Editorials
Funding the public health response to terrorism
By BMJ
Sep 10, 2005, 00:10

Funding the �war on terror� could cost the lives of millions of Americans, says a senior doctor in this week�s BMJ.

Professor Erica Frank argues that the US government�s decision to shift funds away from basic public health services towards preventing terrorism has cut funding for common diseases and for disaster relief, resulting in enormous numbers of unnecessary deaths.

�The most recent effects of these diversions of funding have been seen in the unfolding tragedy of Hurricane Katrina in New Orleans and the surrounding area,� she writes.

On September 11 2001, 3400 people died because of four horrific, intentional plane crashes. On the same day, 5200 Americans died from common diseases. A similar number of American deaths from these same causes has happened every day since then, she adds.

Concerns about disproportionate funding in the US have been building for some time. As early as 2002, many public health workers thought that the Bush administration�s plan for smallpox vaccination was a misguided redirection of public health funds.

Although pressure to provide mass immunisation against smallpox has subsided, preparedness for bioterrorism still seems magnified well beyond its proportional risk. For example, in September 2002 New York was awarded $1.3m to reduce heart disease, the leading killer of New Yorkers, while $34m was awarded for bioterrorism preparedness in the state.

FBI funds designated for investigating fraud in health care also seem to have shifted to other purposes, including fighting terrorism, and military funds for cleaning up polluted sites and meeting clean air standards have been proposed for capping and exemption by the Pentagon.

These observations are not intended to diminish the tragedies of 11 September 2001 or 7 July 2005 or other terrorist actions, nor to negate the importance of developing effective ways of making sure such tragedies are not repeated, says the author.

It is certainly justifiable for governments to appropriate substantial funds to prevent potential future threats to our security. But public funding for current threats should not be compromised.

�Predictable tragedies happen every day. We know strategies to reduce deaths from tobacco, alcohol, poor diet, unintentional injuries, and other predictable causes. And we know that millions of people will die unless we protect the population against these routine causes of death,� she concludes.

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