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Did Trump downsize two years ago, if not partially dismantle, the department that handles epidemics and other public health emergencies?

As with all things concerning government budget and employment, this isn’t a straightforward question to answer.First, let’s just go right into the money[1][1][1][1] [2][2][2][2] [3][3][3][3] [4][4][4][4] [5][5][5][5] [6][6][6][6] [7][7][7][7] [8][8][8][8] [9][9][9][9] (note: the government’s budget calendar, ie, the “Fiscal Year,” goes from October 1 to September 30, and is named for the year in which it ends):What you see is that, with the exception of FY14, Congress has usually topped up the CDC over the President’s Budget Request[10][10][10][10] [11][11][11][11] ; and with the exception of FY18, in recent years, Congress has resisted cutting the CDC’s budget at all.FY15 was the year of the Ebola outbreak, and so you might be really curious (as I was) why there was such a deep cut requested that year and a pretty tame budget increase given the outbreak. As it happens, what happened that year has follow-on effects to the present controversy.The requested cuts to CDC’s budget authority that year reflected the Obama Administration’s expectations that health reform would eliminate the need for certain immunization, chronic disease prevention, and health promotion programs.Congress responded with, “lol, don’t be stupid,” and topped up the CDC from the previous fiscal year.And then the Ebola outbreak happened, and both the Administration and Congress recognized that the CDC was not going to be able to respond with the available resources. In December 2014, it passed a supplemental appropriation “to remain available until September 30, 2019,[12][12][12][12] “to combat Ebola and promote global health security generally.”Now, hold that thought, and follow me to the next charts:While the Obama Administration proposed cuts in CDC’s budget authority elsewhere, FY15 was the first budget year to reflect its commitment to support the international Global Health Security Agenda (GHSA)[13][13][13][13] , and accordingly proposed a significant increase in the CDC’s (and other agencies’[14][14][14][14] ) global health programs.Congress initially said, “lol, no,” and, as can be observed, even made a cut below the prior year’s enacted level.This brings us back to the supplemental, emergency appropriation and requests under the Trump Administration.Back in FY15, the CDC was given a total of $1.7 billion in supplemental appropriations to combat Ebola, $597 million of which was specifically earmarked “to support national public health institutes and global health security” - which, if you follow the report in Footnote 13, became the CDC’s authority to support the GHSA (Footnote 39 of the report - yes, I have now reached peak footnoting). As noted, that money was due to expire in FY19.As observed, President Trump’s first budget (FY18) - which triggered the current political footballing - proposed a deep cut to global health programs[15][15][15][15] , to which Congress said, “lol, no,” and even topped it up over the previous year. This brings us to FY19.With the GHSA money due to expire, the CDC tried to do what any agency would do after having baked a long-term supplemental appropriation into its operations: keep it.CDC’s FY 2019 request for Global Disease Detection and Other Programs of $108,762,000 includes an increase of $50,957,236 above the FY 2018 Annualized CR level to protect Americans by upgrading public health capacity in countries at risk for uncontrolled outbreaks of infectious diseases. Supporting other nations' ability to identify and contain outbreaks at their source will save lives and money. Better protection from these threats, finding and stopping them at their borders, will protect the health of all Americans. This funding level maintains the level of activities proposed in the FY 2018 Budget, with $58,762,000 (requested with two-year availability) to support activities under the Global Health Security Agenda. These new resources will provide bridge funding for CDC to continue work towards the goals of GHSA. To date, CDC's GHSA activities have been supported by supplemental funding provided in FY 2015 that is set to expire at the end of FY 2019. This request will help transition funding for CDC's GHSA activities from supplemental to base appropriations. These funds will allow CDC to continue their commitments to GHSA as planned through the end of FY 2019, and the two-year availability of these resources means that they can be used into FY 2020.To which Congress said, “Hey, that’s a pretty good idea,” while also laughing off the proposed cuts to global HIV/AIDS prevention[16][16][16][16] and other immunization programs (which the Administration has since tried to cut every year); and that funding became a part of base appropriations.So while the Trump Administration succeeded in bringing GHSA money in permanently, thereby topping up the global health programs account, it has continued to request funding for Global Disease Detection and Emergency Response at levels below enactment, with Congress pushing back.Moreover, while GHSA does contribute to building other nations’ ability to detect diseases - thereby improving global surveillance overall - the surveillance stream is just one of several capability-building programs funded through GHSA. As such, the amount obligated doesn’t directly translate to a targeted disease detection and response program.Now, some of you might have noticed that the discussion about budgeting is a bit tangential to the thrust of the question: downsizing and/or dismantling, which tends to concern employment. Fortunately, I have a chart for that, too:It only goes to March 2019 because that’s the latest release of Fedscope’s data; however, the trends are clear. Employment picked up after FY15 and through to the early part of FY17 before declining. But what’s odd about the decline in employment is that the CDC’s budget authority has otherwise increased.Looking at the change in major occupations……while the bulk are down from their highs at the start of the Trump Administration, many are at or near-enough the levels that they were just prior to the transition; so there’s not as much evidence of “gutting” as much as, perhaps, attrition. However, regarding disease detection and responsiveness, the following causes some worry:And as much has been made of the reduction in overseas staff, while the total number of CDC staff assigned overseas has declined……it hasn’t been a massive “gutting.” However, looking at where the CDC’s presence remains……(#mapswithoutnz) and it becomes clear that the primary overseas mission of the CDC remains combating HIV/AIDS in subsaharan Africa rather than capacity building or disease detection broadly. There are more CDC personnel detailed to the WHO headquarters in Switzerland (13) than China (5) and India (6) combined.I think the short story here is that while the Trump Administration has repeatedly sought to make deep cuts to the CDC’s budget, to include its global health programs, Congress has not entertained them. However, Congress’ support for programs to build other nations’ disease surveillance, prevention and response capabilities has not directly translated to building the CDC’s own overseas capacity in that regard.Moreover, while the decline in the CDC’s workforce might very well be due to natural attrition, it then seems to be concerning that the workforce is either not being replaced much less being staffed to meet the increase in its budget authority - although any concerns about staffing or management within the agency don’t seem to be manifesting in overall job satisfaction[17][17][17][17] .Short answer: It’s a complicated picture arising out of the push-and-pull between the Administration and Congress.Footnotes[1] Budget | Funding | CDC[1] Budget | Funding | CDC[1] Budget | Funding | CDC[1] Budget | Funding | CDC[2] https://www.cdc.gov/budget/documents/fy2014/fy-2014-budget-request-summary.pdf[2] https://www.cdc.gov/budget/documents/fy2014/fy-2014-budget-request-summary.pdf[2] https://www.cdc.gov/budget/documents/fy2014/fy-2014-budget-request-summary.pdf[2] https://www.cdc.gov/budget/documents/fy2014/fy-2014-budget-request-summary.pdf[3] Page on cdc.gov[3] Page on cdc.gov[3] Page on cdc.gov[3] Page on cdc.gov[4] https://www.cdc.gov/budget/documents/fy2016/fy-2016-overview-and-detail-table.pdf[4] https://www.cdc.gov/budget/documents/fy2016/fy-2016-overview-and-detail-table.pdf[4] https://www.cdc.gov/budget/documents/fy2016/fy-2016-overview-and-detail-table.pdf[4] https://www.cdc.gov/budget/documents/fy2016/fy-2016-overview-and-detail-table.pdf[5] https://www.cdc.gov/budget/documents/fy2017/fy-2017-cdc-budget-overview.pdf[5] https://www.cdc.gov/budget/documents/fy2017/fy-2017-cdc-budget-overview.pdf[5] https://www.cdc.gov/budget/documents/fy2017/fy-2017-cdc-budget-overview.pdf[5] https://www.cdc.gov/budget/documents/fy2017/fy-2017-cdc-budget-overview.pdf[6] https://www.cdc.gov/budget/documents/fy2018/fy-2018-cdc-budget-overview.pdf[6] https://www.cdc.gov/budget/documents/fy2018/fy-2018-cdc-budget-overview.pdf[6] https://www.cdc.gov/budget/documents/fy2018/fy-2018-cdc-budget-overview.pdf[6] https://www.cdc.gov/budget/documents/fy2018/fy-2018-cdc-budget-overview.pdf[7] https://www.cdc.gov/budget/documents/fy2019/fy-2019-detail-table.pdf[7] https://www.cdc.gov/budget/documents/fy2019/fy-2019-detail-table.pdf[7] https://www.cdc.gov/budget/documents/fy2019/fy-2019-detail-table.pdf[7] https://www.cdc.gov/budget/documents/fy2019/fy-2019-detail-table.pdf[8] https://www.cdc.gov/budget/documents/fy2020/fy-2020-detail-table.pdf[8] https://www.cdc.gov/budget/documents/fy2020/fy-2020-detail-table.pdf[8] https://www.cdc.gov/budget/documents/fy2020/fy-2020-detail-table.pdf[8] https://www.cdc.gov/budget/documents/fy2020/fy-2020-detail-table.pdf[9] https://www.cdc.gov/budget/documents/fy2021/FY-2021-CDC-Budget-Detail.pdf[9] https://www.cdc.gov/budget/documents/fy2021/FY-2021-CDC-Budget-Detail.pdf[9] https://www.cdc.gov/budget/documents/fy2021/FY-2021-CDC-Budget-Detail.pdf[9] https://www.cdc.gov/budget/documents/fy2021/FY-2021-CDC-Budget-Detail.pdf[10] Did Trump try to cut the CDC's budget as Democrats claim?: ANALYSIS [10] Did Trump try to cut the CDC's budget as Democrats claim?: ANALYSIS [10] Did Trump try to cut the CDC's budget as Democrats claim?: ANALYSIS [10] Did Trump try to cut the CDC's budget as Democrats claim?: ANALYSIS [11] President’s budget would hinder US public health progress: Huge cuts proposed[11] President’s budget would hinder US public health progress: Huge cuts proposed[11] President’s budget would hinder US public health progress: Huge cuts proposed[11] President’s budget would hinder US public health progress: Huge cuts proposed[12] https://www.congress.gov/113/plaws/publ235/PLAW-113publ235.pdf[12] https://www.congress.gov/113/plaws/publ235/PLAW-113publ235.pdf[12] https://www.congress.gov/113/plaws/publ235/PLAW-113publ235.pdf[12] https://www.congress.gov/113/plaws/publ235/PLAW-113publ235.pdf[13] FACT SHEET: Global Health Security Agenda: Getting Ahead of the Curve on Epidemic Threats[13] FACT SHEET: Global Health Security Agenda: Getting Ahead of the Curve on Epidemic Threats[13] FACT SHEET: Global Health Security Agenda: Getting Ahead of the Curve on Epidemic Threats[13] FACT SHEET: Global Health Security Agenda: Getting Ahead of the Curve on Epidemic Threats[14] https://fas.org/sgp/crs/row/R43115.pdf[14] https://fas.org/sgp/crs/row/R43115.pdf[14] https://fas.org/sgp/crs/row/R43115.pdf[14] https://fas.org/sgp/crs/row/R43115.pdf[15] Trump Proposes Deep Cuts In Detecting Disease Outbreaks Worldwide[15] Trump Proposes Deep Cuts In Detecting Disease Outbreaks Worldwide[15] Trump Proposes Deep Cuts In Detecting Disease Outbreaks Worldwide[15] Trump Proposes Deep Cuts In Detecting Disease Outbreaks Worldwide[16] Impact of Federal HIV Budget Cuts - NMAC[16] Impact of Federal HIV Budget Cuts - NMAC[16] Impact of Federal HIV Budget Cuts - NMAC[16] Impact of Federal HIV Budget Cuts - NMAC[17] Best Places to Work in the Federal Government[17] Best Places to Work in the Federal Government[17] Best Places to Work in the Federal Government[17] Best Places to Work in the Federal Government

How would you feel about a law that requires people over the age of 80 to pass a specialized driving test in order to continue driving?

In the US, 33 states have “older driver” laws already.There’s no point in “feeling” anything about it. If you think you should not be tested again, move to a state that does not test. If you support testing, allow that eventually, you will also be tested.We should probably test everybody, more often, but we chose not to pay for that.| GHSA

What is the full form of GHSA?

THE acronym GHSA stands for Global Health Security Agenda. What is the purpose of its creation? The Global Health Security Agenda (GHSA) is a group of countries, international organisations, NGOs and private sector companies that have come together to advance a world safe and secure from infectious disease threats. Under the GHSA, nations from all over the world make new, concrete commitments to elevate global health security as a national leaders-level priority. GHSA membership provides support for implementation through advocacy, collaboration, information sharing and technical advice. GHSA hosts ministerial, senior officials and technical meetings to discuss current challenges and share information on progress towards greater global health security. So far, 65 countries have joined this movement with the sole objective of improving their capacity to detect, providing reports and responses on the threat of emerging infectious diseases in the wake of pandemic Covid-19GHSA Members contribute and benefit from the tools, lessons learned, networks, and other resources that this multi-stakeholder coalition brings together, as it works toward common goals.GHSA membership may include any country or non-governmental stakeholder that is willing to take action to support GHSA’s vision of a world safe and secure from global health threats posed by infectious diseases.There are more than thirty definitions of the acronym GHSA. Some of them are listed hereunder:-1) Georgia High School Association - The Georgia High School Association (GHSA) is an organization that governs athletics and activities for member high schools in Georgia, USA.2) Georgia Head Start Association3) Governors Highway Safety Associations4) Golden Heart Softball Association5) Grace Hopper STEM Academy6) Governors Highway Safety Association7) Graduate History Student AssociationSAVE THE EARTH - FLORA AND FAUNAWISHING YOU ALL THE BEST! LET’S JOIN TOGETHER IN ERADICATING THIS LETHAL PANDEMIC COVID-19!!

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