Efforts to prevent infectious-disease epidemics and other health threats were funded mostly through a five-year supplemental package
By Betsy McKay
Wall Street Journal, Jan. 19, 2018 4:51 p.m. ET
The Centers for Disease Control and Prevention plans to scale back or discontinue its work to prevent infectious-disease epidemics and other health threats in 39 foreign countries because it expects funding for the work to end, the agency told employees.
The CDC currently works in 49 countries as part of an initiative called the global health security agenda, to prevent, detect and respond to dangerous infectious disease threats. It helps expand surveillance for new viruses and drug-resistant bacteria, modernize laboratories to detect dangerous pathogensand train workers who respond to epidemics.
The activities are funded mostly through a five-year supplemental package that was awarded to the CDC and other government agencies in fiscal 2015 to respond to the Ebola epidemic in West Africa.
The package included $582 million in funds to work with countries around the world after the Ebola crisis in 2014 and 2015. But that funding runs out at the end of fiscal 2019.
Public health leaders had said they hoped dollars for the work would eventually be added into the CDC’s core budget, after the epidemic delivered a wake-up call about the world’s lack of preparedness for deadly epidemics. More than 11,300 people died in the Ebola epidemic, mainly in Africa.
In an email to U.S. and overseas leaders in its global health center, the CDC said it anticipates that if its funding situation remains the same, it will have to narrow activities to 10 “priority countries” starting in October 2019. The email was reviewed by The Wall Street Journal.
The Division of Global Health Protection “will have to scale its global health security portfolio to focus efforts based on existing resources,” wrote Rebecca Martin, director of the CDC’s Center for Global Health. “Faced with this anticipated fiscal reality, we have had to make some very difficult decisions.”
The 10 countries where global health security activities will remain are India, Thailand, Vietnam, Kenya, Uganda, Liberia, Nigeria, Senegal, Jordan and Guatemala, according to the email—countries of strategic or regional importance for the CDC.
Other countries where the agency currently conducts global health security agenda activities include Democratic Republic of the Congo, one of the world’s main hot spots for emerging infectious diseases and the site of the first Ebola outbreak in history; Pakistan; Indonesia; Haiti; and China, where CDC provides technical assistance to the country, which is devoting increasing resources to global health needs. In these 39 countries, the CDC “will plan for the completion of its country-based programs,” transitioning them to other possible funders by October 2020, according to the email.
But if more funding becomes available in fiscal 2019, work in the 10 priority countries could be enhanced and could continue in some of the other countries, according to the email.
Those countries next on the priority list, after the top 10, are China, the DRC, Ethiopia, Indonesia and Sierra Leone, according to another CDC document reviewed by the Journal.
The CDC said in a statement that it is taking these steps now because “we recognize the need for forward planning, and are confident that by planning now we will successfully achieve smooth transitions.”
The CDC is carrying out the work as part of a global health security agenda launched in 2014. Professionals trained in the initiative have helped quickly contain an anthrax outbreak in Kenya and yellow fever in Uganda and identify over 4,000 cases of measles in Sierra Leone.
Reductions now would halt critical work midstream and result in a loss of newly trained local experts, said Tom Frieden, the former CDC director who led the effort until a year ago and is now president and chief executive of Resolve to Save Lives, an initiative working on strengthening epidemic preparedness.
“They’re more likely to have outbreaks and less likely to be able to stop them themselves,” he said of countries that will be affected. “We’ll have to respond instead of having them respond.”
The global health security agenda is “the most important international intervention for emerging infectious disease infrastructure in many years,” said Tom Inglesby, director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health. He added that U.S. leadership has helped persuade other nations to help fund the effort.
The CDC will continue to help respond to emerging disease threats and conduct work that had already been under way to improve detection of emerging infectious diseases globally. It will also continue programs combating HIV, tuberculosis, malaria, flu, and conducting immunization programs, Dr. Martin wrote.