In the U.S., there has been a significant decrease in money allocated for public health initiatives and healthcare delivery, and an increase in budget allocations for scientific research. More specifically, the Centers for Disease Control and Prevention (CDC), which has historically received funding for protection against infectious diseases and for prevention of chronic disease, has seen an approximately 1.2 billion dollar decrease in funding since 2017, whereas the Food and Drug Administration (FDA) saw a 454 million dollar increase in funding, which is approximately the amount of their total budget that is spent on medical product innovation initiatives.5
The allocation of government financing for public health, healthcare delivery, and health-related scientific research is heavily influenced by U.S. politics and who is resident in the oval office, as the majority of public health funding is considered discretionary, making the amount of public health funding wax and wane with the political agendas of the federal administration. Since President Trump was elected, government financing for HRSA, CDC, SAMHSA, and CMS has decreased while FDA and NIH budgets have increased.5 A table depicting the amount in budgetary changes for each agency since Trump’s election is shown below, in billions.
Agency 2017 2019 2017-2019 (+/-)
HRSA 10,458 9,604 -854
CDC 12,100 10,921 -1,179
SAMHSA 4,258 3,548 -710
CMS 6,027 5,729 -298
FDA 2,800 3,254 +454
NIH 34,229 34,767 +538
Source: Enard KR. HMP-5720-04 Government Financing of Health Care: Military Health System, Veterans Health System, Public Health. February 2019.
The Trump administration has been very clear about its intentions for the FDA and has aggressively pressed for a more streamlined process for drug approvals in order to significantly increase the number of generic drug approvals as part of the American Patients First blueprint.6 This blueprint is intended to lower drug prices and reduce out-of-pocket costs for individuals and Medicare Part D beneficiaries and will ultimately have a major impact on the economy and the pharmaceutical industry.7 Overall, the Trump administration is heavily influencing the financing for drug research and approvals through its policies and budget allocations to the FDA.
Most importantly, the CDC has seen a 1.2 billion dollar decrease in funding since Trump’s election, aligning with his administration’s view on the importance of public health.5 This decrease in funding negatively impacted the CDC’s initiatives related to immunizations, emerging and zoonotic infectious diseases, chronic disease prevention and health promotion, birth defects and other disabilities,