Historical analysis of appropriations for public health preparedness and response at CDC

CDC currently receives approximately 1.5 billion dollars annually to prepare for and respond to urgent public health threats through awards to state and local health departments and to upgrade CDC capacity. In order to better understand the trends associated with this source of funding for public health agencies, authors examined the appropriated preparedness funds between Fiscal Years (FY) 1999 and 2010 and the corresponding appropriations language. Inflationary-adjusted dollars were used in the fiscal analysis. Funding was categorized into four groups: 1) support for state and local public health preparedness; 2) development or maintenance of the stockpile of countermeasures and materiel; 3) enhancement of CDC's capabilities to detect or respond to a public health emergency; and 4) funding for other preparedness programs. Preliminary findings demonstrate more than 18 billion dollars has been appropriated for public health preparedness and response since FY 1999, although the amount and purpose of funding varies over time. Funding to state and local public health departments began in FY 1999 as bioterrorism grants and peaked through the Public Health Emergency Preparedness (PHEP) cooperative agreements of more than 1 billion dollars in FY 2002. Funding for PHEP has decreased gradually to current year funding of approximately 600 million dollars. The findings suggest that public health preparedness funding has decreased in some categories, and associated appropriations language changed significantly between 1999 and 2002, but has remained relatively stable. The policy analysis will provide a dimensional understanding of the scope of national public health preparedness based on federal funding activities.