Bioterrorism funds can't mitigate states' deep budget cuts. (Public Health Funding Still Down Overall).

PHILADELPHIA -- Stepped-up federal funding for bioterrorism preparedness has yielded some beneficial effects at the state level, notably by helping health officials temper the impact of budget cuts, two state health officials said at the annual meeting of the American Public Health Association.

The new focus on bioterrorism comes at a time when state health budgets have been reduced in every state in the nation, said Dr. Georges C. Benjamin, then secretary of the Maryland Department of Health and Mental Hygiene.

"Overall, we are losing money in the public health budgets in the fifty states, despite the funds for terrorism preparedness," said Dr. Benjamin, who recently resigned his post in Maryland to become the new executive director of the APHA.

The widely publicized flow of dollars into bioterrorism preparedness has obscured the larger reality of budget cuts, he observed.

"With regard to bioterrorism and our national public health response, there is an impression that we are building a house on a solid foundation. However, the foundation is being pulled out from under the house," Dr. Benjamin said.

He cited Maryland as an example of the trade-offs that states face. "We have received and spent money to increase our epidemiology capacity and thus to identify and track diseases. However, at the same time, we had to freeze new hires and essentially cut our budget for food safety, which includes some of the same type of workers.

Cutbacks in food safety--often an early casualty of health budget reductions--may inadvertently weaken the ability of states and municipalities to deal with bioterrorism. "Other than the anthrax incidents, the only other previous terrorist [biologic] attack in recent U.S. history is the case of deliberate salmonella poisoning in salad bars in Oregon," Dr. Benjamin said.