Monday, October 13, 2014

Ebola Blame Game- BBC

'Republican cuts kill': Advert politicises Ebola

A man in protective clothing walks near the apartment of a second Dallas-area Ebola victim.
With the Ebola outbreak in Africa and subsequent appearance of the disease on US soil coming in the middle of US congressional campaigns, it was only a matter of time before the subject became a topic of political discussion.

Debate has centred around whether recent reductions to US public health funding have had an adverse effect on the government's ability to respond to the disease and, if so, who deserves the blame.

Last week former Secretary of State Hillary Clinton said the US response to the Ebola crisis has been at least partially hampered by budget cuts to the Centers for Disease Control and Prevention (CDC) approved by Congress.

"They're working heroically, but they don't have the resources they used to have," she said.

"Emergency preparedness is an easy budget to cut when there aren't any emergencies happening”
Sarah Kliff Vox
On Friday Francis Collins, the head of the National Institutes of Health (NIH), also lamented a shrinking public health budget.

"Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would've gone through clinical trials and would have been ready," he told the Huffington Post.

Judy Stone, an infectious disease specialist, explains what the cuts have looked like for Scientific American's medicine blog:

"NIH's budget was reduced by $446m [£278m] from 2010 to 2014, and subjected to inappropriate politically motivated interference in its decision-making. The CDC's discretionary funding was cut by $585m during this same period. Shockingly, annual funding for the CDC's public health preparedness and response efforts were $1b lower for 2013 fiscal year than for 2002. These funding decreases have resulted in more than 45,700 job losses at state and local health departments since 2008."

Vox's Sarah Kliff calls these numbers "disturbing".

"Emergency preparedness is an easy budget to cut when there aren't any emergencies happening," she writes. "But the decision has consequences: we're learning with the current outbreak that our public health systems - both in the United States, and globally - simply are not prepared to handle an Outbreak of a dangerous disease like Ebola."

On Monday the liberal independent political group Agenda Project Action Fund, unveiled a highly charged television advert on the subject, which it plans to air in states with competitive Senate races, such as Kentucky, North Carolina, South Dakota and Kansas.

The minute-long video mixes footage of Ebola victims and healthcare workers in protective garb with Republicans calling for budget cuts and news reports on how those cuts have affected public health funding.

The advert's closing line: "Republican cuts kill."

"Our goal is for every single American citizen to understand the role Republican anti-government fanatics played in the Ebola panic and in the death of literally thousands of people around the world," Erica Payne, the advert's producer, told McClatchy News.

Erick Erickson, founder of the conservative Red State blog, says the advert "reeks of desperation.

"The CDC and NIH are swimming in money, just like every other appendage of this ridiculously overpriced, painfully mis-managed government”
John Hayward Human Events
"At a time when more and more Americans, including millennials, are concluding government just doesn't work, it probably won't be effective," he writes.

Human Events's John Hayward says government incompetence - the "Ineptocracy" - is to blame:
"The CDC and NIH are swimming in money, just like every other appendage of this ridiculously overpriced, painfully mis-managed government. Like every other agency, they fritter away their money on silly distractions and naked attempts to extend their power."

Republican Louisiana Governor Bobby Jindal writes in Politico that the CDC has received $3bn (£1.87bn) in transfers from a Prevention and Public Health Fund set up by President Barack Obama's healthcare reform, but only 6% of that amount has gone toward "epidemiology and laboratory capacity".

Instead, he says, the CDC has spent hundreds of millions of dollars on parks, sidewalks, bike lanes and farmer's markets.

"When that same government prioritises funding for jungle gyms and bike paths over steps to protect our nation from possible pandemics, citizens have every right to question the decisions that got us to this point," he write

Reason magazine's Nick Gillespie looks at the funding for the CDC over the past four years and finds overall agency funding has been relatively stable. As for the NIH, its 2014 budget of $30.1bn (£18.75bn) is down from $31bn in 2010 but a sharp increase over $23bn it received in 2002 and roughly equivalent to its $30.2bn for 2009.

NIH Director Francis Collins speaks at the White House.  
NIH director Francis Collins says agency budget cuts have hindered the development of an Ebola vaccine
He says that dismissing these top-line numbers and focusing on individual programmes means "you're really talking about the ways in which bureaucracies, especially in the budget sector, misallocate resources".

"The one thing you really can't do is say that the federal government, which is not actually controlled by the Republicans (just saying), has been slashing its spending on anything," he concludes.
It's less than a month until the mid-term congressional elections, and as long as the Ebola story stays in the headlines, there is the possibility that candidates and causes will attempt to use it for political advantage.

As the New Yorker's Michael Specter writes, however, it's what happens when the headlines fade, political rhetoric dies down and life returns to normal that makes a difference.

"Our response to pandemics - whether SARS, avian influenza, MERS, or Ebola - has become predictable," he says. "First, there is the panic. Then, as the pandemic ebbs, we forget. We can't afford to do either."

A debate over responsible levels of funding for infectious disease control would be welcomed by many in the healthcare world. That is not a discussion the US political establishment is capable of having over the next few weeks, however.

Will the attention last beyond election day?

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