PHI & Other Leading Health Organizations Urge Support for CDC’s Critical Role in the COVID-19 Pandemic Response

July 1, 2020

The Honorable Alex M. Azar
Secretary
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

Dear Secretary Azar,

Our organizations have been directly involved in the fight against the coronavirus (COVID-19) – from serving on the frontlines, to working with policymakers to make evidence-based decisions, and to collecting and sharing data. We are deeply concerned about increasing reports of resistance to evidence-based public health messages and threats to public health leaders and agencies. Such actions undermine the efforts to protect the health and wellbeing of America’s residents at a critical juncture when cases of COVID-19 are rising.

At this sentinel moment, we urge you to affirm the invaluable role of the Centers for Disease Control and Prevention (CDC) and resist any efforts that would undermine its mission. Similarly, we stand in solidarity with the local, tribal, and territorial public health agencies as they strive to provide guidance in how to re-open safely, avoid preventable deaths and decrease the likelihood of a second major shutdown on the economy.

CDC, state, local, tribal, and territorial public health staff have been working around the clock for months to respond to the pandemic and protect the public, while often relying on overworked staff and inadequate systems that are the result of decades of underfunding.1 The United States spends an estimated $3.6 trillion annually on health, but less than three percent of that spending is directed toward public health and prevention.2, 3 And, public health spending as a proportion of total health spending has been decreasing since 2000 and falling in inflation adjusted terms since the Great Recession.4 CDC’s core budget remains inadequate to meet the nation’s public health needs. While emergency supplemental funding has been critical to begin to address the immediate COVID needs, robust, sustained, and predictable funding for its full public health mission is essential to sustain its core public health activities and work to prevent the next emergency.

Underfunding CDC has a direct impact on the public health agencies in states and local communities that rely on federal funding from the CDC. While some funding also comes from state and local sources, federal funds are critical for states and communities to help reach our national goals of a safer and healthier population. Moreover, funds from state and local governments are incredibly sensitive to economic shifts and are very likely to shrink further as a result of the current economic outlook.

The broad scope of CDC’s work – from chronic disease to injury prevention to environmental health to emergency preparedness to infectious disease – is critical. It is not possible to effectively meet the needs of the American people if that scope is narrowed. We have seen how many chronic diseases and conditions that afflict Americans, such as obesity, heart disease and diabetes, have increased the risk of hospitalization and death from COVID-19. The pandemic has also starkly highlighted the unacceptable health disparities related to racism and discrimination which can only be addressed with a sweeping, rather than a narrow, health focus.

CDC, along with the White House, the Department of Health and Human Services, state and local health departments have made some missteps in their response to COVID-19 which should be acknowledged and learned from. After the global pandemic we must work collaboratively to modernize CDC and the entire public health system while at the same time ensuring it has the funding and support necessary to do so.

Nonetheless, CDC continues to be the world’s premiere public health institution and should be treated as such during this pandemic. It is a scientific organization that functions best as an apolitical agency trusted to guide the strategy of our nation to be healthier and safer. We must amplify the unfettered voice of CDC, not stifle it. The core mission of the CDC is clear, and it is replicated in every state, local, tribal and territorial public health agency: prevent illness and injury and save lives. Now more than ever we need them to accomplish their mission.

Secretary Azar, the health of all Americans is at stake. We urge you to speak up and amplify the critical role of CDC and that of all public health agencies during this monumental crisis.

Sincerely,

1,000 Days
Academic Health Resource
Academy for Eating Disorders
Action on Smoking and Health
Advocates for Better Children’s Diets
AES Consulting
AFSCME
AIDS Alliance for Women, Infants, Children, Youth & Families
AIDS United
AlohaCare
Alzheimer’s and Dementia Alliance of WI
Alzheimer’s Association
Alzheimer’s Impact Movement (AIM)
Alzheimer’s of Central Alabama
Alzheimer’s Orange County
American Academy of Family Physicians
American Academy of Pediatrics
American Academy of Pediatrics, California
American Association for Clinical Chemistry
American Association for Dental Research
American Association for the Study of Liver Diseases
American Association of Colleges of Pharmacy
American Association on Health and Disability
American Cancer Society Cancer Action Network (ACS CAN)
American College Health Association
American College of Clinical Pharmacy
American College of Clinical Pharmacy (ACCP)
American College of Obstetricians and Gynecologists
American College of Physicians
American College of Preventive Medicine
American Council on Exercise
American Foundation for Suicide Prevention
American Geriatrics Society
American Heart Association
American Kidney Fund
American Lung Association
American Medical Women’s Association
American Organization for Nursing Leadership
American Public Health Association
American School Health Association
American Sexual Health Association
American Society for Clinical Pathology
American Society for Microbiology
American Society of Hematology
American Society of Pediatric Nephrology
American Society of Tropical Medicine & Hygiene
American Thoracic Society
American University Department of Health Studies
APLA Health
Arizona Community Health Workers Association
Arizona Public Health Association
Art & Science of Health Promotion Institute
Asian Health Coalition
Asian Health Services
Association for Prevention Teaching and Research
Association for Professionals in Infection Control and Epidemiology
Association of American Cancer Institutes
Association of American Medical Colleges
Association of Asian Pacific Community Health Organizations (AAPCHO)
Association of Food and Drug Officials
Association of Immunization Managers
Association of Maternal & Child Health Programs
Association of Minority Health Professions Schools
Association of Ohio Health Commissioners
Association of Population Centers
Association of Public Health Laboratories
Association of Schools and Programs of Public Health
Association of SNAP Nutrition Education Administrators
Association of State and Territorial Health Officials
Association of State Public Health Nutritionists
Autistic Self Advocacy Network
Big Cities Health Coalition
Bipartisan Policy Center
Black AIDS Institute
Black Men’s Health Initiative
Boston Public Health Commission
Bristol Health Equity Zone
Bronx Health REACH
California Coalition for Children’s Safety and Health
California Immunization Coalition
California Pan-Ethnic Health Network
California School Nurses Organization
Cambridge Public Health Department
Campaign for Tobacco-Free Kids
Cancer Council of the Pacific Islands
Caring Ambassadors Program
Cascade AIDS Project
Center for Community Resilience
Center for Health and Learning
Center for Law and Social Policy (CLASP)
CenterLink: The Community of LGBT Centers
Ceres Community Project
ChangeLab Solutions
Child Welfare League of America
Children’s Environmental Health Network
Children’s Mental Health Network
Christian Council of Delmarva
City of Houston Health Department
City of Milwaukee of Health Department
Climate for Health, ecoAmerica
Coalition for a Tobacco Free Arkansas
Coalition of National Health Education Organizations
Cohen Veterans Bioscience
Colorado Association of Local Public Health Officials
Colorado Public Health Association
Colorado Public Health Nursing Leaders
Community Access National Network
Community Education Group
Connecticut Public Health Association
Cooley’s Anemia Foundation
Council of State and Territorial Epidemiologists
Counter Tools
County Health Executives Association of California
Cuyahoga County Board of Health
Cystic Fibrosis Foundation
Delaware Academy of Medicine
Delaware Academy of Medicine / Delaware Public Health Association
Delaware Academy of Medicine and the Delaware Public Health Association
East Shore District Health Dept.
Eating Disorders Coalition for Research, Policy & Action
Education Development Center
Element Health, Inc.
Endocrine Society
Enlace Chicago
Epilepsy Alliance America
Equality California
Eta Sigma Gamma
Families USA
Family Voices
Fetal Alcohol Syndrome Information Network
FHI 360
FIRST Family Service Center
Fletcher Group, Inc.
Florida Institute for Health Innovation
Florida Public Health Association
Foundation for Healthy Generations
Galaxy Aviation Corp
Gateway Region YMCA
George Mason University Center for Climate Change Communication
GLMA: Health Professionals Advancing LGBTQ Equality
Global Alliance for Behavioral Health and Social Justice
Global Health Council
Global Health Technologies Coalition (GHTC)
Global Healthy Living Foundation
Global Liver Institute
Grand Traverse County Health Department
Green & Healthy Homes Initiative
Harm Reduction Michigan
Hawaii Public Health Association
Hawaii State Dept of Health, Office of Primary Care and Rural Health
Health by Design
Health Care Improvement Foundation
Health Enhancement Research Organization (HERO)
Health Resources in Action
Healthcare Foundation Northern Sonoma County
Healthcare Ready
HealthHIV
HealthPartners Institute
Healthy Schools Campaign
Healthy Weight Partnership Inc.
Heartland Alliance
Hep B United
Hepatitis B Foundation
HIV Medicine Association
Hogg Foundation for Mental Health
Hope and Help Center of Central Florida, Inc.
Idaho Public Health Association
Immunization Action Coalition
Immunize Nevada
Impetus – Let’s Get Started LLC
Indiana Public Health Association
Infectious Diseases Society of America
Institute for Family Health
Interdisciplinary Association for Population Health Science (IAPHS)
International Association of Emergency Managers
International Association of Fire Chiefs
IWC Resources, LP
Jeffrey Modell Foundation
Journal of Public Health Management and Practice
Jump IN for Healthy Kids
Kaplan Health Innovations
Kentucky Health Departments Association
KidsAndCars.org
Lakeshore Foundation
League of American Bicyclists
Linn County Public Health
Louisiana Community Health Worker Outreach Network
Louisiana Public Health Association
Lupus and Allied Diseases Association, Inc.
Macoupin County Public Health Department
Maine Public Health Association
March of Dimes
MaryCatherine Jones Consulting, LLC
Maryland Association of County Health Officers (MACHO)
Maryland Office of Minority Health
Massachusetts Public Health Association
Medicago
MEND Foundation
Metropolitan Group
Michigan Association for Local Public Health
MindWise Innovations
Minneapolis Health Department
Mississippi Public Health Institute
Montana Public Health Association
Monterey County Health Department
Morehouse School of Medicine
MountainCare
Multnomah County Health Department
NAPHSIS
NASTAD
National Adult Day Services Association
National Association of Chronic Disease Directors
National Association of Community Health Workers
National Association of County and City Health Officials
National Association of Pediatric Nurse Practitioners
National Association of School Nurses
National Athletic Trainers’ Association
National Birth Equity Collaborative
National Center for Disaster Preparedness, Columbia University
National Center for Healthy Housing
National Coalition for LGBT Health
National Coalition for the Homeless
National Coalition of STD Directors
National Environmental Health Association (NEHA)
National Forum for Heart Disease & Stroke Prevention
National Hemophilia Foundation
National Kidney Foundation
National Lipid Association
National Medical Association (NMA)
National Network of Public Health Institutes
National Nurse-Led Care Consortium
National Prevention Science Coalition to Improve Lives
National REACH Coalition
National Safety Council
National Viral Hepatitis Roundtable
National WIC Association
Nebraska Association of Local Health Directors
Network for Environmental & economic Responsibility of United Church of Christ
Nevada Public Health Organization
Nevada Rural Hospital Partners
New Jersey Association of County and City Health Officials
New Jersey Public Health Association
New York State Public Health Association
North Carolina Healthcare Foundation
Northwest Center for Public Health Practice
NYU Grossman School of Medicine
NYU School of Global Public Health
Ohio Public Health Association
Onyx Strategic Consulting LLC
Pacific Island Health Officers Association
Partnering for Community Transformation Inc
Partnership to Fight Chronic Disease
Partnership to Fight Infectious Disease
PATH
Patrick Risha CTE Awareness Foundation
Pawtucket Central Falls Health Equity Zone
Peggy Lillis Foundation
Pennsylvania Public Health Association
PFLAG National
Population Association of America
Population Health Alliance
Prevent Blindness
Prevent Child Abuse America
Prevention Institute
Preventive Cardiovascular Nurses Association
Public Health Advocates
Public Health Alliance of Southern California
Public Health Foundation
Public Health Institute
Public Health Law Center
Public Health Solutions
Puerto Rico Public Health Association
Pulmonary Hypertension Association
Redstone Global Center for Prevention and Wellness GWU
Research!America
Residential Eating Disorders Consortium
Resolve to Save Lives, an initiative of Vital Strategies
Respiratory Health Association
Rhode Island Department of Health
RiverStone Health
RiverStone Health
Rural Health Association of Tennessee
Rural Health Association of Utah
Safe Routes Partnership
Safe States Alliance
Samueli Integrative Health Programs
SANIPLAN
School-Based Health Alliance
SF Hep B Free – Bay Area
SHAPE America – Society of Health and Physical Educators
Shoals Community Clinic
Silver State Equality-Nevada
Smoke Free St. Joe
Society for Advancement of Violence and Injury Research
Society for Maternal-Fetal Medicine
Society for Public Health Education
Society of State Leaders of Health and Physical Education
Southern California Public Health Association
Southwick BOH
Stanislaus County Medical Society
Susan G. Komen
Tennessee Justice Center
Tennessee Public Health Association
Texas Public Health Association
The AIDS Institute
The Broussard Company
The Center for Community Resilience, George Washington University
The Consortium
The Foundation for Sustainable Communities
The George Washington University (GW) Cancer Center
The Gerontological Society of America
The Immunization Partnership
The John A. Hartford Foundation
The Los Angeles Trust for Children’s Health
The National Commission for Health Education Credentialing, Inc
The Nourished Principles, LLC
The Permanente Medical Group
Thomas Jefferson University
Training Resources Network, Inc.
Treatment Action Group
Trust for America’s Health
Truth Initiative
U.S. Breastfeeding Committee
UCLA Fielding School of Public Health
UNC Gillings School of Global Public Health
United Ostomy Associations of America
United Way of Greenwood and Abbeville Counties
University of Washington Department of Global Health
University of Washington School of Nursing
University of Washington School of Public Health
University of Wisconsin Population Health Institute
Vaccinate Your Family
Washington State Association of Local Health Officials
Washington State Department of Health
Washington State Public Health Association
WelCore Health, LLC
West Valley Neighborhoods Coalition
Whitefoord
Winer Family Foundation
Wisconsin Public Health Association
Women Of A Certain Age
WomenHeart: The National Coalition for Women with Heart Disease
Women’s Resource Center
Woodhull Freedom Foundation
Xavier University for Population Health
YMCA of the USA
Zell Community Health Strategies

Citations

1 Farberman, RK, McKillop M, Lieberman DA, et al. The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2020. https://www.tfah.org/reportdetails/publichealthfunding2020/ (accessed June 30, 2020).
2 National Health Expenditures Accounts. In Centers for Medicare & Medicaid Services, 2018.
https://www.cms.gov/researchstatistics-data-and-systems/statistics-trendsandreports/nationalhealthexpenddata/nationalhealthaccountshistorical (accessed March 14, 2020).
3 Himmelstein DU and Woolhandler S. “Public Health’s Falling Share of US Health Spending.” American Journal of Public Health, 106(1): 56-57, 2016. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302908
(accessed March 14, 2020).
4 Ibid.

Originally published by Trust for America's Health