Tom Frieden

Tom Frieden, MD, MPH, director of the Centers for Disease Control and Prevention, spoke about the agency’s budget request for fiscal year 2015 at APHA’s headquarters March 12 in Washington, D.C. Photo by Natalie McGill/The Nation’s Health/APHA

U.S. President Barack Obama’s 2015 fiscal year budget request mixes good and bad news for public health, says Centers for Disease Control and Prevention Director Tom Frieden.

In a conversation at APHA yesterday, Frieden talked through the budget request and how it will affect public health over the upcoming year. Total funds would decrease by $243 million from FY 2014, cutting funding for initiatives including environmental health tracking, immunization, and state and local preparedness and response.

However, investments would increase in CDC programs for health care-associated infections, food safety, polio eradication, violent death reporting, gun violence prevention research, HIV/AIDS and public health’s workforce capacity. Frieden added that one of CDC’s foremost priorities, advanced molecular detection, was funded.

“Fundamentally it’s about saving lives, time and money by unlocking the microbial genome to more quickly identify outbreaks, stop them and figure out how to prevent them,” he said in a conversation with the CDC Coalition, a group of public health advocates led by the Association. “I do want to emphasize it does not replace traditional epidemiology. We’re not going to magically get some new gizmo to provide the answer to an outbreak.

“But the five-year initiative will increase our ability to identify pathogens, develop new diagnostics, help states meet reference-testing needs and implement sustainable standards.”

Advanced molecular detection is one of CDC’s five initiatives for the upcoming year, which also include:

  • global health security;
  • antimicrobial resistance;
  • Million Hearts, an initiative to prevent 1 million heart attack and strokes over five years; and
  • prescription drug overdose.

Frieden strongly urged increased integration of public health and health care, saying that “health care spends so much money and yet the health return for our health care dollars is nowhere near where it could be. One way we can increase that health return for our health dollar is to get public health more involved in health care.”

APHA Executive Director Georges Benjamin, MD, said that while Congress temporarily put politics aside and provided stability over the next couple of years, there remains an urgent need to take permanent steps that ease current and future limits it has placed on discretionary spending.

“2014 is a decent year for us,” Benjamin said. “2015’s going to be more of a challenge.”