Abstract
This article is the latest in an annual series analyzing federal funding for health security programs. We examine proposed funding in the President's Budget Request for FY2019, provide updated amounts for FY2018, and update actual funding amounts for FY2010 through FY2017. Building health security for the nation is the responsibility of multiple agencies in the US federal government, as well as that of state, tribal, territorial, and local governments and the private sector. This series of articles focuses on the federal government's role in health security by identifying health security–related programs in public health, health care, national security, and defense and reporting funding levels for that ongoing work.
This article is the latest in an annual series analyzing federal funding for health security programs. It examines proposed funding in the President's Budget Request for FY2019, provides updated amounts for FY2018, and updates actual funding amounts for FY2010 through FY2017. This series focuses on the federal government's role in health security by identifying health security–related programs in public health, health care, national security, and defense and reporting funding levels for that ongoing work.
T
For this series, we use the broad National Health Security Strategy definition of health security as “[a] state in which a nation and its people are prepared for, protected from, and resilient in the face of health threats.”16,17 Building health security for the nation is the responsibility of multiple agencies in the US federal government, as well as that of state, tribal, territorial, and local governments and the private sector. This series focuses on the federal government's role in health security by identifying health security–related programs in public health, health care, national security, and defense and reporting funding levels for that ongoing work.
In this series, US federal funding is divided into 5 health security domains:
Biosecurity: Federal programs focused on prevention, preparedness, and response to attacks on civilians with biological agents and accidental releases of biological material; Radiological and Nuclear Security: Federal programs focused on prevention, preparedness, and consequence management of radiological and nuclear terrorism and large-scale radiological accidents; Chemical Security: Federal programs focused on prevention, preparedness, and response to large-scale acute chemical exposures of civilian populations, both intentional and accidental; Pandemic Influenza and Emerging Infectious Diseases: Federal programs focused on preparedness and response to large, naturally occurring, and potentially destabilizing epidemics; and Multiple-Hazard and General Preparedness: Federal programs focused on multiple hazards or on building infrastructure and capacity to respond to large-scale health threats.
General Methods
This analysis documents funding levels for health security–related programs. It separates funding for health security into categories based on the major focus of the program being included. Choices regarding how an individual program is categorized can be difficult because of limited publicly available information describing the programs or identifying program-level funding amounts.
Efforts are made each year to obtain funding information down to the program level in order to be as accurate as possible. However, in some cases, funding for specific programs cannot be separated from larger line items, and so those line items are either included in their entirety or are included in the “multiple-hazard and preparedness” section of this analysis.
The authors recognize that this is not a perfect accounting of all of the federal health security work. Analysis of agency budgets and programs included in previous years resulted in a number of program additions and a few changes in the categorization of programs. As a result, funding totals for different areas of health security and agencies included may be difficult to compare with previous years' articles. However, funding comparisons can be made between fiscal years in this article.
Federal funding amounts were analyzed from FY2010 through proposed funding for FY2019, using information from FY2019 federal agency budget materials as well as budget documents from prior years. Sources for this analysis include federal agency “Budgets in Brief,” agency congressional budget justifications, and personal contacts with agency representatives to obtain and track program funding. Programs have been categorized based on their major focus, as described in budget documents or on program websites. Summary tables for program funding in each category are provided in this article, with more detailed tables available online (see Supplemental material at www.liebertonline.com/hs).
This analysis of federal health security budgets prioritizes programs supporting prevention, preparedness and response, and related research efforts. Specifically, research programs that support either medical countermeasure (MCM) research and development (R&D) or threat/risk characterization efforts were included in the analysis. Prevention programs explicitly targeted at preventing large-scale accidents or terrorist attacks with chemical, biological, or radiological agents are also included. Finally, federal emergency preparedness and response programs are included if they focus on protecting the health of US citizens in large-scale health emergencies.
The analysis excludes programs focused on routine provision of health care, on occupational health and safety, or on warfare between nation states. In addition, the analysis excludes programs focused on protecting the warfighter with no stated or likely civilian applications now or in the future. Specific inclusion and exclusion criteria and methods applied to each domain are detailed in each respective section of this analysis.
In total, the proposed FY2019 budget includes $13.60 billion for health security–related programs, a decrease in funding of $636.1 million, or 4%, from the estimated $14.24 billion in FY2018, and a 3% decrease from the FY2017 actual funding level of $13.96 billion.
Most FY2019 health security funding ($7.62 billion, 56%) would go toward programs with multiple-hazard and general preparedness goals and missions. However, this amount would be a 7% reduction in funding when compared to the multiple-hazards category in FY2018. Radiological and nuclear security programs would receive 18% ($2.38 billion) of all health security funding, a decrease of 6% from the previous year. Biosecurity programs would be funded at $1.61 billion (12% of health security funding) in FY2019, a decrease of 3% compared to FY2018. Chemical security programs would represent 3% ($396.1 million) of all health security funding in FY2019, a 2% decrease from the prior year. Finally, 11% of health security funding ($1.59 billion) would be directed toward pandemic influenza and emerging infectious disease programs, the only category of funding to see an increase (8%) above FY2018 (Figures 1 and 2).
FY2019 Federal Health Security Funding by Program Focus (in $millions)
Percent Change in Health Security Funding Level by Category, FY2018 to FY2019
Biosecurity Program Funding
The FY2019 budget allocates $1.61 billion to civilian biodefense programs, $50 million below the FY2018 budget (Table 1). This category includes programs designated to protect US civilians from deliberate and accidental release of harmful biological agents through investments in prevention, preparedness, response, mitigation, and recovery.
Federal Civilian Biosecurity Program Funding (in $millions)
Funds for CBP AQI for agriculture inspection are provided by USDA from fees collected by APHIS.
Operations costs for NBAF would be transferred to USDA in FY2019. Plum Island funding would be continued by DHS until transitioned to NBAF. Amounts for FY2017-FY2019 are approximate.
Amounts for NBACC in FY2015 and FY2018 are approximate. Detail was lacking in the budget, so the amounts were calculated based on other totals.
Amounts for FDA bioterrorism crosscut numbers were obtained through personal contact with FDA officials because they were not provided in the FY2018 or FY2019 Administration budget materials.
The NSF Homeland Security Programs were removed from the budget in the FY2018 and FY2019 budgets.
Methods
This section focuses on programs that explicitly enhance civilian biodefense. Excluded from this section are the many federal programs that address biodefense as a subset of their other activities but do not primarily emphasize biodefense. Those programs are instead categorized as “multiple-hazard and preparedness” programs.
Funding by Federal Agency
Department of Defense (DoD)
The Department of Defense budget includes $600 million for programs with civilian biodefense applications in FY2019, a $108 million decrease from FY2018 estimates. This budget covers programs under the defense-wide Chemical and Biological Defense Program (CBDP), the Defense Threat Reduction Agency (DTRA), the Defense Advanced Research Projects Agency (DARPA), and the Defense Health Program at the Uniformed Services University of the Health Sciences (USHUS).
CBDP's funding includes $313.9 million for research programs that contribute to civilian biodefense. These programs cover a range of applied and technological research initiatives. This funding represents a $102.2 million reduction from FY2018 levels and a $21.0 million reduction from FY2017 levels. 18 The largest line-item reduction from FY2018 was a $28.8 million decrease in CBDP's Medical Biological Defense, which in FY2018 was expanded to fund development of a recombinant botulinum toxin vaccine and Ebola medical countermeasure efficiency studies.
The DoD budget also includes funding for DTRA's Cooperative Biological Engagement (CBE) program. CBE's goal is to mitigate biological threats to US civilians by limiting biological weapons proliferation, improving biosafety standards at laboratories, and strengthening global public health capacity. 19 The FY2019 budget increases CBE's funding by $24.8 million to a total of $197.6 million.
In FY2019, $85.4 million would be allocated to DARPA's Research, Development, Testing and Evaluation (RDT&E) civilian-applicable biodefense programs, a $30.4 million decrease from FY2018 estimated funding. 20 These programs are at the forefront of scientific and technological research to improve military and civilian biosecurity.
An additional $3.1 million is allocated to the Defense Health Program RDT&E's Biological Defense Directorate, based at the Naval Medical Research Center. 21 This budget is $0.1 million higher than estimated FY2018 funding. This program helps detect, identify, and analyze a range of pathogens, including Ebola and anthrax, by developing and implementing diagnostic applications.
Department of Homeland Security (DHS)
The Department of Homeland Security's FY2019 civilian biodefense funding totals $731.9 million, $80.9 million higher than FY2018 estimated levels. These programs are housed under Customs and Border Protection (CBP), the Countering Weapons of Mass Destruction Office (CWMD), and the Science and Technology Directorate (S&T). DHS's biodefense programs have undergone a large reorganization this year, with activity under the Office of Health Affairs and S&T moving into CWMD, whose mandate is to mitigate risks from nuclear, chemical, radiological, and biological weapons of mass destruction through prevention, surveillance, and forensics. This reorganization has caused the budget to become less transparent, as CWMD does not break out line items in its biosecurity budget. 22
Department of Health and Human Services (HHS)
Civilian biodefense programs at the Department of Health and Human Services, all of which fall under the FDA's bioterrorism portfolio, would receive $266.8 million in FY2019, level with FY2018. These programs include the Advancing Medical Countermeasures Initiative (MCMi), the Food Defense Program, and operations and security at the Life Sciences Biodefense Laboratory. 23 HHS funds a range of other programs with biosecurity applications that are not predominantly or exclusively targeted at biosecurity, including at the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the office of the Assistant Secretary for Preparedness and Response (ASPR). These programs are assessed under the “multiple-hazard and general preparedness” heading.
Radiological/Nuclear Security Program Funding
Programs included in this section of the analysis focus on prevention, preparedness, and consequence management of terrorist and accidental radiological and nuclear incidents. For FY2019, these programs would receive $2.38 billion, a reduction of 6% from FY2018 estimated funding (Table 2).
Federal Civilian Radiological/Nuclear Security Program Funding (in $millions)
The Nuclear Counterterrorism Incident Response Program and the Counterterrorism and Counterproliferation Programs were transferred from the Weapons
Activities appropriation to the NNSA Defense Nuclear Nonproliferation appropriation starting in FY 2016.
Has offsetting collection authority.
Methods
Budget documents and program websites were reviewed to determine if programs were solely or primarily focused on radiological/nuclear hazards. Programs included in this section are related to domestic preparedness and response, international threat reduction, non-state nonproliferation, and counterterrorism activities. Programs related to US nuclear stockpile stewardship, state-level nonproliferation, and missile defense are excluded from the analysis.
Funding by Federal Agency
Department of Energy (DOE)
The National Nuclear Security Administration (NNSA) houses all Department of Energy programs related to nuclear and radiological emergencies included in this analysis. The DOE total proposed budget for FY2019 shows only a slight increase of 0.5% over FY2018 estimates, for a total of $1.9 billion. Two programs would see large increases in funding: Material Management and Minimization, which would be funded at a level of $332.1 million (16% increase), and Nuclear Counterterrorism and Incident Response, which would be funded at $319.2 million (18.2% increase). Two programs would see large reductions under the proposed budget: Global Material Security would be funded at $337.1 million (8% decrease), and Nonproliferation Construction would be funded at $279 million (16% decrease). 24
Department of Homeland Security
Reorganization within DHS has altered funding lines in ways that prevent comparison with previous years. The functions of the Domestic Nuclear Detection Office (DNDO) have now been transferred to CWMD. Within CWMD, nuclear and radiological programs include Technical Forensics (nuclear), International Rail (R/N detection), the Radiation Portal Monitor Program, the Radiation Portal Monitor Replacement Program, and CWMD Research and Development (support for nuclear detection architecture). Together, these programs total $164 million for FY2019, significantly less than the estimated $335.4 million that DNDO received last year. The Radiological Emergency Preparedness Program (REPP), which has an offsetting collection authority, would be funded at a steady $33.5 million for FY2019. 22
Department of Defense
Proposed funding in DoD for civilian-applicable radiological and nuclear programs would result in a 7% increase from estimated FY2018 funding to $194.4 million. This analysis includes only programs with applications for civilian defense, so this amount excludes programs in DoD that have radiological and nuclear defense missions that are focused solely on the warfighter. Other programs with a general CBRNE focus are included in the “multiple-hazard and preparedness program” section when radiological and nuclear components could not be separated from the overall funding amount. The Global Nuclear Security Program—the Defense Threat Reduction Agency's (DTRA) Cooperative Threat Reduction (CTR) program—would see a 62% increase from $17.9 million to $29.0 million. 18 Radiological/nuclear defense research and development (R&D) programs in DTRA and the Defense Health Program would receive approximately level funding, with the exception of a 48% increase in funding for Detection Technologies advanced technology development ($8.4 million), and a 17% decrease to Forensics Technologies advanced technology development (−$6.7 million) in DTRA.21,25
Department of State
Overall, the radiological and nuclear programs focused on civilian defense in the Department of State would see very little change in funding. The International Atomic Energy Agency (IAEA) voluntary contribution would be reduced by $1 million to $90.9 million, while the Weapons of Mass Destruction Terrorism Program would remain steady at $6 million for FY2019. 26 Programs focused on nuclear nonproliferation at a nation-state level were excluded from this analysis, while programs focusing on multiple threats are included in the “multiple-hazard and preparedness program” section.
Nuclear Regulatory Commission (NRC)
Radiological and nuclear security programs in the Nuclear Regulatory Commission would see a 10% increase to $33.6 million in the proposed FY2019 budget. This is entirely due to a 25% increase in Event Response to $19 million. The Homeland Security program would receive a 3% decrease to $14.6 million. 27
Environmental Protection Agency (EPA)
Programs at the Environmental Protection Agency related to radiological and nuclear security would see significant cuts in FY2019, with an overall reduction in funding of 53% to $8.7 million. Radiation Protection would be cut by 60% to $5 million, while Radiation Response Preparedness would be cut 40% to $3.7 million. 28
Department of Health and Human Services
Programs related to radiological and nuclear security in HHS are accounted for in the “multiple-hazards and general preparedness” section of this analysis because of the difficulty in separating radiological and nuclear–related programs from larger line items.
Chemical Security Program Funding
The federal government supports a range of programs intended to prevent, prepare for, and respond to acute, potentially harmful chemical exposures, resulting either from a deliberate release of a chemical weapon or a deliberate or accidental release of a toxic industrial chemical. In FY2019, the President's budget includes $396.1 million for chemical defense programs, which is a $6.4 million (2%) reduction from FY2018 funding levels (Table 3).
Federal Civilian Chemical Security Program Funding (in $millions)
Funding amounts for this program in FY2017 and FY2018 are estimates only. Funding information was not provided for those years in the FY2019 budget materials.
This program was combined with Chemical Risk Review and Reduction as of FY2015.
Funding for this program was subtracted from the CDC State and Local Preparedness and Response Capability in the Multi-Hazard and Preparedness Section in FY2013 to FY2016; funding amounts were not available in the FY2019 budget.
Methods
Federal chemical defense programs were included if they explicitly support countermeasures research or prevention and response capabilities for large-scale civilian exposures to either chemical weapons or toxic industrial chemicals. Research and development programs undertaken by the DoD were included because of their potential application to future civilian chemical defense capabilities. Environmental health and other chemical risk assessment programs were excluded from this analysis.
Funding by Federal Agency
Department of Defense
The DoD invests the most in chemical defense, with a requested budget of $205.9 million in FY2019, which represents an increase of $5.9 million from the FY2018 estimate of $200.0 million. The defense agencies primarily responsible for executing the chemical defense mission are DTRA for chemical weapons destruction and threat reduction activities, 25 CBDP for research and development of medical countermeasures, 20 and the Department of the Army for the Chemical Stockpile Emergency Preparedness Project. 29 The DoD chemical defense budget primarily supports research, development, and acquisition of anti-chemical therapeutics, detectors, and personal protective equipment.
Environmental Protection Agency
The EPA's budget for chemical defense programs in FY2019 is $90.9 million, which is a decrease of $21.0 million from the FY2018 estimate of $111.9 million. EPA's chemical defense portfolio includes the chemical risk review and reduction program, which works to manage the potential risks from toxic industrial chemicals; the Human Health Risk Assessment program, which conducts research on the potential health risks of chemical exposures; and the State and Local Prevention and Preparedness program, which is responsible for implementing the Improving Chemical Facility Safety and Security Executive Order. 30
Department of Homeland Security
Chemical defense programs at DHS are budgeted at $77.8 million in FY2019, an increase of $8.7 million from the FY2018 estimated total of $69.1 million. Because of the reorganization of DHS programs, chemical defense programs in the Office of Health Affairs (OHA) and the S&T directorate have been discontinued. It is unclear whether the Chemical Threat Assessment program or chemical forensics work from S&T will be taken up by the Countering Weapons of Mass Destruction Office (CWMD). The only line item related to chemical security in CWMD currently is the Chemical Support Programs, which would be funded at $0.9 million. The budget does not provide enough detail to determine what work will be supported by this funding. All other chemical program funding ($76.9 million) is being requested for the Infrastructure Security Compliance program in NPPD, which is intended to improve security at industrial facilities. 22
Department of State
In FY2019, the proposed US contribution to the Organisation for the Prohibition of Chemical Weapons (OPCW), which is the implementing agency for the Chemical Weapons Convention, is $21.5 million, which is level with the estimated contribution for FY2018. 26
Department of Health and Human Services
HHS chemical security programs, including CDC's Chemical Laboratories (LRN-C) program, which is intended to enhance laboratory preparedness for chemical threats, and NIH's CounterACT program, which supports basic research into the pathology and treatment of toxic chemical exposures, could not be included in this year's analysis because funding amounts were not provided in the CDC or NIAID budget documents and couldn't be determined.
Pandemic Influenza and Emerging Infectious Diseases Program Funding
Programs included in this section of the analysis are aimed at prevention, preparedness, response, recovery, and mitigation of pandemic influenza and emerging infectious diseases with destabilizing potential. The proposed funding level for pandemic and emerging infectious diseases programs in FY2019 is $1.59 billion—an increase of $114.8 million (8%) over the FY2018 estimate (Table 4).
Federal Civilian Pandemic Influenza and Emerging Infectious Diseases Program Funding (in $millions)
Starting in FY2014, the Global Disease Detection and Emergency Response program and the GHSA were located under Global Public Health Protection. In the FY2019 budget, they were moved back to GDD.
Funding for Global Health Security at USAID would not be new money in FY2019, but reprogrammed money from previously appropriated Ebola emergency funds.
Methods
Programs included in this section of the analysis were limited to those with a focus on pandemic influenza preparedness and response, newly emerging or reemerging infectious diseases with potential destabilizing effects (such as dengue or Zika viruses), and antimicrobial resistance. Emerging infectious disease was defined, following NIH convention, as including “infectious diseases that have newly appeared in a population or have existed but are rapidly increasing in incidence or geographic range, or that are caused by one of the NIAID Category A, B, or C priority pathogens.” 31 This analysis excludes programs focused on established infectious diseases that have their own funding streams, such as HIV, TB, and malaria, and chronic diseases. This section does not detail the emergency funding appropriations for Ebola response in 2014 and 2015, which can be found in a previous analysis. 13
Funding by Federal Agency
Department of Health and Human Services
Most federal programs dedicated to pandemic influenza and emerging infectious diseases are run by HHS. Proposed funding in FY2019 for these programs totals $1.45 billion, an increase of $117.2 million from estimated FY2018 funding.
The CDC has dedicated funding for a number of important pandemic and emerging infectious disease programs. In FY2019, CDC Emerging and Zoonotic Infectious Disease programs are budgeted to receive $508.3 million, a decrease of $60 million (−11%) from FY2018. The CDC Global Public Health Protection program, which implements the Global Health Security Agenda (GHSA), including work in global disease detection, outbreak monitoring, and response teams, would receive an increase of $51.0 million (88%), for a total of $108.8 million. The Influenza Planning and Response program, which supports influenza prevention, detection, and monitoring activities as well as pandemic planning and response, would see a 5% ($8.6 million) increase in funding and is budgeted to receive $180 million. 32
At the NIH, funding for influenza research is proposed at $312.0 million, a $32 million (9%) reduction from the FY2018 estimated funding level. 33 Included programs at the FDA would see increases, with $43.3 million in funding budgeted for pandemic influenza, and $47.8 million budgeted for antimicrobial resistance. 23
The ASPR budget for pandemic influenza is set to receive a large increase in funding, rising from $108.0 million in FY2018 to a proposed $246.0 million in FY2019. In addition, the Office of Global Affairs would receive $4 million in pandemic influenza funding, for a total of $250 million out of the Public Health and Social Services Emergency Fund to address this problem. This $250 million is targeted at supporting the development of “new diagnostic tools, vaccines, and immunotherapeutics; and to support international preparedness for pandemic influcenza.” 34
US Agency for International Development (USAID)
FY2019 funding for the Global Health Security program at USAID would remain flat at $72.5 million. However, it is important to note that funding for this program in FY2019 would not be new money but would be repurposed from previously appropriated Ebola supplemental funds (appropriated in FY2015). This program works to reduce threats to human health by improving prevention, detection, and response to infectious disease outbreaks in humans and animals. 26
Department of Defense
The FY2019 budget for DoD programs that focus on pandemic influenza and emerging infectious diseases totals $64.93 million, a proposed 4% decrease from FY2018 levels. The Combating Antibiotic Resistant Bacteria program in the defense health program would be funded at $1.9 million in FY2019, a $200,000 reduction from the FY2018 level. 21 DARPA programs focused on combating pandemic influenza and emerging infectious diseases include Analysis and Adaptation of Human Resilience ($7.1 million), Outpacing Infectious Disease ($15.6 million), Preventing the Emergence of Disease (PED) ($15.3 million), and Pandemic Prevention ($25.0 million). One DARPA program, Enhanced Monitoring of Health and Disease, would be eliminated under the FY2019 budget. 19
Multiple-Hazard and Preparedness Program Funding
This section is focused on federal programs aimed at prevention, preparedness, response, recovery, and mitigation of multiple types of hazards and programs that aim to build preparedness and response systems for large-scale health events generally. Total proposed funding for multiple-hazard and preparedness programs in FY2019 is $7.62 billion. Compared with estimated funding for FY2018, this year's budget would represent a 7% decrease in funding (–$537.4 million). This proposed decrease is largely due to funding reductions at HHS, DHS, State, EPA, and NSF (Table 5).
Federal Civilian Multiple-Hazard and Preparedness Program Funding (in $millions)
Funding amounts for LRN-C for FY2013-FY2018 have been subtracted from the total for State and Local Preparedness and Response. These annual amounts are represented in the chemical program section.
In FY2019, the funding amount for RNC countermeasures research at NIAID was not provided in budget materials. It is unclear whether this program is still receiving funding.
The funding levels for the Operational Medicine programs are estimates only for years prior to FY2019. In FY2019 the programs would be moved to Worldwide Security Protection from Diplomatic Programs.
Methods
Programs included in this section have a focus on multiple hazards, have general preparedness and response goals, and/or are targeted at building infrastructure and capacity to respond to large-scale domestic health threats of many types and causes. Examples of programs that are included in this section are those aimed at a combination of chemical, biological, radiological, and nuclear threats or weapons of mass destruction preparedness and response; programs aimed at building public health, medical, or emergency management capacity to respond to large-scale health emergencies; and basic infectious disease research programs, the results of which may have implications for a multitude of emerging infectious diseases.
Funding by Federal Agency
Department of Health and Human Services
Total FY2019 HHS funding for multiple-hazard and preparedness programs is proposed at $4.78 billion. This represents a reduction in funding of $225.6 million (−5%) compared with the FY2018 estimate.
Most funding for this category in HHS is provided through the NIH Biodefense and Emerging Infectious Disease Research program ($1.97 billion). 33 This funding level is 9% ($204 million) below the FY2018 estimate. Funding for nuclear/radiological/chemical countermeasures research at NIH, which is normally around $75 million, was not included in this year's budget materials and so is not accounted for in this analysis.
Funding for programs under this heading at the CDC would be reduced overall by 42% in FY2019. This is primarily due to the impending move of the Strategic National Stockpile (SNS) program ($575 million) out of CDC and into the Office of the Assistant Secretary for Preparedness and Response (ASPR). The State and Local Preparedness and Response Capability ($660.0 million, including the Public Health Emergency Preparedness cooperative agreements) would receive a small reduction of $3.7 million compared to FY2018. The CDC Preparedness and Response Capability ($140 million), which includes funding for CDC's emergency operations center and the BioSense surveillance program, would receive a reduction of 13%. 32
Multiple-hazard and preparedness funding in ASPR would receive a 42% increase under the proposed FY2019 budget, due primarily to the addition of the SNS program to the ASPR portfolio. Funding for other programs in ASPR, including the Hospital Preparedness Program (HPP), Project BioShield (which supports the procurement of medical countermeasures against chemical, biological, radiological, and nuclear threats), and the Biomedical Advanced Research and Development Authority (BARDA), would gain small amounts of additional funding. Finally, the Medical Reserve Corps (MRC), a program that was funded at $13 million in FY2010, would be reduced by 33% to $4 million. 34
Department of Homeland Security
The FY2019 DHS budget includes $1.45 billion in funding for programs focused on multiple hazards and preparedness related to health security. This would be a significant decrease in funding of $388.4 million (−21%) compared with the FY2018 estimated level of $1.83 billion. The largest portion of funding in this category falls under FEMA, totaling $1.26 billion proposed for FY2019. This FEMA budget is a reduction of $415.9 million from FY2018, coming largely from cuts to preparedness grant programs. These proposed grant program cuts include a $114.4 million reduction to the State Homeland Security Grant Program, a $152.1 million reduction to the Urban Area Security Initiative (UASI), and $62.9 million in reductions to both the Public Transportation Security Assistance and Port Security Grant Programs. 22
New in FY2019, the Countering Weapons of Mass Destruction (CWMD) Office would be funded in this category for a total of $103.6 million. The CWMD Office would take on programs like Strategic Planning & Analysis, Readiness Program, Test and Evaluation, Acquisition, Medical Support, and Radiological/Nuclear and Chemical Detection Support, which were previously administered in some form by other offices and directorates in DHS. 22 In FY2019, all responsibilities of the Office of Health Affairs (OHA) would be discontinued. Some programs from OHA have been transferred to CWMD, but budget documents do not clearly indicate which programs will continue under the new office and in what form.
In the Science and Technology Directorate, the Integrated Terrorism Risk Assessment (ITRA) program, Integrated Consortium of Laboratory Networks, and Standards Thrust would be discontinued. Some of this work may continue in CWMD, but the budget is not clear on what will happen to these programs. Finally, the Container Security Initiative in Customs and Border Protection would receive a 14% increase in funding to $71.6 million in FY2018. 22
Department of Defense
Multiple-hazard and preparedness programs in DoD include those that support WMD and CBRN threat prevention, preparedness, and response. The FY2019 DoD budget for this section totals $701.8 million, which would be an increase in funding of $75.6 million or 12%.
The Army National Guard CBRNE Enterprise, which includes WMD civil support teams that support first responders with identification, assessment, and advice in the event of a domestic CBRNE incident, and CBRNE capabilities to support the teams, would receive a combined $173.9 million under the proposed FY2019 budget. 35
DTRA's multiple-hazard and preparedness programs include the Cooperative Threat Reduction (CTR) Program, which works to reduce WMD proliferation from the former Soviet Union and other regions; 18 international nonproliferation programs; and WMD-focused research and development. 25 In total, these programs would receive $255.3 million in the proposed FY2019 budget, a decrease of $10.7 million (−4%), mainly due to a lower amount for the CTR Proliferation Prevention Program. DARPA's multi-hazard programs, which focus on development of medical countermeasures and detection technologies for CBRN threats, would receive $63.7 million, a 160% increase from FY2018 amounts. This increase would be due to additional funding proposed for the Defense Against Mass Terror Threats program, which has a chemical/biological/radiological focus, and additional funding for development of Persistent Terrestrial Living Sensors and Transient CBRN Threat Defense. 19 Multiple-hazard research in CBDP would receive an increase of $45.7 million, for a total of $208.9 million in the proposed FY2019 budget. 20
Department of State
Proposed funding for multiple-hazard and preparedness programs in the Department of State would be reduced by $6.7 million in FY2019, for a total of $184.5 million. The Office of Chemical and Biological Weapons Affairs in Arms Control, Verification, and Compliance would receive relatively steady funding ($1.9 million) in FY2019, and the International Security and Nonproliferation office (ISN) would be slightly reduced by $2 million, for a total of $42.2 million. 26 In State's Nonproliferation, Anti-Terrorism, Demining and Related Programs (NADRP), the Nonproliferation and Disarmament Fund and the Export Control and Related Border Security Assistance program would remain steady at $5 million and $59.7 million, respectively. The Global Threat Reduction program under NADRP would receive a slight increase of $1.9 million in FY2019. Finally, the Operational Medicine Program, which sends medical teams to respond to emergencies, would get an estimated funding cut of 42% from $15 million to $8.7 million. 36
Environmental Protection Agency
The FY2019 EPA budget for multiple-hazard and preparedness programs totals $265.7 million for FY2019, a slight decrease of $4 million from the FY2018 estimated level. Programs include Communications and Information; Critical Infrastructure Protection; Preparedness, Response, and Recovery; and Protection of EPA Personnel and Infrastructure. In addition, the Superfund program includes programs for Emergency Response and Removal of contaminated materials and Emergency Preparedness programs. These programs all play a role in EPA's CBR preparedness and response to environmental contamination emergencies with impacts on human health. 28
Department of Justice (DoJ)
This multiple-hazard and preparedness analysis includes the National Security Division of the Department of Justice. Under the proposed FY2019 budget, funding for this program would receive a small increase of $6.1 million, for a total of $101.4 million. 37
Department of Commerce (DoC)
Multiple-hazard and preparedness programs in the Department of Commerce are located in the Bureau of Industry and Security (BIS) Export Administration. Proposed funding for these programs in FY2019 would total $65.1 million, an increase of $6.6 million (11%) above FY2018. 38
US Department of Agriculture (USDA)
Funding for USDA programs related to multiple hazards and preparedness would remain steady at $75.0 million in FY2019. USDA programs include the Food Safety and Inspection Service's (FSIS) Public Health Data Communication Infrastructure System and the Animal and Plant Health Inspection Service (APHIS) program for emergency management. 39
Department of Veterans Affairs (VA)
The Emerging Pathogens/Bioterrorism program in the VA would receive $0.7 million in the proposed FY2019 budget, representing flat funding from FY2018. 40
Conclusions
Federal health security programs dedicated to civilian biological, radiological and nuclear, and chemical defense; pandemic influenza and emerging infectious diseases; and multiple-hazards and general preparedness are budgeted to receive $13.6 billion in funding for FY2019. This proposed funding level represents a reduction to health security programs of $636.1 million (−4%) when compared to FY2018, and a reduction of 3% compared to the FY2017 actual funding level. Most federal health security funding in FY2019 (56%, or $7.62 billion) would be directed toward multiple-hazard and preparedness programs that protect the country from a variety of threats to health. Yet, this funding category would also receive the largest funding cut ($537.4 billion, or −7%) in FY2019. Radiological/nuclear security programs would receive about 18% ($2.38 billion) of the federal health security budget in FY2019, a decrease in funding of 6% or $157.3 million. Biosecurity programs would receive around 12% ($1.61 billion) of the overall health security budget in FY2019, again a decrease in funding of 3% or $49.8 million from FY2019. Programs dedicated to chemical incident prevention, preparedness, and response would receive 3% ($396.1 million) of the health security budget, a decrease in funding of $6.4 million (−2%) from FY2018. Finally, the only category to receive a funding increase in FY2019 would be pandemic influenza and emerging infectious disease programs, which contribute about 11% ($1.59 billion) to the health security budget, an increase of $114.8 million (8%) above FY2018.
References
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