Credit: REUTERS/Eric Cox
Rising monkeypox cases expose the nation’s need for public health funding
Experts are calling for increased funding of public health. The advocacy group Trust for America’s Health says $4.5 billion annually is needed nationwide. GPB’s Ellen Eldridge reports.
The nation has not invested enough in its public health system, according to a new report from Trust for America's Health.
A lack of funding in core public health programs slowed the response to the COVID-19 pandemic and exacerbated its effects, especially among people of color, low-income wage earners and older Americans, President and CEO Nadine Gracia said.
These are populations that experience higher rates of chronic disease and have fewer resources to recover from an emergency.
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"What we've seen in the COVID-19 pandemic is how critical emergency funding has been to address the public health response," Gracia said. "But that emergency funding isn't a substitute and it isn't sufficient to really fix and address some of the chronic, long-standing deficits in funding to public health."
That's why she said TFAH is calling for a $4.5 billion annual increase nationwide in core funding for the public health system. Money is needed to meet the foundational capabilities of promoting and protecting the health of communities.
Public health funding in Georgia
While Georgia and some other states did see a year-over-year increase in public funding, Gracia pointed out that federal funds meant to help with the economic impact of COVID will not be renewed next year.
So the money could not be used to address long-standing deficits in the public health system, including ensuring the provision of basic public health services, replacing antiquated data systems and growing the public health workforce.
The challenge with regards to the funding of public health at the federal, state and local levels, is what Gracia called a "boom-and-bust cycle of funding" in which, when there is not an emergency or crisis, public health at its baseline is underfunded.
"And then when an emergency happens, you'll see that Congress and state and local lawmakers will then have this infusion of emergency funding to help support the crisis itself," Gracia said. "Once that crisis is over, the funding either ends or it's directed or something else, and we're back to that state of underfunding of public health."
It's difficult to recruit, hire and retain a public health workforce to do the day-to-day work of public health, as well as to be able to scale up during a time of emergency, she said.
An October 2021 analysis conducted by the de Beaumont Foundation and the Public Health National Center for Innovations, found that state and local health departments need an 80% increase in the size of their workforces to be able to provide comprehensive public health services to their communities.
Unable to meet demand during crises
Cuts made to the Public Health Emergency Preparedness Program (PHEP), which is a primary source of federal funding to the states and localities, leave local health departments scrambling to meet demand for things like monkeypox vaccines.
Officials in San Francisco and New York City declared a public health emergency due to the spread of the monkeypox virus.
New York had recorded 1,345 cases as of Friday, according to data compiled by the Centers for Disease Control and Prevention. California had the second-most, with 799.
Federal leaders last week announced distribution plans for 780,000 shots of the two-dose Jynneos vaccine. The doses were be allocated to states, cities and other localities based on their case numbers and the size of their populations that are considered high-risk for the disease.
Georgia initially received 3,000 doses, which is enough to vaccinate 1,500 people.
The Coastal Health District received its first shipment of Jynneos on Friday, and vaccinations begin Monday, Aug. 1, to qualifying individuals.
Currently, appointments are only available at the Chatham County Health Department’s main clinic at 1395 Eisenhower Drive, though additional locations will be added as vaccine supply increases.
Appointments can be self-scheduled online at //coastalhealthdistrict.org/monkeypox.
The U.S. has ordered 5.5 million more vaccine doses for delivery by mid-2023 and has rights to the raw ingredients that could make 11.1 million more doses.
Federal funding for PHEP has been cut by more than 30% since FY 2007, and more than 55% of local health departments rely solely on federal funding for emergency preparedness activities, according to a 2013 National Profile of Local Health Departments.
Surveys on budget cuts since 2009 from the National Association of County and City Health Officials have consistently found that emergency preparedness services are one of the most frequently reduced programs at local health departments.
Another program, the hospital preparedness program, which is the primary source of federal funding to help health care systems actually prepare for emergencies, has experienced a nearly two-thirds reduction over the last two decades, when adjusted for inflation, Gracia said.
Though it's difficult to fund core needs while meeting the demands of new crises, Trust for America's Health believes a $4.5 billion increase in annual funding is a needed investment in the nation's health security.
"Investments in public health should be particularly directed to those communities that, due to the impacts of structural racism, poverty, discrimination, and disinvestment are at greatest risk during a health emergency,” Gracia said.