Several important provisions to rebuild our nation’s deteriorating public health infrastructure fell victim to the Senate’s short-sighted wrangling to trim the size of the stimulus bill and need to be put back in when the House and Senate reconcile their bills. Far from being “pork-barrel” spending, these were vital reinvestments that would have stimulated the economy while protecting the nation’s health.

For example, the Senate cut the $5.8 billion Wellness and Prevention Fund, a package that included immunizations, health promotion, HIV/AIDS prevention, and other net cost-saving programs. As Americans lose their jobs in numbers not seen in decades, more and more are joining the 45 million Americans already without health insurance. They will depend on government assistance. We can invest now in prevention and wellness to keep them healthy and productive, or we can pay more later for their health care bills and lost productivity.

Furthermore, the funding to implement these wellness and prevention programs would have gone to create or save jobs in state and local health departments. Health departments are the backbone of the nation’s public health infrastructure. Among their key functions, they play a central role in detecting disease outbreaks such as the current one linked to Salmonella-tainted peanut butter. But these agencies are losing jobs in the economic crisis. National Association of County and City Health Officials reports that more than half of local health departments surveyed reported staff reductions in 2008, and one-third expect to lose jobs this year. Funding in the House version of the stimulus bill can begin to patch this widening hole in our public health safety net by saving or creating nearly 18,000 public health jobs, according to the Association of State and Territorial Health Officials.

While prevention and wellness funding targeted the day-to-day health of our citizens, two other provisions struck from the Senate bill—funding for pandemic influenza preparations and for advanced development of biological countermeasures—would have provided critical investments in preparing for infectious disease threats. The principle is the same: Investing in preparation and prevention not only is much cheaper than reacting after the fact, it also creates jobs and stimulates the economy now.

As the House and Senate begin difficult negotiations on the final version of the American Recovery and Reinvestment Act, members of Congress must restore funding for pandemic influenza, BARDA, and the Wellness and Prevention Fund, for the sake of job creation, economic stimulus, and the nation’s health.

By: Infectious Diseases Society of America President Anne Gershon, MD