The demonstrators meet outside the centers for Disease Control and Prevention in Atlanta on Wednesday, during a controversial meeting of the advisory committee on vaccines.
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Elijah Nouvelage / Getty Images
Health services across the country have noticed that something strange happens with the financing of centers for Disease Control and Prevention: it does not appear on time and there has been no communication on why.
The Federal Public Health Agency is going out Most of the money He receives from Congress to the health services of states and premises, which then contract with local organizations. This is how public health work is funded in the United States
According to two CDC staff who know the agency’s budget, the CDC has not yet received its full funding for the year 2025. NPR has agreed not to appoint staff members because they were not allowed to speak to the media.
The two CDC staff say that funding is now late months, and it will soon be too late to disperse the agency’s subsidies that local health services are waiting for. In the meantime, the CDC worked with only 30 days of funding at a time. Staff members say that this represents the abolition of the agency’s financing. One of them called him “Intelligence by inertia”.
The Ministry of Health and Social Services did not answer NPR questions for this story or answered a request for comments on this characterization.
A big change from the usual process
“Most State health services obtain most of their funding from the federal authorities – in the case of Alabama, we obtain more than two thirds of our funding from federal subsidies, mainly CDCs”, explains Dr Scott HarrisWho directs the Alabama Health Department and is the president of the Association of State and Territorial Health Offiners. “Less than 10% of our money comes from dollars of state.”
“Nothing can really happen if we don’t know that we are going to get money – if there is no preaching,” says Harris.
This year, CDC reward notices simply do not arrive on time. “For example, one of our cardiovascular subsidies expires at the end of this month,” he said, “we have no reward advice, so it is really risky for causing us a lot of costs in the coming weeks to do work in this program, without knowing if we have the capacity to be reimbursed.”
Harris says he heard state health services across the country in the same situation, the funding of the CDC being mysteriously delayed.
The subsidies related to HIV prevention work in many states expired at the end of May without any information on future financing. In Ohio, this meant that the state HOTLINE of the State and the delivery of free test tests were suddenly arrested. San Antonio Aids Foundation was to Break its test services. And in Charlotte, in Northern Carolina, funding delays have led to job losses in the local health service, explains the health commissioner of the county of Mecklenburg Raynard Washington.
“The majority of these six people we sent to us at the beginning of June were the staff of the disease specialists in diseases – contact tracers for HIV, syphilis and other STIs,” said Washington, referring to sexually transmitted infections.
“The result in the field is that our other staff that we have who does this work must take more workload, then very often, we end up taking behind,” he said. Being behind it could mean that people who have potentially been exposed to something do not know, he adds. “The ultimate risk is that they also exhibit other people, then the chain continues to develop from there.”
Funding for more subsidies will soon expire, says Dr Philip HuangDirector of Dallas County Health and Human Services in Texas. Huang says that the State Health Department simply warned them that if they do not receive a reward notice for vaccination and emergency preparation subsidies, they should interrupt the activities funded by these subsidies.
“(It is) extremely painful for us because we have around 60 employees on these subsidies and significant funding that are assigned,” he said.
Washington adds that North Carolina has not received a new award notice for the Breast and cervical cancer screening program either.
The CDC works with a “pipette” monthly budget
In March, President Trump signed a continuous resolution for the 2025 financial year, which included $ 9 billion for the CDC.
“Once (a budget) is adopted and signed by the president, there is always a gap,” said one of the CDC staff who spoke at NPR who is a senior agency official. There is a “distribution” process to give each agency their money, which generally takes between 45 and 60 days.
During this period, to be able to make payments and follow regular invoices, the CDC receives money by 30 days.
This year? “Forty -five days came and came. Sixty days have come, more and more time came and came – no word, no information,” explains the senior leader of the CDC. “We continue to ask – where is our money? Where is the money approved by the congress?”
Without a money pot to distribute to various centers and divisions, the CDC cannot send the notice of rewards according to which local health services and health services must be able to continue their work and know that they will be reimbursed for this.
One month after the month of financing by 30 days increments, it is like receiving money “with a pipette”, adds the senior official.
HHS did not answer NPR questions about the reasons for these funding delays in the CDC in publication.
CDC staff say that they lack time to be able to spend the funds in 2025 from the agency before the end of the fiscal year in September due to all the stages involved in the financing of the door.
“Money does not arise from one account or the other – people must actually do the manual work of the funds provided for real accounts at the appropriate levels,” explains the other member of the CDC staff.
“If they can delay until the end of September, then that’s it,” added the staff member. “These projects will not occur. This money returns directly to the treasure.”
This is why the two CDC staff who spoke with NPR say that this is equivalent to the abolition of the agency’s financing.
“At this point, we absolutely assume that this is intentionally done to end us,” explains the senior official.
HHS did not respond to a request for comments on this characterization.
HIV funds were late, but uncertainty remains
This week, state health services have learned that the End the HIV epidemic The subsidies that expired at the end of May were finally allocated.
There was no explanation for the delay, explains Washington, the health commissioner in Charlotte, NC
“Now I have to go to know if the staff we have dismissed is ready to go back to work,” he said. “If they do not wish, then we must start to hire, to train – we have lost months of work due to administrative delays.”
And delays continue, he said. There was no communication on what could happen with the many subsidies that expire on Monday, then June ending. “Throughout this experience, we have just said to ourselves:” We have no answer “,” he said. “This is the difficult part when you try to plan.”
Harris de l’Alabama agrees. “We must be paid to do these things, whether tobacco prevention or diabetes work or preparation for public health or anything,” he said. “We can’t really do it without funding.”