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America Has Conquered Plagues Before. We Can Do It Again.


Crucial programs — including ones that provide vaccinations, test for sexually transmitted infections and monitor local food and water supplies — have been trimmed or eliminated. As a result, several old public health foes have returned: Measles and syphilis are both resurgent, as is nicotine consumption among teenagers and the contamination of food and water with bacteria and lead.

Each of these crises has received its own flurry of outrage, but none of them have been enough to break what experts say is the nation’s default public health strategy: neglect, panic, repeat.

“We ignore the public health sector unless there’s a major catastrophe,” said Scott Becker, the head of the Association for Public Health Laboratories. “Then we throw a pile of money at the problem. Then we rescind that money as soon as the crisis abates.”

There is a better way.

Imagine a public health system in which all public health entities used the same cutting edge technology in their laboratories and on their computers. This would include equipment that enables rapid diagnostic tests to be developed and deployed quickly in a crisis; web portals where data on disease spread, hospital capacity and high-risk communities can be logged and shared across the country; and user-friendly apps that enable private citizens to facilitate the efforts of epidemiologists.

The technology to create such a system already exists — it only has to be adapted and implemented.

That, of course, requires investment. In 2019, a consortium of public health organizations lobbied the federal government for $1 billion to help the nation’s public health system modernize its data infrastructure. They were granted $50 million. In the wake of Covid-19, that sum has been increased to $500 million. But much more is needed. There is a $5.4 billion gap between current public health spending and the cost of modernizing public health infrastructure, according to the Trust for America’s Health report.

However much money is ultimately allotted for this work, it will have to be deployed equitably, in high-income and low-income communities alike. Health departments everywhere are struggling to contain the Covid-19 pandemic, but that struggle is particularly acute in marginalized communities, where health is already fragile, public health departments are sometimes nonexistent and mistrust of officials tends to run high.

Early data from several states indicates that Hispanics and African-Americans already account for a disproportionately high number of coronavirus-related deaths, a finding that is both unsurprising and unacceptable. A better system would direct federal aid to where it’s needed most — and would work to eradicate legacies of injustice and abuse that mar the history of public health victories.



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