Why Amer­ica’s health can’t af­ford any bud­get cuts to CDC

Austin American-Statesman - - VIEWPOINTS -

Why are Pres­i­dent Don­ald Trump’s pro­posed cuts to the U.S. Cen­ters for Dis­ease Con­trol and Pre­ven­tion such a bad idea? One big rea­son is that they are on the fore­front of what Dr. Tom Frieden, former CDC direc­tor, rightly called “one of our most se­ri­ous health threats” — killer an­tibi­otic-re­sis­tant bac­te­ria.

A 2013 CDC re­port found that an­tibi­otic-re­sis­tant bac­te­ria, aka “su­per­bugs,” in­fect mil­lions of Amer­i­cans per year and kill at least 23,000 of us an­nu­ally. Four years later, ex­perts say those num­bers have likely grown.

Los­ing ef­fec­tive an­tibi­otics as a tool in medicine — a somber re­al­ity in some cases al­ready — means com­mon in­fec­tions will once again kill. Med­i­cal ad­vance­ments like can­cer treat­ment, rou­tine surg­eries and or­gan trans­plants be­come much more dan­ger­ous.

So, the CDC should, if any­thing, in­crease spend­ing to ad­dress the “su­per­bug” cri­sis, yet the pres­i­dent’s pro­posed bud­get would re­sult in a 17 per­cent cut.

The CDC uses its fund­ing in three key ways to ad­dress an­tibi­otic re­sis­tance: de­tect­ing and re­spond­ing quickly to su­per­bug out­breaks; im­ple­ment­ing bet­ter pro­to­cols to pre­vent in­fec­tions from su­per­bugs; and im­prov­ing an­tibi­otic stew­ard­ship to keep the bugs from be­com­ing “su­per” in the first place.

Much of the fund­ing at stake goes to state-spe­cific ini­tia­tives that help pre­vent a lo­cal or statewide dis­ease out­break from be­com­ing a na­tional epi­demic.

In fis­cal year 2016, Texas re­ceived $3.7 mil­lion from the CDC through its ini­tia­tives on an­tibi­otic re­sis­tance to fund rapid re­sponse units tasked with pro­tect­ing Tex­ans from fast-mov­ing and deadly su­per­bugs.

Iden­ti­fy­ing and con­tain­ing a dis­ease out­break has se­ri­ous im­pli­ca­tions for pub­lic health. MRSA is an an­tibi­otic-re­sis­tant bac­te­ria that can have lethal con­se­quences, es­pe­cially for pa­tients with weak­ened im­mune sys­tems. Last April, the Los An­ge­les Times re­ported on a MRSA out­break at the UC Irvine Med­i­cal Cen­ter. As doc­tors strug­gled to find the source of the in­fec­tions, the out­break con­tin­ued to spread, even­tu­ally in­fect­ing 10 infants who were al­ready se­ri­ously ill.

In a dif­fer­ent case, a Ne­vada woman re­cently died from an in­fec­tion that health ex­perts have deemed the “night­mare bac­te­ria,” known in short­hand as CRE. That’s be­cause this par­tic­u­lar form of bac­te­ria was re­sis­tant to every an­tibi­otic avail­able in the U.S.

Whether it’s a MRSA in­fec­tion or the “night­mare bac­te­ria,” it is crit­i­cal for health au­thor­i­ties to be able to iden­tify the par­tic­u­lar type of bac­te­ria caus­ing the ill­ness so that they can prop­erly treat it, if pos­si­ble, and con­tain its spread.

The CDC’s pro­grams give state and re­gional health de­part­ments the kind of sta­teof-the-art tech­nol­ogy needed to de­tect, track and con­tain a su­per­bug. With­out it, they’d be fly­ing blind in re­spond­ing to an out­break, which would put more lives at risk.

Per­haps more im­por­tant than con­tain­ing a dan­ger­ous out­break is get­ting at the root cause of what fu­els drug-re­sis­tant bac­te­ria. The overuse of an­tibi­otics in any set­ting makes the drugs less ef­fec­tive. CDC’s pro­grams in­clude ef­forts to track an­tibi­otic use in health care set­tings and cut down on in­ap­pro­pri­ate use that may be breed­ing drug-re­sis­tant bac­te­ria. Fund­ing cuts to an­tibi­otic stew­ard­ship ef­forts will be a ma­jor set­back in pre­vent­ing the spread of su­per­bugs.

As Trump and bud­get ne­go­tia­tors in the House and Se­nate move for­ward with the bud­get process, they should keep in mind that what’s at stake is the health and safety of our loved ones.

We cer­tainly can­not af­ford to lose any re­sources in the fight to com­bat an­tibi­otic re­sis­tance. A wiser course would be to in­vest more in the fight to keep our an­tibi­otics work­ing.


The CDC should, if any­thing, in­crease spend­ing to ad­dress the “su­per­bug” cri­sis, yet the pres­i­dent’s pro­posed bud­get would re­sult in a 17 per­cent cut, writes Bay Scog­gin.

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