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Bush Budget Targets Bioterrorism

Proposal 'recognizes new realities confronting our nation'

MONDAY, Feb. 4, 2002 (HealthDayNews) -- President Bush's proposed budget for fiscal year 2003 significantly raises the amount of money the nation would spend to fight bioterrorism.

The president's $2.13 trillion spending plan -- an increase of 3.7 percent from 2002-- would allocate $5.9 billion to prevent, control and treat germ warfare attacks like last fall's anthrax-by-mail campaign that killed five people.

Of that sum, $4.3 billion would be given to the U.S. Department of Health and Human Services (HHS), which would receive a total of $63.6 billion in 2003, up from $58.2 billion this year.

"The budget for 2003 recognizes the new realities confronting our nation, and funds the war against terrorism and the defense of our homeland," Bush said in a statement released today with the budget proposal. "The budget for 2003 is much more than a tabulation of numbers. It is a plan to fight a war we did not seek -- but a war we are determined to win."

HHS serves as an umbrella agency for scores of federal health agencies and programs like the Food and Drug Administration and the Centers for Disease Control and Prevention. And the theme of Bush's budget proposal was clear: "No HHS activity is now more important than its role in national bioterrorism preparedness," the budget document states.

For example, the president would provide more money to the U.S. Food and Drug Administration to triple the number of safety inspections it conducts of imported foods to "keep them from being used as a conduit for terrorism."

At the Centers for Disease Control and Prevention, which is in charge of monitoring and responding to disease outbreaks, the budget would climb from roughly $4.4 billion this year to nearly $5.7 billion under the president's plan.

The National Institutes of Health would see its budget rise from $23.3 billion in 2002 to more than $27.3 billion in 2003. The NIH is one of the world's premier research institutions, conducting and funding studies on everything from cancer and AIDS to alternative medicine. During his presidential campaign, Bush vowed to raise the NIH budget above $27 billion.

Some HHS programs wouldn't fare as well as those concerned with combating bioterrorism.

The Administration for Children and Families would receive an additional $89 million, to $13.02 billion, a gain of about six-tenths of a percent -- beneath the likely rate of inflation of about 3.5 percent. The agency oversees Head Start, foster care and other child and family welfare programs.

The Health Resources and Services Administration (HRSA) provides support for maternal and child health initiatives, promotes minority access to health-care facilities and is a major source of money for poor people with HIV and AIDS. Its funding would drop $745 million, to $6.01 billion next year.

HRSA also administers community health clinics, which Bush lauded in his campaign debates against Al Gore. The 2003 budget would provide $114 million for such clinics, which serve uninsured and under-insured people -- about $50 million less than what Congress authorized last year.

Even so, Heather Mizeur, director of state affairs for the National Association of Community Health Centers, said she's pleased with the proposed allocation.

"It's less than the $200 million we requested, but we believe it's a good first step on getting a down payment" to build up the network of clinics, she said.

Community clinics currently treat about 12 million people a year, four million of whom lack insurance. Mizeur's group is hoping to expand the number of clinics over the next five years to serve 20 million, including 11 million uninsured patients.

The president's proposed budget also offers more money under HHS for education programs that stress sexual abstinence among teens, a move family planning groups have criticized.

Dr. Joseph Barbera, co-director of The Institute for Crisis, Disaster and Risk Management at George Washington University in Washington, D.C., said he supports Bush's call for increased spending to fight bioterrorism.

But, he said it's "vitally important" that officials don't merely throw money at the fight against bioterrorism. The problem "absolutely needs money but it has to be applied in the right manner," he said.

The first priority should be formulating a comprehensive plan to respond to the possibility of mass casualties -- not five or 25 people, but thousands, even millions. Such a plan would require a "contractual relationship" between federal, state and local governments and hospitals, he said.

"There's still no real public policy that recognizes hospitals as performing a public safety function related to bioterrorism" in the way that, say, fire departments work with cities, Barbera said.

Patrick M. Libbey, director of the Thurston County Public Health & Social Services Department in Olympia, Wash., supports the funding increase for bioterrorism control, and said agencies like his are already well-equipped to spend more money if they get it.

Libbey agreed with Barbera that improving the response to a bioterrorism threat -- or any epidemic, for that matter -- should be a paramount goal of every hospital.

Libbey, who is also president of the National Association of County and City Health Officials, said money spent on fighting bioterrorism doesn't have to come at the expense of other public health efforts.

"If what we end up with as a result of this is only applicable to a bioterror event, we haven't done it right. But if we improve our surveillance and response to a health event, either natural or intentional," other areas would benefit, too, he said.

What to Do: The president's budget plan must be approved by Congress. For more on the spending plan, visit the White House. For more on how the proposal would affect health care, see the U.S. Department of Health and Human Services.

SOURCES: Interviews with Heather Mizeur, director of state affairs, National Association of Community Health Centers, Washington, D.C.; Joseph Barbera, M.D., co-director of the Institute for Crisis Disaster and Risk Management, andassociate professor and co-director, Institute for Crisis, Disaster and Risk Management, George Washington University, Washington, D.C.; Patrick M. Libbey, director, Thurston County Public Health & Social Services Department, Olympia, Wa., and president, National Association of County and City Health Officials; President Bush's Fiscal 2003 budget, Feb. 4, 2002
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