Chronic diseases do not disappear, but a national center devoted to its prevention can be, a perspective which is alarming of the initiates of the agency and public health officials across the country.
The Ministry of Health and Social Services’ Budget for 2026Posted on Friday, proposed $ 14 billion in discretionary funding for programs that aim to reverse Chronic disease epidemicBut that would also abolish the national CDC center for the prevention of chronic diseases and health promotion.
“If this center is eliminated, the state services and local services lose basic prevention funds. And they lose labor for schools, chronic disease prevention, data collection, surveillance systems,” a senior CDC Chronic Disease told a state of anonymity for fear of remuneration. “If people care about children, schools are counting on this.”
Federal health leaders wish to integrate the Chronicle Center for Diseases in Administration for a healthy America, a new entity within the HHS which will also pass other centers under its umbrella: Health Resources and Services Administration, Toxicominse and Mental Health Services Administration, the office of the Deputy Secretary of Health and the National Institute of Environmental Health Sciences. The proposal affirms that these movements will strengthen the response to chronic disease.
“The AHA will administer $ 14.0 billion in discretionary funding for programs that aim to reverse the epidemic of chronic diseases,” said the proposal. “It will favor prevention – an article missing in the American health system – primary care, maternal and child health, mental health, prevention and treatment of drug addiction, environmental health, HIV / AIDS, development of labor and politics, research and surveillance.”
Which leaves the current chronic disease center in limbo, its budget has decreased, its enrollment dissolved by dismissal Contested in court and its location to be determined because its surviving programs are dispersed. The president’s financing requests tend to undergo major changes before the Congress succeeded in a budget, but for the moment, public health experts express a perplexity on the way this proposal could harmonize with the Secretary of Health Robert F. Kennedy Jr. Make America healthy agenda.
“It looks quite devastating for chronic diseases when they say they are really interested in prioritizing chronic diseases,” said Dallas County Health and Human Services. “And then this Maha report that came out – I mean, it is a very limited program that they speak in terms of treating chronic diseases.”
The displacement of prevention to AHA may cause more problems than it solves, the head of government and public affairs have told Stat for the National Association of Health Managers of the County and the City. Part of this is uncertainty about the programs that can survive.
“This other agency does not exist at the moment,” she said. “You don’t just change work. It would be something that must be built. So we are losing people who do the work right now. We don’t really know where the programs appear again when and that will work. ”
A spokesperson for HHS defended the decision, saying that complex and duplicate health programs have led to fragmented efforts that dilute taxpayers and their impact on Americans. Certain CDC programs will continue in the AHA, also said the message by email, adding: “We must put an end to this model of waste and ineffective health programming in favor of strategic and contact details. The creation of AHA does not eliminate priorities or functions; Instead, it unites previously independent programs to work together to make America healthy. ”
Not visible on the AHA agenda: the CDC program to encourage the cessation of tobacco, which has already budget axA decision that makes no sense for Huang, who, years ago in his role as director of chronic diseases for Texas, has traveled the state to urge restaurants not to smoke.
“For them, having eliminated the office of smoking and health is absolutely crazy if you say that you are trying to resolve chronic diseases,” he said. Among the avoidable causes of chronic disease, “tobacco is the most blatant”.
The CDC official also called upon the smoking cessation of one of the most effective interventions of public health, “as the elimination of the smallpox for chronic diseases”.
A new generation of young people, exposed to arguments selling electronic cigarettes and tobacco sachets, could hear messages only from advertisers and not fundamental campaigns to prevent heart disease, stroke and cancer accidents, added the CDC manager.
Huang was struck by Kennedy’s response when he was asked to appoint the main cause of preventable death in the Americans.
“What he says are the main engines of chronic disease are ultra-transformed foods, environmental toxins, technology and drugs, including vaccines,” said Huang. “They are perhaps factors, but we know a lot about what causes these chronic diseases. Tobacco is the avoidable cause of the disease, and it could not even identify this during its audience. ”
Conservative voices have been Call for the CDC To return to its roots, shrink its scope to infectious diseases like the one that inspired its creation and its location in the southeast of the United States: malaria.
Since its foundation in 1946, the expertise and activities of the CDC have been deeper and deeper, as indicated by “prevention” in its name, include a multitude of diseases, studying their origin, their treatment, their prevention and their prevalence. The agency’s knowledge, standards and surveys are shared worldwide and in all American states and territories.
The list of non -transmitted diseases is long, including cancer, heart disease, diabetes, maternal mortality, obesity, mental illness, epilepsy and dementia. The same goes for the counting of causes in addition to tobacco: high blood pressure, unhealthy diet, limited physical activity, poor access to cancer screening.
If the CDC footprint is shrinking to epidemics of transmitted diseases, the Chronic Disease Center program will be exploded. The pain would be felt far from the siege in Atlanta, said the CDC manager. Indeed, 80% of dollars funding the CDC center now takes place towards health and local and local services.
“Prevention as a whole is being deposited, which will put pressure on clinics of the health care service system to do what they do not do now: prevention outside the clinic, in neighborhoods, to prevent heart disease, diabetes, cancer.”
The budgetary plan would provide $ 500 million “to combat priority activities to make America again healthy”, of which 260 million dollars would fight against chronic diseases by attacking nutrition and environmental impacts.
This would include $ 119 million for a new prevention innovation program, which, according to the proposal, would improve the health of Americans thanks to a reliable integration of broadband technologies, “ensure access to nutrition services and places of physical activity and reduce dependence on drugs”.
At May 22 Letter of 29 American senators In response to President Trump’s budget, legislators urged legislators to protect robust funding for the CDC as a whole while distinguishing its chronic disease center.
“The elimination of the Chronic Office for the Prevention of CDC diseases also contradicts the declared objective of the administration to combat the epidemic of chronic diseases in our country,” said the letter. “These cuts will not make Americans healthy.”
One of the main roles of the National Center is to provide the collection and complete analysis of data to public health services across the country, a division of labor which allows small staff to do more.
Jason Orcena, Public Health Commissioner for Union County, Ohio, said that there was a precious synergy between the CDC and its office, which serves 70,000 people in a county which includes both suburban and rural areas with different health needs.
“There is a strong dependence on these national surveillance tools to help supervise the work we do locally as part of our local community health assessments and our community health improvement plan,” he said. “This is one of the things that the center and the CDC in general do and the state is doing as well. We are counting on them through this economy of scale to have experts really in these areas because I cannot afford to have someone expert in all things.”
When asked what disease or condition concerns him the most, Orcena said: “The one I don’t know yet.”
Georges Benjamin, executive director of the American public Health Association, stressed that there are 3,300 departments across the country, some with hundreds of employees and some with only two.
“We are the filling of the gap so that people ensure that even in the traditional medical system, things do not fall through the meshes of the net,” he said about individual public health systems. “If you are starting to see a new cancer develop, it will be picked up by the Chronic Disease Center.”
Example: HIV was initially recognized after a rare cancer linked to infection began to appear in men who have had sex with men, later linked to the disease which has become an epidemic.
“It is the division that will understand this. It is not the NIH,” said Benjamin about the Chronic Center for CDC diseases.
At the state and local level, public health officials face confusing messages on the financing of individual projects. Earlier this year, they resisted the loss of money to pay COVVI-19 programs, many of which had pivoted to cover health needs beyond Covid.
Because chronic diseases have long been under-funded and underestimated, partnerships between local health services and a national system are crucial, said Casalotti de Naccho.
“Gathering all these parts could move to a place so that we can focus more on these diseases,” she said. “Right now, what they see and live is really withdraw from this work, not necessarily pushing it forward. And so I think that is where the field must go: we have to move forward together.”
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