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Chair DeLauro Opening Remarks for House Appropriations Subcommittee on Labor, Health and Human Services, and Education Hearing on Centers for Disease Control and Prevention Budget for Fiscal Year 2021

March 10, 2020

A video of the hearing can be found here.

Good morning. I am pleased to have the Centers for Disease Control and Prevention before the Subcommittee. It has been several years (March 2016) since our last hearing on the budget of the nation's leading public health agency. What good timing.

Let me welcome CDC Director Dr. Robert Redfield. It is good to see you and your colleagues, who are here to answer questions.

  • Dr. Ileana Arias, Associate Deputy Director for Public Health Science and Surveillance;
  • Dr. Debra Houry, Director of the National Center for Injury Prevention and Control; and,
  • Ms. Sherri Berger, Chief Strategy Officer and Chief Operating Officer.

However, I am sorry that Dr. Nancy Messonnier is not here. Her briefings have been clear and prescient, including a bipartisan briefing on coronavirus that we held for the subcommittee in February.

In fact, before we proceed to CDC's FY 2021 budget request, let me start with COVID-19.

Of course, I want to commend the thousands of public health experts on the state and federal level who are working so hard to keep us safe during this outbreak.

But, we are in a crisis. And, there are questions about our preparedness and ongoing response efforts.

I am very concerned about our nation's testing capabilities for coronavirus. Other countries have been testing thousands of people for weeks. But the U.S. is woefully behind the curve. The low number of positive tests in the U.S. is likely a by-product of under-testing, as opposed to an accurate count of the prevalence of coronavirus in the U.S.

My understanding is that testing kits are now being distributed across the country, and commercial firms are involved as well. But the delay has been unacceptable. While CDC rapidly developed a new test for COVID-19, the majority of the initial test kits sent to laboratories were faulty, and there were weeks of delays before replacement kits were sent out. During this time, CDC maintained a narrow testing criteria. It makes us ask if the health of our country was put further at risk because of these actions.

I expect there will be a lot of questions today about testing and those delays.

Another concern is emergency funding. The Congress came together last week and passed an $8.3 billion emergency supplemental. It includes $2.2 billion for CDC. This funding will support CDC, as well as State and local health departments who are critical to responding to this outbreak and saving lives.

But, when this crisis arose, the CDC had only $105 million available in the Infectious Diseases Rapid Response Reserve Fund. The Supplemental added $300 million. I have been a leader for years on a public health emergency fund and have repeatedly introduced legislation, the Public Health Emergency Act, to provide $5 billion in emergency funding to the Public Health Emergency Fund. We can only imagine where we would be if we had $5 billion at the outset of this, instead of $105 million in the Rapid Response Reserve Fund.

The former shadow health minister of South Africa, Wilmot James, a global public health expert, has said of public health infrastructure, "Why do we lurch from crisis to crisis and lapse into complacency in between?"

This outbreak is a reminder of the importance of a well-prepared, well-trained, well-trusted and well-funded public health system. Because beyond COVID-19, professionals at CDC, day in and day out, are working to combat foodborne illnesses and influenza, to promote healthy lifestyles, to reduce and prevent the use of tobacco products, and on and on.

It is important work. And, it is why I am proud that the Congress increased CDC's funding for FY 2020 by $636 million, or 9 percent, above FY 2019. Some highlights include:

  • for the first time in more than 20 years funding specifically support firearm injury and mortality prevention research [$12.5 million];
  • the first year of a multi-year effort to support modernization of public health data surveillance and analytics at CDC, State and local health departments [$50 million];
  • the first year of a multi-year initiative to reduce transmission of HIV by 90 percent over the next 10 years [$140 million];
  • the establishment of a suicide prevention program [$10 million];
  • tobacco prevention, specifically given the e-cigarette and vaping epidemic among our young people [+$20 million]; and,
  • increases for Global Disease Detection [+$75 million] and the Infectious Diseases Rapid Response Reserve Fund [+$35 million].

Unfortunately, the President's 2021 budget proposal would reverse this progress. The budget proposes to cut CDC funding by $693 million, or 9 percent, below the FY 2020 appropriation.

And, despite the presentation of the President's Budget, which claims that infectious disease, global health and preparedness were prioritized in CDC's request, key programs would be cut: the Public Health Data Initiative, the Public Health Workforce program, and the Infectious Diseases Rapid Response Reserve Fund that allowed CDC to quickly respond to COVID-19.

This subcommittee will not be pursuing the administration's proposed cuts. To cut from our public health infrastructure during an outbreak is beyond consideration. Instead, I intend to invest in CDC and our nation's public health system. We will not lurch from crisis to crisis and lapse into complacency in between. We cannot. This coronavirus outbreak makes that very clear.

Let me stop there. Dr. Redfield, I look forward to further discussion of your budget and of other policy areas under your jurisdiction. I appreciate you being here today. But, before I turn to you, let me turn to my colleague, the Ranking Member from Oklahoma, Mr. Tom Cole, for any remarks he would like to make. Mr. Cole?