Dr. David Fleming, CDC deputy director for science and public health, told the Subcommittee on Labor, Health and Human Services and Education the agency's $6.6 billion request would bolster efforts against both natural disease outbreaks and possible bioterrorism.
"Our ability to respond as a nation is only as strong as the weakest health department," Fleming said in prepared testimony. "If any of us is at risk, we are all at risk."
Bioterrorism preparedness tops the spending list, with $1.5 billion aimed at continuing aggressive efforts to boost state and local response capabilities, Fleming said. The proposal's largest block of funding for "natural occurrences," $1.1 billion, would go toward programs for preventing the spread of HIV, tuberculosis and sexually transmitted diseases.
Committee members, however, focused their questions on far more everyday issues. Rep. Roger Wicker, R-Miss., scolded Fleming for what he termed as CDC's violation of congressional language barring the agency from taking sides in the gun-control debate, including issuing a report on gun licensing while the California Legislature was considering a bill on that issue.
"When a (research) grant application is reviewed ... what procedures are in place to ensure the CDC is in full compliance with federal law?" Wicker said. "What controls will the CDC implement to ensure no monies are spent on studies where the objectives are to promote or advocate gun control?"
Fleming said the agency will certainly comply with appropriations law, but reminded the committee one of the CDC's strengths is in gathering objective epidemiological data on all kinds of health issues, including violence. Such surveillance methods do collect info on weapons, he said, but the agency simply wants to compile the facts and make them available to properly inform debate on the issue.
"Advocacy on a particular policy is not something we would be doing," Fleming said. "I would draw a distinction between conclusions that can be drawn from scientific data and the next step, which is advocating for a policy."
Wicker and Rep. David Obey, D-Wis., used their questions to argue whether the Bush administration truly supports better CDC funding. Obey prefaced his queries by pointing out the White House vigorously resisted supplemental funding for the CDC and other agencies in the wake of Sept. 11, while Wicker riposted with the overall increases represented in the '03 request.
Obey and Rep. Nancy Pelosi, D-Calif., also raised the issue of a proposed cut in funding for the National Institute of Occupational Safety and Health. Pelosi said occupational health issues cost the country more than $100 billion a year, and Obey pointed out the NIOSH cuts would prevent any new research grants into these areas.
"We've all agreed here that any initiatives on the challenges we face should be scientifically based," Pelosi said. "I guess we're at another meeting of the Flat Earth Society when the administration has decided to cut off the science. How will we make the decisions ... when we take $28 million out of the science that would enable us to go forward?"
Rep. Steny Hoyer, D-Md., pointed out childhood immunization programs recorded a slight drop in the overall percentage of kids covered, but the '03 request leaves funding for such efforts flat. He asked Fleming how much immunization funding CDC asked for from its parent, the Department of Health and Human Services.
Fleming did not have an immediate answer, and Hoyer requested a full response before the committee marks up the budget request, adding there was no excuse for a nation as advanced as the United States to skimp on funding such programs.
Fleming told Hoyer vaccinations are among the most cost-effective public health measures, with each dollar spent on shots resulting in about $27 being saved on later health care. Their overall effectiveness would be even greater, he said if the CDC could deploy some form of electronic shot record that could follow a child throughout the country.
Rep. Ralph Regula, R-Ohio, the subcommittee chairman, told Fleming to bring the panel ideas on how to implement such a program.
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