"Public Health Is Purchasable".

Abstract

A s I write these words in the early weeks of summer, the Ebola fever panic of 2014 has long since receded into our collective rearview mirror and the number of Zika virus cases, along with the discovery of more and more babies with Zika-induced microcephaly, is steadily increasing. By the time you read this column, swarms of Aedes aegypti and Aedes albopictus mosquitoes carrying the virus will have likely traveled from South America to points north, east, and west, accompanied by the predictable media hoopla that characterizes every American epidemic. Sadly, the interregna between the many contagious crises of the still young 21st century have been characterized by a global amnesia. As the “epi curve” of each scourge descends, public health officials, elected leaders, and the population at large turn their attention to other issues at the expense of planning for the next newly emerging infectious disease. And just as predictably, the appearance of each new pandemic or epidemic inspires a situation in which our public health officials must waste valuable time and energy securing adequate government funding to fight and contain the new threat. Ironically, in 1983, the US Congress established a public health emergency fund, much like the one for the Federal Emergency Management Agency (FEMA) uses to rapidly respond to natural disasters. Yet the balance of that federal public health emergency fund, as of June 2, 2016, was a mere $57,000! This sorry situation serves to remind us of, perhaps, the savviest paragraph on public health ever composed; it is one I will quote in 2 parts as this essay progresses. Let’s begin with the opening lines of what ought to be memorized as public health gospel: