CDC Needs $1 Billion Budget Increase, Director Says

WASHINGTON — Because of "urgent realities" and "urgent threats," the Centers for Disease Control and Prevention needs a budget increase of roughly $1 billion this year, the director of the Atlanta-based institution has told Congress.

Without it, "our children may be the first generation in more than a century with a shorter expected life span than their parents," Dr. Julie Gerberding said in a report to the House Appropriations Committee.

She said CDC's budget, now about $9.2 billion a year, should be increased to $10.2 billion in the 2008 budget year that starts Oct. 1.

President Bush, in his proposed federal budget for 2008, had recommended reducing the CDC budget by about $500 million from the current level, while earmarking hundreds of millions of dollars for pandemic preparedness and bioterrorism.

In the 10-page report submitted April 20 at the request of Rep. David Obey, D-Wis., chairman of the Appropriations Committee, Gerberding warned that bioterrorism, climate change, chronic diseases like diabetes, and emerging plagues such as drug-resistant tuberculosis represent "urgent threats that have become more prominent in the dawn of the 21st century."

She said spending more money on CDC's disease prevention programs would save money in the long run by reducing a national medical bill that "threatens to overwhelm our financial resources."

"CDC workforce is a national treasure," she said, adding that the agency will need funds to keep a "capable, agile workforce that can learn, adapt and perform."

Some members of Congress and former CDC directors have warned of low employee morale under Gerberding's management.

Peppering the report with warnings and observations in bold-faced type, Gerberding said the agency needs increases of:

— Nearly $400 million to deal with infectious diseases.

— More than $100 million for health promotion campaigns.

— About $80 million for terrorism preparedness.

— More than $65 million for global health programs.

She warned congressional budget writers that "the time for action is now" because "lives are at stake — especially those of the most vulnerable people in our society."

The report was made public by the Campaign for Public Health, a nonprofit group created specifically to advocate budget increases for CDC.

The group's own analysis of the CDC budget had concluded the agency needs slightly more than the $10,185,151,000 recommended by Gerberding's report.

Obey requested the report in March at a hearing where Gerberding testified on the president's budget request for CDC.

Appropriations committees often ask heads of government agencies to submit "professional judgment" statements on their budgets.

But Obey took the somewhat unusual step of directing Gerberding to submit the report directly to the committee, rather than following the customary procedure of sending it to the White House first for clearance.

"I think it's a wonderful document," said Dr. Georges Benjamin, executive director of the American Public Health Association.

"It is the kind of unvarnished guidance the Congress needs to make its decisions," he said. When Gerberding next testifies before an appropriations committee "she'll defend the president's budget, because that's her job, but this is her unfettered opinion," he said.

Benjamin and others noted that while CDC's budget seems to have increased over the past several years, erosion of its traditional disease control activities has been "masked" by infusions of cash earmarked for spending on bioterrorism and pandemic activities.

Beyond confirming that the report had been submitted directly to the committee as Obey requested, CDC spokesman Tom Skinner declined to elaborate on its contents.

While Gerberding described world poverty, climate change and "ideological extremism" as urgent threats, she warned that "the simultaneous intersection of all three is awesome."

"Terrorism, infectious disease outbreaks and pandemics and natural disasters that affect a greater number of Americans and people around the globe are the likely outcomes for which CDC and its partners must prepare," she said.

She also said the center needs more money to communicate health information to the public.

"The growing babble of junk science, unsubstantiated opinion and distracting debate that occupies an increasing proportion of cyberspace makes CDC's highly trusted role in distinguishing credible health information all the more critical," she said.

On the Web:

Report posted by Campaign for Public Health: www.fundcdc.org/documents/4.19BudgetChartNEWEST.pdf