May 31, 2018

Tamara Moore, 202-868-4008

Increased Sustainable Federal Funding Required for Effective Emergency Preparedness
Government report reinforces need to ensure robust resources for routine use and infectious diseases outbreaks

May 31, 2018 (Arlington, VA) — The Society for Healthcare Epidemiology of America (SHEA) supports the Government Accountability Office's (GAO) recent report, "Funding and Performance of Key Preparedness and Capacity-Building Programs," reinforcing the critical importance of ensuring sustainable, predictable, and robust public health funding for both routine surveillance and reporting activities, as well as emergency preparedness.

"This report demonstrates that awards from annual appropriations are not enough to support the resources needed during an infectious diseases outbreak," said Keith Kaye, MD, MPH, president of SHEA. "In emergency response efforts, communities are left vulnerable to every day infectious diseases threats while precious funds are redistributed to outbreak response. It is critical to establish mechanisms for robust and timely supplemental funding for outbreak situations."

The GAO report analyzed preparedness funding for three programs within the Department of Health and Human Services (HHS) from 2002-2017: Epidemiology and Laboratory Capacity (ELC), Public Health Emergency Program (PHEP); and the Hospital Preparedness Program (HPP). These programs carry out public health preparedness and response efforts that are funded substantially through annual appropriations. The remaining is funding is from supplemental appropriations to respond to specific infectious diseases threats, including Zika and Ebola. The report was developed based on data provided on awards, as well as measurement data on awardees’ infectious diseases preparedness capacity. Federal and non-federal stakeholders were interviewed for additional insight.

In this 15-year review, the three programs that support infectious diseases emergency preparedness saw a net decrease in federal investments that were course corrected through supplemental funding when an outbreak occurred. Additionally, HHS officials and non-federal stakeholders noted in the report that the timing of supplemental awards limited the public health response since funding took an average of four months to be received. The lag often resulted in removing resources from routine activities and personnel hires to remedy the gap between the outbreak onset and receipt of the funding. This causes public health departments to decrease their normal functions to address the outbreak, which leaves the locality or region vulnerable to other outbreaks unrelated to the emergency.

Evidence of this issue was highlighted in a study published in the journal, Infection Control and Hospital Epidemiology titled, "Lessons Learned from Hospital Ebola Preparation." The study found that hospital Ebola preparations required extraordinary resources, which were diverted from routine infection prevention activities. During a sample week of preparations, 80 percent of hospital epidemiology time was reported as committed to Ebola, amounting to a median of 160 hours of staff time per hospital. During the time that such effort was focused on Ebola, only 30 percent of routine infection prevention activities were completed.

"This report demonstrates the need to increase funding overall for emergency preparedness, and the importance of fully funding programs such as the Prevention and Public Health Fund,” said Kaye. “Doing so will help ensure healthcare epidemiologists and other infection prevention and control professionals have the resources available to support critical ongoing infection prevention and response efforts, as well as the ability to respond quickly during an unexpected outbreak. This will ultimately save lives and reduce the burden of infectious diseases on the healthcare system."


The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society's work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at, and @SHEA_Epi.