magazine noted Tuesday that "when the novel coronavirus reached our shores, the CDC was spending only $500 million a year on programs aimed at tackling emerging diseases. The National Institutes of Health's total budget for its program on infectious diseases, meanwhile, was roughly $5.5 billion, with only a small fraction of that sum going toward pandemic prevention. Little to nothing was spent on shoring up U.S. hospitals' surge capacity."

"By contrast, in late 2019, Congress increased the Pentagon's budget—which was already larger than the military budgets of China, India, Russia, the U.K., Saudi Arabia, Germany, France, Japan, and Australia combined—by $21 billion," Levitz pointed out. "In other words: The U.S. government treated preparing for a pandemic as a nigh-trivial concern, or a matter roughly 0.01% as important as modernizing the nation's stockpile of nuclear warheads."

Levitz suggested that "perhaps America could only have learned the hard way. Only after seeing a novel pathogen kill hundreds of thousands of its citizens, shutter its economy, and shred much of its social fabric would Congress finally see that spending a pittance on public health had significant downsides."

"This is what I thought a little over a year ago, anyway," he added. "Today, such an assessment looks far too optimistic... Congress is already back to treating pandemic preparedness as a minor concern."

Reports of Democrats' willingness to reduce new funds for pandemic preparedness from $30 billion to $5 billion came just days after the Senate Armed Services Committee agreed to increase Biden's already gargantuan $715 billion Pentagon budget by $25 billion. That sum is also exactly how much Public Citizen estimates it would cost to vaccinate the world and put an end to the Covid-19 pandemic that has killed more than 4.24 million people globally. 

Investing $30 billion to prepare for future pandemics pales in comparison to how much has been spent responding to the current one.

"By one estimate," Levitz wrote, "Covid will cost our country more than $16 trillion. The true costs of the pandemic, however, cannot be fully quantified. The knock-on effects of prolonged shutdowns and premature deaths are vast. As Alec McGillis documents in a recent ProPublica report, the pandemic eviscerated communal life in America's most disadvantaged neighborhoods, denied kids with unstable homes the reprieve of school time, left adolescents to wile away their days with social media spats, enlarged the black market for firearms—and thus birthed the largest homicide spike in U.S. history."

According to Levitz:

Pandemic preparedness is an easy line-item to shrink for the same reason that it was an easy one to underfund pre-Covid: The constituency with the greatest stake in preventing or mitigating the next public health crisis is unidentifiable, let alone, organizable. The 600,000 Americans who died of Covid-19 over the past 17 months did not know in 2019 that they had a potentially life-or-death stake in the size of the CDC's budget. If Democrats go small on pandemic preparedness, the victims of the next novel virus will not light up Congress' phone lines. By contrast, if the party scraps its plan to add dental, hearing, and vision benefits to Medicare, the AARP would make its discontent known.

Public health advocates, however, are actively lobbying Democrats to keep all $30 billion for pandemic preparedness in the reconciliation package.

"We've been meeting with offices across the Hill to try and make sure they hear this message," Adriane Casalotti, chief of public and government affairs at the National Association of County and City Health Officials, told The Hill. "We don't want to find ourselves unprepared for the next crisis."

"Things could have gone differently if we had made, and maintained, the kind of investments in public health we have long needed... We have to learn from this history, because we cannot afford to repeat it."
—Sen. Patty Murray

While the $1.9 trillion American Rescue Plan that Biden signed in March provided $10 billion to prepare for future pandemics, epidemiologists and other experts say that is insufficient after decades of underinvestment in local and state public health departments.

"We have starved public health for a long time," said Frieden, who is now president of Resolve to Save Lives, a global health nonprofit. "Public health tends to be at the end of the line when it comes to giving out money, and that's been happening for decades."

Levitz argued that "Democrats are rightly concerned with finding space in their $3.5 trillion bill for investments in eldercare, paid leave, community college, and other vital social programs." Nonetheless, he warned, "inadequate investment in public health threatens the core objectives of such programs." He likened a $30 billion investment in pandemic preparedness to "an insurance policy" for all of the other initiatives in the bill.

Gabriel Bankman-Fried, executive director of Guarding Against Pandemics, told The Atlantic that "prevention is always better than treatment, and the fact that, after an event as significant as Covid, we have to fight for this $30 billion defies belief."

Frieden added that "if we're not going to really make a down payment" on improving our public health system after the devastation wrought by Covid-19, "we are not going to do it."

As The Hill reported, "advocates see an ally" in Sen. Patty Murray (D-Wash.), chair of the Senate Health, Education, Labor, and Pensions Committee. Murray is pushing for a piece of legislation called the Public Health Infrastructure Saves Lives Act, which would provide $4.5 billion per year to strengthen the nation's public health preparation and response.

In a blog post published last week, Murray cited a new poll from Data for Progress, which found that 71% of voters, including 60% of Republicans, want Congress to allocate $30 billion for pandemic preparedness.

When Covid-19 struck, "our public health system was underfunded, and our nation was unprepared," resulting in a catastrophic loss of life and severe economic damage, Murray wrote

"Things could have gone differently if we had made, and maintained, the kind of investments in public health we have long needed," the lawmaker added. "We have to learn from this history, because we cannot afford to repeat it."


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