Public Health News Watch Wednesday: Report for April 19, 2017

President Trump wants to “drain the swamp” in Washington.

But, some experts are arguing he may be throwing the baby out with the bathwater.

Although the President’s administration has been trading barbs and threats with North Korea—reviving Cold War-era fears over the potential use of nuclear weapons—health and security wonks are suggesting there may be a greater risk to the American public as a result of something they have not done: fill several key leadership posts relevant to healthcare and health-emergency response. Consequently, experts claim that the United States is more vulnerable to a pandemic infectious disease than it has been in recent memory.

As reported on April 8th in The Chicago Tribune, President Trump has yet to fill several key administrative positions “critical to responding to an outbreak”—including, but not limited to, the directorships at the Centers for Disease Control and Prevention (CDC) and the US Agency for International Development (USAID), as well as “sub-Cabinet posts” at the Department of Health and Human Services (DHHS) in charge of global affairs, emergency preparedness, and outbreak response. Interestingly, as The Tribune reports, none of these appointments require Senate hearings and approvals, meaning they are not simply caught up in the bureaucratic morass in our nation’s capital.

Indeed, it would seem that by not making an effort to fill these positions promptly after taking office, the President is merely indicating his policy priorities. The Tribune also notes that the President, who was sworn in 3 months ago, has made few if any statements with regard to public health and outbreak emergency response. Additionally, his proposed budget, presented in March, called for extensive cuts to many of these same agencies.

“If you defund the scientific infrastructure in general, all aspects are going to have to suffer and that includes preparedness for new diseases as well as research and therapy for existing diseases,” said David Freedman, MD, professor of medicine and epidemiology at the University of Alabama at Birmingham told the healthcare business news site ModernHealthcare.com recently.

Members of the Republican Party have even questioned the decision to scale back healthcare infrastructure at a time when numerous infectious threats are potentially in play, including Zika, Middle East Respiratory Syndrome (MERS), and pandemic influenza. Even Forbes magazine, which arguably leans to the conservative, published a commentary by an infectious disease specialist under the headline, “How Does Trump's Plan To Gut Health And Medical Research Make America Great?”

The argument against filling these positions, and maintaining funding levels for these agencies, of course, comes back to the “big-government-vs.-small-government” debate that, at least in part, served as a sort of a touchstone for President Trump during his campaign. However, in an interview with the non-profit, non-partisan news site MinnPost.com, Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota and co-author of Deadliest Enemy: Our War Against Killer Germs, didn’t mince words.

“You need government to be [involved in healthcare response],” he said. “This is as strategic as any missile or tank could ever be. This is why this is national security.”

It seems most of the infectious disease community agrees. That swamp in Washington may be another story.

Brian P. Duleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.