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What's Worse for Public Health? Proposed EPA Cuts or a More Virulent SARS?—Public Health Watch

Two recent federal government decisions and actions could put the public at increased risk for an infectious disease outbreak.

With Congressional Republicans on the verge of passing the most comprehensive tax legislation since the 1980s—a bill projected to add some $1.5 trillion to the national deficit—at least one question remains unanswered. How, if at all, will the federal government offset the financial impact of the new tax plan?

The simple answer, of course, is spending cuts, and it seems the Environmental Protection Agency (EPA) may bear the brunt of this belt-tightening. And, if that’s the case, it could have significant impacts on public health.

As noted in a commentary on CNN.com by Environmental Defense Fund (EDF) president Fred Krupp, President Donald Trump promised on the campaign trail to clip the EPA down to “little tidbits,” and he has since followed through on that pledge, proposing to cut the agency’s budget by 30% earlier this year. This funding reduction would likely mean that the EPA’s enforcement division, which holds industrial polluters accountable, will be significantly scaled back, as would programs designed to protect the air we breathe and the water we drink—at least according to Krupp.

In short, to follow his argument, this could mean more crises, such as the those involving the water supply in Flint, Michigan or new infectious disease outbreaks, the latter based on the findings of a “scoping” literature review published in November in The Canadian Veterinary Journal, which identified a “co-occurrence of pollutants and infections”—particularly those transmitted from animals to humans. Similarly, a commentary by Patrick Ayscue, DVM, posted on Contagion® on November 3 highlighted the links between climate change—which has been attributed to carbon emissions and greenhouse gasses, among other pollutants—and outbreaks such as Zika and yellow fever.

Obviously, it could be argued that if budget cuts take the teeth out of EPA enforcement of regulations governing pollution, an important check against its damaging effects would be rendered, well, toothless.

Interestingly, this discussion of the present and future of the EPA comes at the same time that, as reported by The Washington Post on December 19, the United States has announced its intention to lift the 3-year federal funding moratorium for research programs looking into ways to make diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and influenza more virulent and transmissible. Of course, the moratorium was not a financial decision, but rather a safety one: It was implemented after researchers in Wisconsin and the Netherlands announced that they had made the H5N1 bird flu virus more contagious in ferrets (a commonly used animal model for humans). Not long after that, the US Centers for Disease Control and Prevention admitted that some of its lab personnel had been exposed to anthrax and that a lethal strain of the avian flu virus had been sent to one of its labs in error.

With the moratorium lifted, researchers can now apply for federal funding for such projects through the US Department of Health and Human Services (HHS), according to the Post report.

So, if you’re scoring at home, that’s 2 recent federal government decisions and actions that could put the public at increased risk for an infectious disease outbreak.

Not bad for a week’s work.

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous health care-related publications. He is the former editor of Infectious Disease Special Edition.