President Donald Trump’s new budget proposes drastically cutting resources in virtually all aspects of domestic and international public health preparedness and medical research. The proposed budget includes a $1.2 billion cut to the Centers for Disease Control and Prevention (CDC), a 17% reduction. Unfortunately, this comes at a time when infectious diseases are significantly more capable of wreaking international havoc.
While most lawmakers view the budget as “dead on arrival,” the detailed breakdown offers a window into the policies and priorities of the Trump administration as it prepares for what could be a contentious bipartisan debate. In a move to increase the U.S. defense budget by 10%, Trump has lost sight of the greatest national security threat of them all: a disease outbreak killing millions of people.
In Deadliest Enemy: Our War Against Killer Germs, a book I recently co-authored with Mark Olshaker, we laid out a crisis agenda of the most pressing challenges to national and global health security. Solutions to huge lurking regional threats such as Ebola, mosquito-borne illnesses like Zika, and bioterrorism from anthrax or a genetically engineered smallpox virus are only three, four, and five on our list.
The number one threat—a worldwide lethal influenza outbreak equal to or greater than the 1918–19 Spanish flu pandemic—would literally read like the outline for an apocalyptic horror film. And the H7N9 strain we chose for an imagined but scientifically plausible scenario in our book is currently percolating to the surface in Southeast Asia.
We remain woefully unprepared for next influenza pandemic. Our current vaccines are based on 1940s technology that leaves many unprotected even when vaccinated. Furthermore, our extremely limited global capacity to make an influenza vaccine means only a small percentage of the world’s population would have access to the vaccine in the first six to nine months of a pandemic.
Our number two threat—antimicrobial resistance—is a slow-moving tsunami that within decades could bring us back to the infectious Dark Ages, when a simple scrape could kill and untreatable tuberculosis was rampant. A recent comprehensive study on the future impact of antimicrobial resistance concluded that by 2050, more people worldwide will die from these resistant infections than from cancer and diabetes combined.
It is beyond foolish to neglect the danger of infectious diseases on human and animal health. The threat of a killer virus or bacteria wreaking havoc in the U.S. is far greater than any military or terrorist assault, including the explosion of an atom bomb. Instead of wasting their time and energy debating the specifics of the Trump administration’s proposed budget, American lawmakers should determine what to prioritize in the 2018 federal budget that can help the U.S. limit the deadly impact of emerging infectious diseases. This includes increasing, not cutting, the CDC and National Institutes of Health (NIH) allocations, putting serious resources into a game-changing influenza vaccine, and promoting an international effort to combat profligate antibiotic use in humans and animals and to support research and development for new antimicrobial agents.
The allocation of these funds is not just about partisan politics, but national security on the most existential level.
Michael T. Osterholm is Regents Professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota. He is co-author of Deadliest Enemy: Our War Against Killer Germs.
