US lawmakers’ efforts to support global disease surveillance are not contagious…yet
An outside observer might get the idea that the US Congress is ignoring the international disease threat. Federal agencies have clearly indicated that these diseases pose a health threat and an economic and security risk to the country, but there is little evidence of a widespread push for better global disease surveillance around the world aside from the emergency earmarking of funds for (mostly domestic) influenza surveillance and the reshuffling of bureaucratic priorities within the government’s health-related agencies. In an effort to take the government’s commitment to a higher level (albeit still not commensurate with the threat), some lawmakers have introduced legislation aimed at improving disease surveillance around the world.
Senator Joe Biden (democrat from Delaware, and current aspirant for the democratic presidential nomination) along with co-sponsors Sen. Robert P. Casey, Jr. [PA], Sen. Chuck Hagel [NE], and Sen. Edward Kennedy [MA], introduced a bill titled “The Global Pathogen Surveillance Act” (S. 1687) to the Senate on June 25, 2007. The bill essentially requires that the United States provide funding and other support to bolster the infectious disease surveillance capacity in developing countries through: 1) direct monetary support of the World Health Organization’s efforts in the area, 2) earmarking scholarship support for foreign nationals to study in graduate programs in public health surveillance, laboratory science, and other related programs, 3) purchasing communication equipment for use by developing countries in support of disease surveillance, and 4) expand the programs and outreach of the already existing US HHS/CDC and DoD programs in other nations. The bill has been introduced in three separate congressional sessions—the first two times it failed to be introduced in the House of Representatives after being approved by the Senate Committee on Foreign Relations. See the original press release on the bill from Sen. Biden’s office here and the Congressional Budget Office’s (CBO) cost estimate for implementing the bill here.
Another bill (which tangentially overlaps the other bill) is the “Wildlife GAINS act” (S. 1246, H.R. 1405) introduced in the Senate in March of this year by Joe Lieberman, Sen. Daniel Akaka [D-HI], Sen. Jeff Bingaman [D-NM], and Sen. Samuel Brownback [R-KS] and introduced in the House by Rep. Rosa DeLauro [D-CT]. The bill seeks to “establish and maintain a wildlife global animal information network for surveillance internationally to combat the growing threat of emerging diseases that involve wild animals, such as bird flu.” Currently the bill is sitting with the House Subcommittee on Horticulture and Organic Agriculture and the Senate Committee on Health, Education, Labor, and Pensions without having been voted on. This bill is itself a re-working of a previous proposal (“The Global Network for Avian Influenza Surveillance Act”) that failed to get a full House vote during the previous congressional session. The CBO cost estimate for Wildlife GAINS can be seen here.
Making law is cumbersome and time-consuming, and many factors can determine success and failure. Still, the main culprit behind the inability to turn these bills into law can be probably attributed to a lack of popular understanding of their importance to protect US public health. As with so many other preventative, “global good” measures, investing in a longer-term solution comes at the expense of immediate political pressures. Probably it will take a serious health emergency to shock the public out of complacency, but hopefully these bills (or something like them) will be move beyond the subcommittee rooms of the capital and into become law before that occurs.