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Schuchat Warns Loss of DHHS Fund Could Have Profound Impact on Infectious Disease Prevention

MAR 14, 2017 | BRIAN P. DUNLEAVY
The Centers for Disease Control and Prevention (CDC) has been banging the drum for years about the critical public health challenges posed by antibiotic-resistant bacteria.
 
Now, with a new administration in the White House and a Republican-controlled Senate and House of Representatives, officials at the agency are faced with presenting their case—and advocating for increased funding for vital programs—to a whole new set of political leaders. In some ways, these efforts started on March 7, 2017 with acting CDC director Anne Schuchat, MD, testifying before Congress. Dr. Schuchat has been with the agency since 1988; she replaces—for now—Thomas Frieden, MD, MPH, who announced his resignation in January.
 
“We don’t have a lot of time,” Dr. Schuchat told Congress. “Resistance is a problem now, because it is a threat to modern medicine itself.”
 
Current CDC figures estimate that, to date, more than 2 million illnesses and 20,000 deaths have been caused by antibiotic-resistant bacteria. More than 250,000 illnesses and 14,000 deaths have been attributed to resistant strains of Clostridium difficile alone, the agency reports. Of course, it is now widely known that bacteria develop resistance in large part due to the improper prescribing of antibiotics. The CDC believes as many as 50% of all antibiotic prescriptions currently written in the United States are inappropriate.
 
Dr. Schuchat appeared before Congress to testify in support of the US Department of Health and Human Service’s (DHHS) Prevention and Public Health Fund, which, among other things, funds roughly 12% of the CDC’s budget. It has been reported that the healthcare reform bill currently being debated in Congress, which would replace the Affordable Care Act, will eviscerate the fund.
 
According to Dr. Schuchat’s testimony, monies from the Prevention and Public Health Fund (roughly $1 billion) have been used by the CDC to deliver vaccines against infectious diseases (as needed), finance disease and vector-surveillance initiatives, monitor water supplies for contamination, and track hospital-associated infections, particularly those which may be resistant to currently available treatments.
 
The CDC and other government agencies have in recent years cited the numerous public health threats posed by infectious diseases in general, and have lobbied officials for increased funding for research and development of novel vaccines and treatments as well as programs to effectively distribute interventions as needed. In 2016, for example, the CDC, DHHS, and National Institutes of Health requested federal funding to combat Zika, a request that was not approved until late in the year.
 
Last week, The Washington Post reported on a CDC warning regarding the emergence of an antibiotic-resistant strain of Candida auris. Contagion® covered the cases that first emerged in the fall. To date, 12 Americans have become infected.
 
“We really are in a different time,” Dr. Schuchat told Congress. “This is the moment for us to really invest.” In an interview with The Washington Post she added, “This is about protecting Americans, so this is about saving lives. An outbreak can happen anywhere. It’s not a red- or blue-state kind of thing. And we want to sustain the defense of Americans’ health from these new emerging threats.”
 
Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.
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