CDC Turns to Private Aid to Stay Healthy

When the national Centers for Disease Control and Prevention dedicated its new emergency operations center this month, it bore the name of a surprising benefactor -- Home Depot co-founder Bernard Marcus.

The reason: Almost two years into a massive war on terrorism, having faced one public health threat in the anthrax attacks of 2001 and facing another in a contagious, pneumonia-like disease called SARS, the federal government was unable to equip the center in a timely fashion on its own.

So it had to turn to a private donor for nearly $4 million.

“The government should have been able to put that together for itself,” said Republican Sen. Arlen Specter of Pennsylvania, who heads the Senate Appropriations subcommittee that oversees the CDC. “The administration came in this year with a budget proposal that’s essentially an abandonment” of the CDC, he said.

The Bush administration defends its record on the CDC and, more generally, on shielding Americans from a new generation of threats. White House officials said spending on homeland security has nearly tripled since the Sept. 11, 2001, terrorist attacks.

“We can’t eliminate all of the dangers that face the nation,” said Homeland Security Secretary Tom Ridge, who was in Los Angeles on Thursday as part of a two-day swing through California for meetings with state and local officials, but “we have made great strides in enhancing the security of America.”

But although the administration has spent billions of dollars bolstering airport security and maintaining patrols over major cities, critics say it has stinted on other critical items -- from protecting port facilities to replacing outmoded police and fire radios. They say it has done so in order to continue pushing its tax cuts.

“They are so desperate to preserve their budget-busting tax cuts that they are looking for places to shortchange,” said Rep. David R. Obey (D-Wis.), the ranking Democrat on the House Appropriations Committee.

Ridge and other senior officials justify the administration’s reluctance to rush into new spending in some areas as guarding against waste.

White House and congressional budget documents suggest that the administration plans to shave overall homeland security spending by $2 billion next fiscal year, a reduction that White House spokesmen justify as reflecting the lower risks to Americans that has come with the quick, U.S.-led victory over Iraq.

In addition, Ridge and others repeatedly have said that the responsibility -- and costs -- of improving security are not just Washington’s, but must be shared by states, municipalities and the private sector.

Critics note that most state and local governments are so cash-strapped they can’t afford new tasks.

And many companies are so uncertain about the future that they won’t make profit-raising investments, much less security-boosting ones.

As a result, critics say, the Bush administration -- by its own measures -- has left gaping holes in America’s home-front defenses. In the 19 months since the Sept. 11 terrorist attacks, they say, the administration has, among other things:

* Identified 123 chemical plants where a “worst case” terrorist attack could kill 1 million people or more -- but failed to prevent chemical industry lobbying from killing a tough bill to bolster plant security. It then negotiated a compromise that would require plants to improve security but provide few ways to enforce the requirement.

* Repeatedly warned that the nation’s ports, including those of Long Beach and Los Angeles, could be used to import bombs -- but devoted almost no new money to improve the security of port facilities or to underwrite its own high-profile program to inspect U.S.-bound cargo as it is being loaded in foreign ports.

* Promised $3.5 billion in new funds this fiscal year for police officers, firefighters and emergency medical personnel who are the “first responders” in case of terrorist attack -- but by its own reckoning will deliver only about half that much.

The problems that dog the Bush team’s broader homeland security efforts appear in sharp focus at the CDC, the nation’s disease-control agency. The story behind the CDC’s new emergency operations center illustrates what critics say is becoming a recurring theme with the White House -- that of issuing alarms about new home-front threats, then often moving only grudgingly to protect against them.

Despite rising threats of epidemics and bioterrorism, President Bush has not sought to increase the CDC’s budget since taking office, although he has agreed to accept additional sums under pressure from congressional Republicans and Democrats. (Since Sept. 11, Bush has asked for and received extra money to improve the nation’s readiness to handle a bioterrorism attack, although most of that is earmarked for states.)

The administration has sought to maintain the current -- and many say antiquated -- structure of the public health system that divides the job of protecting the public between Washington and state and local governments.

“The administration is engaged in a philosophical argument over whether Washington bears the primary responsibility for public health or shares it with state and local officials and even private-sector figures like Bernie Marcus,” said William Roper, who headed the CDC during the first Bush administration and is dean of the University of North Carolina’s school of public health in Chapel Hill.

“Now is not the time for the federal government to be backing off its public health obligations,” Roper said.

But the administration’s recent budget request would reduce the federal disease agency’s overall funding. The White House had claimed it wants to boost money for the CDC.

Some of the deepest cuts would fall on the parts of the agency that are most responsible for coping with new dangers like terrorism threats and severe acute respiratory syndrome. The Center for Infectious Diseases, for instance, would see its budget drop from $343 million to about $331.5 million.

William H. Gimson, the CDC’s chief operating officer, is quick to point out that other portions of the agency’s budget are scheduled for increases, but most of these are for problems such as chronic disease that have nothing to do with epidemics or terrorism. The CDC is in line to get a small portion of the $1.1 billion in new federal funds for bioterrorism preparedness in each of the next two fiscal years. But the amount earmarked for the agency would fall from one year to the next.

Gimson said the cutbacks will not damage the CDC’s ability to respond to SARS and other dangers. “If there’s another public health crisis, we’re ready,” he said. But experts such as Barry R. Bloom, dean of Harvard University’s public health school, have their doubts.

Bloom is particularly concerned about how the CDC came by its new emergency center. “They shouldn’t have to depend on handouts from the private sector to afford a modern facility for disease surveillance,” he said.

When Marcus, the former Home Depot executive, first got involved with the Atlanta-based CDC in the late 1990s, the agency was scattered across almost two dozen locations. “The facilities were awful. Decrepit,” Marcus said in an interview.

One lab building was “like an overgrown lawn-mower shed with holes in the roof and tarps over the machines,” said Jeffrey Koplan, the agency’s director at the time and now a vice president at Emory University. A second building shook so badly when cars passed on a nearby highway that scientists could use the lab only at night.

Marcus and other Atlanta executives began lobbying Congress for money and managed to get Specter and other members of Congress to visit. The lawmakers were suitably horrified and began providing funds for construction. Among the first projects was an infectious disease laboratory.

A group of CDC specialists had just moved into the new lab when the anthrax attacks occurred in October 2001. Officials said that if the lab had not been up and running, the agency could never have coped with the torrent of testing required to piece together what had happened.

But the CDC was not quite as lucky when it came to Sept. 11. Staffers rushed to New York to begin organizing against disease outbreaks, only to discover that they could not notify their Atlanta superiors what they were finding because all the cell phone networks had been knocked out. With no communications system of its own, the nation’s top public health officials were reduced to doing what everybody else was doing -- watching TV.

After the attacks, Koplan assembled a plan that called for spending $250 million annually for five years to rebuild the CDC. White House officials requested only a fraction of that, but Specter and his Democratic counterpart, Sen. Tom Harkin of Iowa, made sure the agency got what it wanted in the last two fiscal years.

Officials said that with the new money the CDC would have eventually outfitted an emergency operations center on its own, but that the project could have taken up to two years.

When Marcus learned of this last spring, he wrote a check for $3.9 million to allow the agency to quickly purchase the latest satellite phones, global positioning receivers and other high-technology gear to prevent a recurrence of the communications blackout it suffered in the New York crisis.

“I have grandchildren,” Marcus said at the time. “I am concerned about their health and welfare. I can’t wait for the ... government to see to that.”

In fact, Marcus is having to wait like the rest of the country. That’s because of what makes public health a uniquely suitable job for government: Everybody has to be covered in order for anybody to benefit. Your neighbor has to be protected from SARS for you to be safe.

For this reason, if no other, experts say private gifts such as Marcus’, while generous, are no substitute for public funds. They argue that the gift’s chief significance may be in its ability to, in effect, shame Washington into adequately funding the CDC.

“I can assure you that Mr. Marcus is not going to show up every two years and update the equipment,” said Koplan, the former CDC director. “What he has done is set a standard that it will be extremely hard for government not to meet in the future.”

But in its latest budget proposal, the Bush administration would halve the $250 million a year the agency has been receiving to rebuild itself.

Among the projects that would be put on hold: another lab to help spot the next threat to the health of Americans.