The House Appropriations Labor-HHS-Education Subcommittee oversees the Centers for Disease Control and Prevention (CDC) budget and released its markup budget this week. The subcommittee’s markup provides the best overview of CDC’s fiscal year (FY) 2022 budget, although these budgets still must concur with the Senate.
Appropriations Committee Chair Representative Rosa DeLauro (D-Connecticut) noted that the subcommittee held 14 hearings with CDC regarding public health infrastructure. The subcommittee concluded that it is outdated, ill supplied, losing workers, and was not prepared to meet the demands of the COVID-19 pandemic.
COVID-19 exposed numerous realities in our nation, including that the nation’s public health infrastructure is extremely fragile. Public health workers are leaving the field in droves, while others need workforce development training.
Congress, she acknowledged, realizes that the nation’s public health partners are essential for not only infectious diseases but also health promotion and protection to keep our communities healthy and functioning. The nation’s public health system can no longer thrive by only getting attention during a crisis. Congress must invest in the public health workforce, laboratories, and data modernization not just to respond to the COVID-19 pandemic, but to respond to any emergency or crisis this year and for years to come.
The House Appropriations committee objective with the CDC budget is to build the public health infrastructure to move the public health workforce forward. Congress must ensure that the nation’s public health system is prepared for future challenges at every level—state, local, and federal.
With this in mind, the committee is boosting the U.S. Department of Health and Human Services (HHS) budget to include $119.8 billion in discretionary funding in FY 2022, a $22.9 billion increase from FY 2021. The biggest recipient will be the National Institutes of Health.
Part of HHS, CDC would see an increase of $2.7 billion for a total budget of $10.6 billion in FY 2022, which reflects a $1 billion increase above the President Biden’s budget request. This budget includes $903 million in transfers from the Prevention and Public Health Fund.
The Public Health Services Act that supports CDC-Wide Activities and Program Support would be funded at $1.15 billion with $1 billion remaining available until September 2024 for additional public health infrastructure support and capacity building.
The Appropriations Committee budget includes significant investments into CDC to bolster the nation’s public health infrastructure, including:
- $1 billion in a new, flexible funding stream for public health infrastructure and capacity nationwide.
- $150 million, an increase of $100 million above the FY 2021 enacted level, to modernize public health data surveillance and analytics at CDC and state and local health departments.
- $106 million, an increase of $50 million above the FY 2021 enacted level, in public health workforce initiatives.
- $843 million, an increase of $250 million above the FY 2021 enacted level, for global health.
- $190 million, an increase of $15 million above the FY 2021 enacted level, for the National Center for Health Statistics.
- $715 million, an increase of $20 million above the FY 2021 enacted level, for public health emergency preparedness cooperative agreements.
The bill provides increases for numerous public health efforts within CDC, including:
- $25 million, an increase of $12.5 million above the FY 2021 enacted level, for firearm injury and mortality prevention research.
- $74 million, an increase of $10 million above the FY 2021 enacted level, for the only federal program that addresses the nation’s racial and ethnic health disparities, Racial and Ethnic Approach to Community Health (REACH). It also includes $27 million, an increase of $5 million, for Good Health and Wellness in Indian Country.
- $119 million, an increase $56 million above the FY 2021 enacted level, for safe motherhood.
- $110 million, an increase of $100 million above the FY 2021 enacted level, for the health impacts of climate change.
- $153 million, an increase of $150 million above the FY 2021 enacted level, for social determinates of health.
- $275 million, an increase of $100 million above the FY 2021 enacted level, for the Ending the HIV Initiative.
- $115 million, an increase of $100 million above the FY 2021 enacted level, for community and youth violence prevention.
- $663 million, an increase of $188 million above the FY 2021 enacted level, for opioid overdose prevention and surveillance.
- $75 million, an increase of $10 million above the FY 2021 enacted level, for food safety.
- $250 million, an increase of $12.5 million above the FY 2021 enacted level, to address tobacco and e-cigarettes.
This budget provides $325.4 million for the National Center for Environmental Health, a $103.5 million increase over the FY 2021 budget of $222.9 million. The National Center for Emerging and Zoonotic Infectious Diseases will receive $674.3 million for FY 2022 under this budget.
Funding for other environmental health agencies, such as the Food and Drug Administration, U.S. Environmental Protection Agency, and U.S. Department of Housing and Urban Development, will be announced in other budget markups.
Overall, Congress is planning significant increases to the nation’s public health infrastructure, even more so than President Biden recommended.
Budgets will still need to be reconciled with Senate Appropriators, but this markup indicates an encouraging year for CDC and a major investment in the nation’s public health infrastructure.
Doug Farquhar is the director of Government Affairs at the National Environmental Health Association in Denver, Colorado.