Amid the mounting toll of budget cuts across the country, a new study from the National Coalition of STD Directors (NCSD) shows just how much an impact the economic crisis is having on sexually transmitted disease (STD) programs and in turn, having more broadly on public health infrastructure.
"These cuts threaten our national ability to control both STDs and our entire public health infrastructure," said Dr. William Wong, lead author of the study, NCSD Board member, and STD Program Director for the Chicago Department of Public Health.
The new study is based on a recent survey of states, large U.S. cities, and U.S. territories and documents the struggle of health departments across the nation to sustain the severe cuts in state and local funding enacted over the past few years. These cuts, coupled with the long-term effects of flat or declining federal resources, have severely hampered the ability of STD programs to maintain an adequate workforce and to keep pace with the increasing demand for STD testing and treatment services and the rising rates of STDs.
The majority of STD programs surveyed (69%) experienced funding cuts between 2008 and 2009 and such cuts are taking a toll. For example, the study shows that between 2008 and 2009, thirty-nine clinics supported by state and local STD programs closed their doors due to inadequate funding. And STD programs are not alone. A recent survey of state HIV programs, conducted by the National Alliance of State and Territorial AIDS Directors (NASTAD), found that in Fiscal Year 2009, 74% of sister HIV programs experienced cuts to prevention activities as a result of state funding cuts.
The NCSD study also documents that over the past decade, demands on STD programs have increased while programs' capacity to provide essential services such as STD screening, treatment, and partner services have diminished, leaving the most vulnerable populations and communities at-risk for the consequences of untreated STDs and HIV.
In one specific case, the number of Disease Intervention Specialists, the frontline public health workers comprising nearly half of the STD program workforce in health departments, declined nationwide by 20% over the last decade. Such reductions in workforce capacity have been widespread in health departments across the nation. In addition, 69% of STD programs nationwide that receive funding from state and local governments have experienced salary freezes or reductions and 27% have experienced layoffs.
"These workers are the real soldiers in our fight against STDs, flu outbreaks, tuberculosis, and other communicable diseases," said Wong. "We can't afford any more troop cutbacks," he added.
Diminished capacity and resources for core STD work have occurred at the same time that STD programs have been playing a key role in the nation's public health readiness; more than two-thirds of STD programs directly participated in H1N1 influenza outbreak activities in Spring 2009, and almost three-quarters of STD programs anticipate participation in H1N1 response during the 2009-10 influenza season.