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US public health agency to cut global surveillance by 80%

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k590 (Published 06 February 2018) Cite this as: BMJ 2018;360:k590
  1. Janice Hopkins Tanne
  1. New York

The US Centers for Disease Control and Prevention (CDC) will cut back its global epidemic surveillance and prevention efforts by 80% because it is running out of funds allocated during the 2014 Ebola epidemic.1

During the Ebola epidemic, Congress gave the agency almost $600m (£433m; €486m) in supplemental funds to help it assist countries prevent, detect, and respond to outbreaks of infectious diseases. It set up a Global Health Security Agenda, which 49 nations joined; established offices abroad; helped train health workers; and set up links with local health authorities.

The funds were for only five years and the remaining $150m will run out in September 2019.

The CDC has said it will reduce its 49 national partners in the security agenda’s prevention, detection, and response campaigns to 10— Guatemala, India, Jordan, Kenya, Liberia, Nigeria, Senegal, Thailand, Uganda, and Vietnam.

The decision runs counter to the CDC’s stated aim to “[stop] outbreaks globally to protect Americans locally.” The agency’s global health efforts include tracking outbreaks of infectious disease, monitoring threats to public health, and identifying new pathogens and strains. In this work, the CDC trains “disease detectives,” investigates outbreaks, and sends experts to tackle emergencies. The agenda funding helped to train epidemiologists, improve laboratories, buy drugs, and establish links with local health authorities.2

The decision was widely criticised by a group of health organisations and by Tom Frieden, who served as director of CDC from 2009 to 2017. In an interview, he said, “I committed myself to do everything I can to make sure that something like Ebola never happens again. We know there will be another pandemic. We don’t know where it will come from, what pathogen it will be, when it will happen, but it will happen and shame on us if we are not better prepared than we are today.”3

Frieden now heads Resolve to Save Lives, a $225m, five year global initiative to reduce deaths from cardiovascular disease and prevent epidemics of infectious disease. It is funded by three major foundations: Bloomberg Philanthropies, the Chan Zuckerberg Initiative, and the Bill and Melinda Gates Foundation.

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