Funding for National Disease Surveillance Network through Epidemiology and Laboratory Capacity (ELC) Grants from the Centers for Disease Control

Issue: Reduced federal funding is crippling the capabilities of state mosquito-borne disease monitoring and response programs.

Background: Since 2000, annual Epidemiology and Laboratory Capacity (ELC) grants from the Centers for Disease Control’s (CDC) Division of Vector-Borne Diseases (DVBD) have been provided to 50 states and 6 large cities to detect, monitor, and control over 20 mosquito-borne and tick-borne diseases in the United States.  Peak annual funding for this program was $34.7 million in 2002, but over the past decade this amount has decreased 74% to a mere $9.2 million in 2012.  Further reductions or elimination of this funding would essentially dismantle this national surveillance infrastructure and extensive interagency collaboration. The spread of West Nile virus (WNV) across the country over the past 13 years demonstrated the need for timely surveillance driving intervention strategies. Nationwide last year WNV accounted for 5387 human cases and 243 fatalities, with the outbreak in Texas alone sickening and/or crippling 1739 people and killing 76.  Outbreaks of Dengue fever in Florida in 2009-2011 and Hawaii in 2011 are additional stark reminders of our vulnerability to other mosquito-borne diseases. Furthermore, introductions of exotic species of mosquitoes and diseases such as Rift Valley Fever or Chikungunya are becoming increasingly likely as travel and trade among countries become more robust. It’s critical to successfully monitor and rapidly respond to potential disease outbreaks to prevent catastrophic and unnecessary loss of life and economic distress.

Discussion: Many state public health agencies and state, county and municipal mosquito control programs rely upon these funds to develop and maintain capacity to track and coordinate response to West Nile virus and other diseases transmitted by insects that may be introduced into this country. We project that elimination of these funds would have the following deleterious effects:

• Many surveillance, prevention and vector-borne disease education programs at state and local levels will be eliminated or severely curtailed - which indeed is now happening.
• Testing of blood and tissue supplies for arthropod-borne infectious agents will be severely restricted, hindering diagnostic support for detection of healthcare associated infections.
• Nearly 85% of state level vector-borne disease personnel are supported by this funding. Critical institutional memory and laboratory capacity will be lost if federal funding is eliminated or reduced.
• A recent (2013) AMCA nationwide survey found for 22 out of 25 (88%) state public health departments that responded that the current level of ELC funding compared to peak funding several years ago is no longer adequate to support their state’s non-human arbovirus testing efforts in the lab, significantly jeopardizing their state’s ability to cope with arbovirus diseases. Furthermore, this funding shortfall cannot support arbovirus surveillance-and-monitoring activities in the field, where 100% of all respondents felt such information was critical for conducting mosquito control operations. 

Any economic savings provided by eliminating this funding will be insignificant compared to the potential healthcare costs to be incurred and, more importantly, the loss of life – both human and animal – if populations of mosquitoes that spread WNV and other exotic diseases are not monitored and suppressed in a timely manner.

Needed Action:  We request that Congress increase the CDC’s vector-borne disease program’s FY-2013 budget of $26.7 million to at least $45.0 million in FY-2014, with $25.0 million specifically earmarked as a pass-through to state public health departments and affiliated state, county or municipal programs, including mosquito control districts.