July 8, 2002 

The Honorable George W. Bush 
1600 Pennsylvania Avenue, NW 
Washington, DC  20500 

Dear President Bush: 

As leaders in the public health community, we are writing to express our concern over your proposal to move vital public health functions to the proposed Department of Homeland Security away from the Department of Health and Human Services.  We are most concerned about the proposal to move portions of the nation’s premier public health agency, the Centers for Disease Control and Prevention (CDC) to the proposed Department of Homeland Security. 

We applaud your ongoing efforts to secure America’s homeland defense and your recognition of the pivotal role our public health system plays in these efforts. However, we believe transferring the control of certain public health preparedness activities will diminish the very dual-purpose system we now need to strengthen. 

Investing in the fundamentals of America’s public health system will help protect our communities from potential acts of biological and chemical terrorism, as well as the serious ongoing threats posed by infectious and chronic diseases. From communications networks, to disease surveillance, trained personnel and laboratory capacity, as well as many other functions, public health fundamentals must be refortified in a way that will address the full range of health threats facing our nation. 

As the General Accounting Office’s Janet Heinrich explained in testimony on June 25, 2002 before the U.S. House Committee on Energy and Commerce’s Subcommittee on Oversight and Investigations, “…when an unusual case of disease occurs public health officials must investigate to determine whether it is naturally occurring or intentionally caused. Although the origin of disease may not be clear at the outset, the same public health resources are needed to investigate, regardless of the source.” 

We are also concerned that shifting public health responsibilities to a new department will   reduce the efficiency and responsiveness of public health agencies at the federal, state and local levels.  Congress has passed two landmark bills concerning public health preparedness, the Public Health Threats and Emergencies Act of 2000 (PL-106-505) and the Public Health Security and Bioterrorism Response Act of 2002 (PL-107-288).  These laws are based on the recognition that the preparations required to respond to bioterrorism and naturally occurring public health threats are indistinguishable. Both require the same strong public health infrastructure. Separating bioterrorism preparedness from the rest of the nation’s public health infrastructure is likely to undermine the purpose and vision of these laws and would reverse the most important steps the nation has taken in decades to achieve broad-based public health preparedness. 

In addition to threatening the dual-use system, the proposed Department of Homeland Security could compromise current public health work by shifting public health priorities away from essential day-to-day activities required to protect and improve the public’s health. Seven out of 10 of Americans die from chronic illnesses. Prevention efforts such as public education campaigns for improved diet and exercise regimens, immunizations for preventable childhood and adult diseases, and screening programs to detect diseases early could be reduced because of competing priorities established by the new Department, where the full range of public health activities will be less well understood. 

We would be happy to discuss this issue with you and provide you with further information on how best to improve our public health protections without sacrificing needed public health activities that research has proven to be effective. Thank you for your attention to improving America’s public health preparedness.  We hope that by opening a dialogue on this important issue, we can work together to make America a safe and healthy place. 

Sincerely, 

AIDS Foundation of Chicago 
Alliance To End Childhood Lead Poisoning 
American Association for Health Education 
American Association on Mental Retardation 
American Nurses Association 
American Psychological Association 
American Public Health Association 
American Social Health Association 
Asian and Pacific Islander American Health Forum 
Association of Academic Health Centers 
Association of Clinicians for the Underserved 
Association of Departments of Family Medicine
Association of Family Practice Residency Directors 
Association of Maternal and Child Health Programs 
Association of Public Health Laboratories 
Association of Schools of Public Health 
Association of Teachers of Preventive Medicine 
Association of Women's Health, Obstetric and Neonatal Nurses
National Alliance of State and Territorial AIDS Directors 
National Association of County and City Health Officials 
National Association of Local Boards of Health 
National Association of People with AIDS 
National Coalition of STD Directors 
North American Primary Care Research Group 
Oncology Nursing Society 
Physicians for Social Responsibility 
Society for Public Health Education 
Society of Teachers of Family Medicine 
Spina Bifida Association of America 
Trust for America’s Health 

CC: 
United States House of Representatives             
United States Senate Secretary Tommy Thompson             
Homeland Security Director Tom Ridge             
CDC Director Dr. Julie Gerberding

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