Issue Category: Infectious Disease

Vaccines Prevent Infectious Disease Outbreaks and Protect Communities (August 2019)

Infectious diseases disrupt the lives millions of Americans every year.  Fortunately, vaccines can prevent many of these diseases.  Nonetheless, because the U.S. vaccination rates are lower than they should be, unnecessary illness and even death occurs.

For example, the seasonal flu causes much preventable suffering.  The Centers for Disease Control and Prevention (CDC) found an estimated 80,000 people died—among them, 185 children—from seasonal flu in 2017–2018, nearly twice what is considered typical during an average flu year. In addition to the devastating health impacts, it is estimated that seasonal flu costs the nation approximately $87 billion in medical spending and lost work productivity annually.

The U.S. is currently in the midst of its worst measles outbreak in two decades, causing more than 1,000 cases.  With the measles outbreak still growing, it is important to highlight the life-saving impacts of vaccines for people of all ages and take actions to ensure that vaccine use remains a common practice.

Key Findings

  • Vaccines have helped save up to 3 million lives per year worldwide by preventing diseases such as hepatitis B, meningitis, measles and polio. Additionally, researchers say that every dollar spent on vaccination brings back return on investment in health, economic and societal benefits in 94 low to middle income countries.
  • The CDC estimates that vaccination of children born between 1994 and 2018 in the U.S. will prevent 419 million illnesses, help avoid 936,000 deaths, and save nearly $1.9 trillion in total societal costs.
  • In 2018, the CDC reported that the percentage of children under age 2 who had not received any recommended vaccinations quadrupled since 2001.
  • Adult vaccination rates remain far below targets in Healthy People 2020, including for hepatitis B, seasonal flu, pneumococcal, and shingles.
  • Seasonal flu vaccination rates for Americans ages 6 months and older dropped from 47 percent in the 2016-2017 season to 42 percent during the 2017-2018 season. The 2017– 2018 flu season in the United States was the deadliest in nearly 40 years—tragically underscoring the importance of annual vaccination.
  • The World Health Organization has named vaccine hesitancy, the reluctance or refusal to vaccinate despite the availability of vaccines, as one of the top ten threats to global health.

Recommendations

  • Significantly increase support for the vaccine infrastructure, outbreak prevention and response. CDC’s immunization program supports state and local immunization programs to increase vaccine rates among uninsured and underinsured adults and children, respond to outbreaks, educate the public and target hard-to-reach populations, improve vaccine confidence, establish partnerships, and improve information systems. Funding has not kept up with needs as states have to spend immunization dollars to respond to outbreaks, increases in the numbers of those who lack health insurance and vaccines, such as HPV, that are underused. Congress should significantly increase funding for CDC’s immunization program.
  • Raise awareness about the importance of vaccination and improve vaccine acceptance. Government, healthcare providers, health systems and other trusted partners should use varied and targeted media channels to educate people about the importance, effectiveness, and safety of vaccinations. Congress should provide needed resources to the United States Department of Health and Human Services to study the causes for vaccine resistance and to educate clinical providers on methods for improving vaccine acceptance.
  • Minimize vaccine exemptions for schoolchildren and healthcare workers. States should enact policies that enable universal childhood vaccinations to ensure children, their classmates, educators and the general public are protected from vaccine-preventable diseases. This includes eliminating non-medical exemptions and opposing legislation to expand exemptions. States should ensure medical vaccine exemptions are only given when appropriate and are not used as a de facto personal belief exemption in states where those exemptions have been eliminated. Healthcare personnel should also be required to receive all recommended vaccinations of the Advisory Committee on Immunization Practices (ACIP) in order to protect staff and patients, assure continuity of operations in the event of an outbreak and, achieve necessary healthcare infection control. Healthcare facilities should ensure access to vaccines for all staff and contractors and remove barriers for staff receiving vaccines.
  • Ensure first-dollar coverage for recommended vaccines under Medicaid, Medicare, and commercial insurance. Public and private payers should ensure that ACIP-recommended vaccines are fully covered, as cost-sharing can be a significant barrier to vaccination.
  • Increase the pool of providers who immunize. As new vaccines are approved, reaching target populations will be critical. States can expand certain health care providers’ roles and scopes of practice to increase the pool of professionals who give shots, such as pharmacists and paramedics.  All insurance plans should consider including pharmacies and other complementary providers as in-network and receive equal payment for vaccine administration services for their adult and pediatric populations.

 

 

Nearly 70 Organizations Call on Congress to Advance the Pandemic and All-Hazards Preparedness & Advancing Innovation Act

March 22, 2019

The Honorable Mitch McConnell Majority Leader U.S. Senate
The Honorable Charles Schumer Minority Leader U.S. Senate
The Honorable Nancy Pelosi Speaker U.S. House of Representatives
The Honorable Kevin McCarthy Minority Leader U.S. House of Representatives

On behalf of the undersigned organizations, representing public health, healthcare providers, emergency managers, environmental health, biotechnology innovators, and researchers, we are again writing to encourage you to advance the Pandemic and All-Hazards Preparedness & Advancing Innovation Act (PAHPAI, H.R. 269), which overwhelmingly passed the House of Representatives in January. A similar version passed the Senate Health Education, Labor & Pensions (HELP) Committee last year. The HELP and Energy & Commerce Committees have made tremendous, bipartisan progress on this important legislation, and it would be a setback for our national health security to further delay reauthorization. The disaster relief package being considered by Congress would be a logical vehicle for PAHPAI.

The recent wildfires, hurricanes and measles outbreaks have demonstrated that all sectors – public health, healthcare and private sector – play a critical role in saving lives during disasters and outbreaks. PAHPA is the backbone of our nation’s health security, providing the U.S. Department of Health and Human Services (HHS) with authorities for preparing the healthcare and public health systems for disasters and strengthening the medical countermeasures enterprise. The legislation addresses gaps we have seen in recent responses, such as the speed of funding for public health emergencies, development and deployment of medical countermeasures for significant threats and preparedness for children in disasters.

The time is now to move this legislation. We are particularly concerned that several authorities have expired as of 2018, including temporary reassignment of state and local personnel, the National Advisory Committee on Children and Disasters, limited antitrust exemption and other provisions critical to HHS contracting. We believe that time is of the essence in reauthorizing these important authorities.

We commend the work of the committed Senators, Representatives and their staff who have devoted considerable thought to this legislation. Our organizations are committed to our nation’s health security, and we remain ready to assist in order to see this legislation enacted into law as soon as possible.

Sincerely,

AABB (formerly known as American Association of Blood Banks)
AFSCME
Alliance for Biosecurity
American Academy of Pediatrics
American Association of Poison Control Centers
American Association on Health and Disability
American Hospital Association
American Public Health Association
American Society for Microbiology
America’s Blood Centers
Asian & Pacific Islander American Health Forum
Association for Professionals in Infection Control and Epidemiology
Association of American Medical Colleges
Association of American Veterinary Medical Colleges
Association of Maternal & Child Health Programs
Association of Public Health Laboratories
Association of Schools and Programs of Public Health
Association of State and Territorial Health Officials
Barnesville Hospital
Berger Health System
Big Cities Health Coalition
Biotechnology Innovation Organization (BIO)
California Life Sciences Association
Central Ohio Trauma System
Child Care Aware of America
Colorado Association of Local Public Health Officials
Commissioned Officers Association of the U.S. Public Health Service, Inc. (COA)
Coshocton Regional Medical Center
Council of State and Territorial Epidemiologists
Entomological Society of America
Fayette County Memorial Hospital
Federation of American Hospitals
Future of Life Institute
Genesis Community Ambulance
Global Health Technologies Coalition
Health Industry Distributors Association
Health Resources in Action
Healthcare Distribution Alliance
Healthcare Leadership Council
Healthcare Ready
Hogg Foundation for Mental Health
Hospital Council of Northwest Ohio
Infectious Diseases Society of America
International Association of Emergency Managers
Johns Hopkins Center for Health Security
Los Angeles County Department of Public Health
Louisiana Public Health Institute
March of Dimes
Mount Carmel Health System
National Association of Counties
National Association of County and City Health Officials
National Association of Federal Veterinarians
National Association of Pediatric Nurse Practitioners
National Association of State Emergency Medical Services Officials
National Center for Disaster Preparedness, Columbia University
National Emergency Management Association National Network of Public Health Institutes
NEHA
Oklahoma City-County Health Department
One Health Commission
One Health Initiative Autonomous pro bono Team
Suburban Hospital Alliance of New York State
The Antimicrobials Working Group (Amplyx Pharmaceuticals, Aridis Pharmaceuticals, Cidara Therapeutics Inc., ContraFect Corporation, Entasis Therapeutics Inc., Iterum Therapeutics Ltd., Melinta Therapeutics Inc., Motif Bio plc, Nabriva Therapeutics US Inc., Paratek Pharmaceuticals Inc., Qpex Biopharma Inc., SCYNEXIS Inc., Summit Therapeutics plc andVenatoRx Pharmaceuticals Inc.)
The Society for Healthcare Epidemiology of America
Trauma Center Association of America
Trust for America’s Health
UCSF Benioff Children’s Hospitals
Virginia Hospital & Healthcare Association

President’s Proposed FY20 Budget Will Harm the Nation’s Public Health

Washington, D.C., March 11, 2019 – Statement from John Auerbach, president and CEO, Trust for America’s Health (TFAH).

Auerbach on the President’s Budget Proposal:

“The President’s proposed budget – which includes a 12 percent cut to the Department of Health and Human Services (HHS) budget and an approximate 10 percent cut to the CDC – would be harmful to the nation’s public health and safety.  States and communities are grappling with increasing healthcare costs, rises in premature deaths due to chronic disease, substance misuse and suicide, and an increased threat of weather-related emergencies.  These realities have created unprecedented demands on our already under-resourced public health infrastructure. Now is the time to strategically increase investments in public health programs and infrastructure, not cut them.”

Auerbach on the consequences of spending caps:

“This proposed budget shows the potential consequences if Congress fails to raise spending caps this year. Health agencies and programs are a continuum.  If we decrease investments in prevention and detection of diseases, we can expect higher costs for treatment and response. We urge Congress to reject the proposed budget and work toward a spending package that invests in America’s health.”

Auerbach on diverted resources:

“We are also deeply concerned by the recent report that HHS has diverted an additional $385 million from other programs to increase shelter capacity for unaccompanied migrant children. These programs can’t afford any further diversions. The $14 million being taken from the Centers for Disease Control and Prevention (CDC), for example, is more than the agency’s budget for activities around climate change, unintentional injuries, or healthcare associated infections.”

TFAH urges Congress and the Administration to work to raise the budget caps and enact appropriations bills that reflect the health needs of our population.  Our specific concerns about the proposed budget include:

An approximate 10 percent reduction to CDC’s overall program budget. The budget request proposes about $750 million in spending cuts to CDC’s program level, compared with FY19.

Proposed CDC program cuts include:

  • Cuts to programs to prevent chronic conditions down by approximately 20 percent – including programs to address obesity, diabetes, cancer, heart disease and stroke. These diseases are the leading causes of death and healthcare costs in the U.S.; decreasing our investment in their prevention would be short-sighted.
  • Cuts to programs to protect health from environmental threats such as lead poisoning and asthma made worse by air quality – down approximately 25 percent.
  • Cuts to programs to prevent birth defects down by approximately 28 percent.
  • Inadequate funding to prevent substance misuse and suicide – Deaths from alcohol, drugs and suicide are at an all-time high,1 yet the budget proposes cuts or level funding for many substance misuse and suicide prevention activities at the Substance Abuse and Mental Health Services Administration and CDC.

The creation of a comprehensive HIV strategy.

Trust for America’s Health applauds the bold goal to end the U.S. HIV epidemic by 2030, but an increased investment in the domestic response to HIV should not come at the expense of efforts to combat other infectious diseases, chronic diseases or environmental threats. At the same time, administrative and legal changes to the ACA and Medicaid are likely to reduce HIV patient access to care.

# # #

Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.

1. Trust for America’s Health and Well Being Trust. Pain in the Nation Update: While Deaths from Alcohol, Drugs, and Suicide Slowed Slightly in 2017, Rates Are Still at Historic Highs, March 5, 2019. https://www.tfah.org/report-details/pain-in-the-nation-update-while-deaths-from-alcohol-drugs-and-suicide-slowed-slightly-in-2017-rates-are-still-at-historic-highs/

Separating parents and children at US border is inhumane and sets the stage for a public health crisis

(Washington, D.C., June 15, 2018) — “The Trump administration’s policy of separating parents and children at the U.S.-Mexico border will have a dire impact on their health, both now and into the future.

“As public health professionals we know that children living without their parents face immediate and long-term health consequences. Risks include the acute mental trauma of separation, the loss of critical health information that only parents would know about their children’s health status, and in the case of breastfeeding children, the significant loss of maternal child bonding essential for normal development. Parents’ health would also be affected by this unjust separation.

“More alarming is the interruption of these children’s chance at achieving a stable childhood. Decades of public health research have shown that family structure, stability and environment are key social determinants of a child’s and a community’s health.

“Furthermore, this practice places children at heightened risk of experiencing adverse childhood events and trauma, which research has definitively linked to poorer long-term health. Negative outcomes associated with adverse childhood events include some of society’s most intractable health issues: alcoholism, substance misuse, depression, suicide, poor physical health and obesity.

“There is no law requiring the separation of parents and children at the border. This policy violates fundamental human rights. We urge the administration to immediately stop the practice of separating immigrant children and parents and ensure those who have been separated are rapidly reunited, to ensure the health and well-being of these children.”

###

APHA champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization influence federal policy, has a nearly 150-year perspective and brings together members from all fields of public health. Visit us at www.apha.org.


Trust for America’s Health is a non-profit, non-partisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.  Twitter: @HealthyAmerica1

TFAH Applauds the Introduction of the Bipartisan Pandemic And All-Hazards Preparedness And Advancing Innovation Act—But Improvements Can Be Made

Washington, D.C., May 22, 2018 – The following is a statement from John Auerbach, President and CEO, of Trust for America’s Health (TFAH) on the introduction of the Senate HELP Committee’s Pandemic and All-Hazards Preparedness and Advancing Innovation (PAHPAI) Act:

“We applaud the Senate introduction of the bipartisan Pandemic and All-Hazards Preparedness and Advancing Innovation Act and urge the Senate to pass the bill.

As we mark the 100-year anniversary of the devastating 1918 flu pandemic, it is a stark reminder of how important preparedness is and how far we’ve come.

While we are much better prepared than we were a century — or even 17 years — ago, some important gaps remain. The nation needs to better prepare our healthcare system for disasters and unusual outbreaks and ensure thoughtful planning occurs for community members who could be at higher risk during disasters, such as older adults, children and people with complex health conditions.

And, the nation must be better at moving vaccines and other lifesaving medications from initial research all the way through to dispensing.

The bill also addresses the needs of the public health sector.  It would formally integrate public health into decision-making around the medical products in development for major health threats.

The bill also clarifies the role of the U.S. Centers for Disease Control and Prevention (CDC) in preparing public health departments for disasters and gives CDC tools to improve biosurveillance capabilities to detect new threats.

And, taking lessons learned from Ebola cases, the bill helps develop specialized hospitals that are capable of responding to extraordinary outbreaks.

While the bill fills many of the existing gaps, TFAH is concerned that authorized funding levels included in this bill are inadequate compared to the scope of the threat. The devastation that we saw this year due to the hurricanes in Puerto Rico, the U.S. Virgin Islands, Texas and Florida, the wildfires in California and the severe flu season throughout the nation illustrate the importance of creating effective and well-prepared public health and healthcare systems. TFAH is also concerned the bill does not go far enough in creating and funding a standing emergency fund to ensure timely response to major public health threats.

Health security is key to our national security, and we are pleased the Senate bill reflects that fact. We look forward to working with policymakers to ensure PAHPAI is as strong as possible — and we are adequately safeguarding all of our nation’s residents.”

###

Trust for America’s Health is a non-profit, non-partisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.

Infectious Disease

Infectious diseases – most of which are preventable – disrupt the lives of millions of Americans every year and have a significant financial impact. COVID-19 is the latest and starkest example. The pandemic caused the deaths of over 1 million Americans and unprecedented disruption in people’s lives from job loss to social isolation and mental distress, to learning loss in children. Additional examples of infectious disease outbreaks include the 2014 Ebola outbreak, the 2015 and 2016 Zika outbreak, and the 2022 Mpox outbreak. Influenza, antibiotic resistant super bugs and food borne illness are additional concerns. Despite these serious and sometimes deadly impacts, investments in infectious disease prevention and control ebb and flow in response to outbreaks.

Public Health Leaders Make Urgent Joint Call to Protect Prevention and Healthcare

Joint Statement from American Public Health Association, Prevention Institute, Public Health Institute and Trust for America’s Health

June 20, 2017

The fight to protect public health is more important than ever.

The Senate is moving quickly—and secretively—on their version of legislation to repeal the Affordable Care Act (ACA). While we don’t know the content of the bill, we do know that the House-passed repeal bill—the American Health Care Act—would cause over 23 million people to lose their healthcare, restructure Medicaid, pare down essential benefits like maternity and newborn care, result in the loss of over a million American jobs, and zero out the Prevention and Public Health Fund. As leaders of organizations dedicated to protecting and advancing the public’s health, we call on Congress now to protect federal investments in public health funding, the Prevention and Public Health Fund, and affordable, high-quality healthcare.

Public health is at the very core of keeping our country safe, healthy, resilient, and secure. It works behind the scenes to ensure we have clean water to drink, safe food to eat, and healthy air to breathe. It works to safeguard us from infectious diseases like measles or Ebola by preventing the onset or spread of disease. It builds on time tested strategies to reduce the toll of chronic diseases and injuries. Public health works to redress long-standing inequities in health and safety, by investing in communities of greatest need. Through prevention, evidence-based treatment of substance use, prescription drug monitoring, and improved opioid prescribing, public health can solve the opioid epidemic, which kills ninety-one Americans a day. From opioid overdoses to rising infant and maternal mortality rates, Americans are seeing both the length and quality of their lives decline—and we need more, not fewer, investments in public health to turn the tide.

Repealing the ACA and its investments in public health and prevention dismantles the capacity of public health to do its work. The pain will be felt in every state, every congressional district, and every neighborhood, and those who are most vulnerable will suffer the most. If the Prevention Fund is eliminated, over the next five years states stand to lose over $3 billion they rely on to prevent chronic disease, halt the spread of infections, and invest in the community resources that support health and safety. Repealing the ACA and the Prevention Fund ensures there is no progress to reduce healthcare spending or improve the health of our workforce. Repealing the ACA will result in an America where preventable suffering and death are more widespread, and an America where the poorest and sickest communities fall even farther behind.

A strong public health infrastructure is at the very core of making our country safe, healthy, and secure. We need to act now to protect it.

The President’s FY 2018 Budget Proposal Would be Perilous for the Nation’s Health

Washington, D.C., May 23, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH) on the President’s Fiscal Year (FY) 2018 proposed budget announcement.

“The proposed $1.2 billion cut to the Centers for Disease Control and Prevention (CDC) would be perilous for the health of the American people.

From Ebola to Zika to opioid misuse to diabetes to heart disease, the CDC is on the frontlines keeping Americans healthy. Cutting nearly 20 percent of the CDC’s Chronic Disease Prevention and Health Promotion center’s budget would be disastrous.

Enormous cuts are also proposed throughout the rest of the agency including to programs that protect the American people from infectious diseases, environmental contaminants, exposure to tobacco and much more. If these budget cuts were to occur, they would cripple CDC’s operations and result in increased illnesses, injuries and preventable deaths.

CDC has already lost more than $580 million in funding since 2010 – and the proposed American Healthcare Act would, in FY 2019, repeal the Prevention and Public Health Fund, which supplies 12 percent of CDC’s budget—of which more than $620 million goes yearly to states.

Even now, with a relatively stable FY 2017 budget, CDC is operating with nearly 700 vacancies and will function with diminished resources once the Zika emergency supplemental funding runs out.

As such, this unprecedented and dramatic cut would have unparalleled and drastic consequences for our nation’s health and would likely lead to staggering increases in our healthcare service costs. It would also create massive holes in state public health funding, as states and local communities rely on the hundreds of millions they receive from CDC every year.

In essence, the proposed budget would force CDC to fight epidemics and health threats with both hands tied behind their back while wearing a blindfold.

We urge the Administration and Congress to work together to ensure CDC is able to protect the American people and help Americans be healthy and thrive.”

 

###

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

TFAH Statement: Strongly Opposed to the House Obamacare Replacement Bill

Washington, D.C., March 7, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“We are strongly opposed to the House Obamacare Replacement bill, which would repeal significant portions of the Affordable Care Act (ACA), including the Prevention and Public Health Fund.

Under this plan, millions of people could lose health insurance—a devastating blow to the health of many of our nation’s most vulnerable individuals and families. Without affordable insurance coverage we will see increased levels of preventable illnesses, injuries and deaths.

In addition, eliminating the Prevention Fund would erase 12 percent of the Centers for Disease Control and Prevention’s (CDC) budget. Of that investment, $625 million directly supports state and local public health efforts to fight preventable diseases such as diabetes, heart disease and cancer.

Losing this funding would wreak havoc on our efforts to reduce chronic disease rates, immunize our children, stop the prescription drug and opioid epidemic and prepare the public health system to prevent infectious disease outbreaks.

We know how to prevent many chronic and infectious illnesses—which make up a significant portion of the $3 trillion the nation spends yearly on healthcare.  If we lose access to health care coverage and to the Prevention Fund, our children, families and communities will suffer and ultimately costs will rise.

The bottom line? This Bill would make untold numbers of the American people less healthy.”

 

###

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.