US set to slash funds for battle against global epidemics

Four years after the United States pledged to help the world fight infectious-disease epidemics such as Ebola, the Centers for Disease Control and Prevention is dramatically downsizing its epidemic prevention activities in 39 out of 49 countries because money is running out, US government officials said.

India, however, seems to be one of the countries that will continue to get funding.

The CDC programs, part of a global health security initiative, train front-line workers in outbreak detection and work to strengthen laboratory and emergency response systems in countries where disease risks are greatest. The goal is to stop future outbreaks at their source.

Most of the funding comes from a one-time, five-year emergency package that Congress approved to respond to the 2014 Ebola epidemic in West Africa. About $600 million was awarded to the CDC to help countries prevent infectious-disease threats from becoming epidemics. That money is slated to run out by September 2019.

Despite statements from President Trump and senior administration officials affirming the importance of controlling outbreaks, officials and global infectious-disease experts are not anticipating that the administration will budget additional resources. The downsizing decision was first reported by The Wall Street Journal.

Two weeks ago, the CDC began notifying staffers and officials abroad about its plan to downsize these activities, because officials assume there will be ''no new resources'', a senior government official told The Washington Post on the condition of anonymity to discuss budget matters. Notice is being given now to CDC country directors ''as the very first phase of a transition'', the official said.

There is a need for ''forward planning,'' the official said, to accommodate longer advance notice for staffers and for leases and property agreements.

The CDC plans to narrow its focus to 10 ''priority countries,'' starting in October 2019, the official said. They are India, Thailand and Vietnam in Asia; Jordan in the Middle East; Kenya, Uganda, Liberia, Nigeria and Senegal in Africa; and Guatemala in Central America.

Countries where the CDC is planning to scale back include some of the world's hot spots for emerging infectious disease, such as China, Pakistan, Haiti, Rwanda and Congo. Last year, when Congo experienced a potentially deadly Ebola outbreak in a remote, forested area, CDC-trained disease detectives and rapid responders helped contain it quickly.

If more funding becomes available in the US fiscal year that starts 1 October, the CDC could resume work in China and Congo, as well as Ethiopia, Indonesia and Sierra Leone, another government official told WP, also speaking on the condition of anonymity to discuss budget matters.

In the meantime, the CDC will continue its work with dozens of countries on other public health issues, such as HIV, tuberculosis, malaria, polio eradication, vaccine-preventable diseases, influenza and emerging infectious diseases.

Global health organisations said critical momentum will be lost if epidemic prevention funding is reduced, leaving the world unprepared for the next outbreak. The risks of deadly and costly pandemic threats are higher than ever, especially in low- and middle-income countries with the weakest public health systems, experts say. A rapid response by a country can mean the difference between an isolated outbreak and a global catastrophe. In less than 36 hours, infectious disease and pathogens can travel from a remote village to major cities on any continent to become a global crisis.

On Monday, a coalition of global health organizations representing more than 200 groups and companies sent a letter to US Health and Human Services Secretary Alex Azar asking the administration to reconsider the planned reductions to programs they described as essential to health and national security.

''Not only will CDC be forced to narrow its countries of operations, but the US also stands to lose vital information about epidemic threats garnered on the ground through trusted relationships, real-time surveillance, and research,'' wrote the coalition, which included the Global Health Security Agenda Consortium and the Global Health Council.

CDC spokeswoman Kathy Harben said the agency and federal partners remain committed to ''prevent, detect and respond to infectious disease threats''.

The United States helped launch an initiative known as the Global Health Security Agenda in 2014 to help countries reduce their vulnerabilities to public health threats. More than 60 countries now participate in that effort. At a meeting in Uganda in the fall, administration officials led by Tim Ziemer, the White House senior director for global health security, affirmed US support to extend the initiative to 2024.

''The world remains under-prepared to prevent, detect, and respond to infectious disease outbreaks, whether naturally occurring, accidental, or deliberately released,'' Ziemer wrote in a blog post before the meeting. ''. . . We recognize that the cost of failing to control outbreaks and losing lives is far greater than the cost of prevention.''

The CDC has about $150 million remaining from the one-time Ebola emergency package for these global health security programs, the senior government official said. That money will be used this year and in fiscal 2019, but without substantial new resources, that leaves only the agency's core annual budget, which has remained flat at about $50 million to $60 million.

Officials at the CDC, the Department of Health and Human Services and the National Security Council pushed for more funding in the president's fiscal 2019 budget to be released this month. A senior government official said Thursday that the president's budget "will include details on global health security funding," but declined to elaborate.