Public health advocates warned Saturday that if President Bush's proposal to cut nearly $800 million from the Centers for Disease Control and Prevention budget is approved by Congress, the nation will be more vulnerable to bioterrorism and avian influenza and less able to deal with the obesity epidemic.
CDC workers said the proposed 9 percent cut in 2006 spending would further rattle an agency dealing with reorganization and a surge of retirements, including some disgruntled top scientists.
Bush's spending plan will not be released until Monday, but some details were reported Saturday by The New York Times, which obtained copies of the spending documents. The newspaper said the CDC's budget would be reduced to $6.9 billion, including substantial cuts in bioterrorism programs and in efforts to combat obesity and chronic diseases.
Critics said the cuts, including a 12.6 percent reduction in state and local bioterrorism programs run by the CDC, would undermine efforts to improve the nation's public health readiness. Bioterror funding was significantly boosted in the wake of the Sept. 11 terrorism and subsequent anthrax attacks.
"The threat of bioterrorism has not lessened," said Tara O'Toole, director of the Center for Biosecurity at the University of Pittsburgh. "To cut back is nonsensical. It calls into question whether or not we're serious about this."
Public health advocates generally praised the reported Bush plans to boost funding for community health centers, children's health insurance plans and the global AIDS effort.
While the proposed budget seeks $120 million -- likely research and vaccine development money -- to deal with a potential worldwide outbreak of influenza, some public health advocates said they were concerned because current funding is inadequate for disease surveillance and response.
Dr. Georges Benjamin, executive director of the American Public Health Association, opposes the proposed loss to another CDC program -- nearly $60 million, or 6.5 percent, from the Public Health Service's chronic disease prevention and health promotion. The program targets heart disease and cancer, the country's top killers.
"If you want to make a dent in the leading expenditures for health, you need to support these programs," Benjamin said.
He also objected to the proposed elimination of a $131 million block grant to states by the CDC for prevention health services, used for everything from diabetes screening to controlling West Nile virus.
Those cuts, on top of lost bioterrorism funding and reductions in public health spending already made by many state governments, could deliver a major blow to a range of health programs, Benjamin said.
"It's a triple whammy for states," he said. "People will lose jobs within government and outside of government because of this."
Benjamin said he also was concerned about reports of a proposed $38 million increase for sexual abstinence programs, which would bring total funding for abstinence-only education to $192.5 million, a 50 percent increase since 2004.
Many public health officials prefer comprehensive sex education, which includes discussion of condoms and other birth control measures. "We should follow the science," he said. "It says a balanced approach is the best approach."
The proposed budget cuts were no surprise to Georgia lawmakers or congressional aides, who said the administration has consistently proposed such cuts in recent years, only to be partly rebuffed by Congress.
"In this budget process for the last three or four years, the initial budget for the CDC was short -- whether it was the operating budget or the capital budget or both -- and we always came out fine in the end," said U.S. Sen. Johnny Isakson, a Republican from Marietta.
"We may have a fight ahead of us, but the CDC should come out fine in the end," Isakson said.
Angie Lundberg, a spokeswoman for U.S. Sen. Saxby Chambliss, agreed. "We look at the budget as the starting point," she said.
Chambliss, a Republican from Moultrie, wrote White House budget officials in December, urging them to spare CDC funding, particularly for construction projects. He described existing agency facilities as being in a "state of extreme disrepair."
"In the event of a biological or chemical attack, Americans look to the CDC for help, research, cures and answers," Chambliss wrote to Josh Bolten, Bush's top budget official. "It is critical that we provide them with modern equipment and facilities to continue improving our public health preparedness."
Staff at the CDC, who declined to speak on the record, said Saturday that rumors of budget cuts have circulated for weeks. The proposed cutbacks would be demoralizing, staff members said, because they would follow cuts made last year -- including those not specified by Congress but imposed internally by CDC's ongoing reorganization.
Staff members said their colleagues have been disturbed by recent departures at the agency. In the past 18 months, the CDC has lost a number of long-serving staff in high-profile positions to retirement, including some who left years before their mandatory retirement deadline. The directorships of six of the CDC's 12 major centers are vacant, along with two new directorships created by the reorganization.
Public health spending has increased considerably since the Sept. 11 terror attacks, but advocates say many more improvements are needed. A December report by Trust for America's Health said that two-thirds of the states met six or fewer of the 10 indicators of public health preparedness.
Few states are ready for bioterror threats in the form of chemical or radiological agents, Shelley Hearne, executive director of the Washington-based nonprofit organization, said Saturday. More progress has been made against biological threats, but there still aren't enough people who know how to test for germs such as anthrax or bubonic plague, she said.
Bioterrorism "is still probably the weakest link in homeland security," she said. "There are still enormous gaps out there."