Budget proposal promises some gains for public health: Food safety work to be strengthened ========================================================================================== * Teddi Dineley Johnson President Barack Obama in February unveiled a 2011 federal budget proposal that promises to advance health information technology, protect food safety and crack down on fraud, waste and abuse in the nation’s health system. “Moving from recession to recovery, and ultimately to prosperity, remains at the heart of my administration’s efforts,” Obama said in his budget message. The overall 2011 U.S. budget is reported to total $3.8 trillion in spending, of which $911 billion would go to the U.S. Department of Health and Human Services, an increase of $51 billion over fiscal year 2010. The proposal includes a total funding level of $10.6 billion for the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry, which reflects an increase of $101 million above fiscal year 2010 funding levels. Despite these numbers, some health organizations, including APHA, say the budget proposal falls short in some key areas, such as adequately investing in the nation’s public health infrastructure and providing sufficient funds for CDC. ![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/40/2/1.3/F1.medium.gif) [Figure1](http://www.thenationshealth.org/content/40/2/1.3/F1) “We are pleased to see increases to strengthen food safety initiatives, expand community health centers and improve global health, including protecting against the spread of infectious disease and other public health threats,” said APHA Executive Director Georges C. Benjamin, MD, FACP, FACEP (E). However, a greater investment in community-based prevention and in CDC’s core public health programs “could pay dividends in better health and quality of life for generations to come,” Benjamin said. Under the CDC proposal, some of the agency’s core programs could lose more than $130 million when compared to the fiscal year 2010 budget, according to analyses by some health advocates. For example, CDC’s efforts on environmental health and injury prevention would receive a nearly $6 million cut, while the Preventive Health and Health Services Block Grant, which states depend on to design community-specific prevention and promotion programs, would be funded at the 2010 level. “Public health departments are as critical a piece of the nation’s infrastructure as roads and bridges,” said Paul Jarris, MD, MBA, executive director of the Association of State and Territorial Health Officials. “If the United States is to safeguard the health and vitality of its people, investments in public health, as in all aspects of our infrastructure, are needed.” On the positive side, the president recommended a funding increase of $16 million, for a total of $352 million, for CDC to build global public health capacity by strengthening the global public health work force, integrating maternal, newborn and child health programs, and improving global access to clean water, sanitation and hygiene. Also under the proposed budget, CDC and the Health Resources and Services Administration would receive more than $3 billion — an increase of $70 million — to enhance HIV/AIDS prevention, care and treatment. Under the proposal, HRSA’s Ryan White program would receive an increase of $40 million to expand access to care for under-served populations, provide life-saving drugs and improve the quality of life for people living with HIV/AIDS. Food safety reform efforts would receive a landmark boost under Obama’s proposal. The 2011 budget recommends $1.4 billion — a 30 percent increase over 2010 — to strengthen the ability of the Food and Drug Administration and CDC to prioritize prevention, enhance surveillance and enforcement, and improve response and recovery, which are key priorities of the Food Safety Working Group that Obama established in March 2009. According to the budget proposal, the funds would enable CDC to improve the speed and accuracy of food-borne disease outbreak detection and investigation, and FDA would be able to increase inspections of the food supply chain and invest in the tools needed to make data-driven decisions about how to deploy food safety resources and prevent illness. During a Feb. 1 news conference releasing the proposed budget, HHS Secretary Kathleen Sebelius said the significant funding increase for food safety would help build a “21st-century food safety system to go with our 21st-century food market,” in which nearly half of all of the nation’s fruit and more than 75 percent of seafood comes from overseas. Sebelius noted that the additional funds would help expand the work of the Food Safety Working Group, update food safety standards, enhance surveillance and response, and put 350 additional food inspectors on the payroll. Other programs and agencies that would receive an infusion of funds under the president’s proposed budget include the Indian Health Service, which would receive nearly $5.4 billion — an increase of $354 million over 2010 — to eliminate disparities experienced by American Indians and Alaska Natives. Public health programs that would be initiated or strengthened under Obama’s budget proposal include the: * Department of Labor’s Office of Disability Employment Policy, which would receive $39 million to increase the work force participation of people with disabilities through innovative partnerships. * National Highway Traffic Safety Administration’s new Distracted Driver Prevention Program, which would receive $50 million to promote laws that would curtail unsafe cell phone use and eliminate texting while driving. * Environmental Protection Agency’s Clean Water and Drinking Water State Revolving Funds, which would receive $3.3 billion to improve water infrastructure. * Department of Agriculture’s Women, Infants and Children nutrition program, which would receive an increase of approximately $350 million over 2010 funding levels. For more on the budget proposal, visit [www.omb.gov](http://www.omb.gov) or [www.hhs.gov](http://www.hhs.gov). * Copyright The Nation’s Health, American Public Health Association