🧵What @DrArwady says here needs to be shouted from the rooftops. A huge challenge local #PublicHealth departments have is they have virtually no flexibility in how they spend money they receive from the federal government (i.e., most of their funding). chicagotribune.com/news/breaking/…
Local health departments receive precious little sustained, year-over-year funding, and only periodically receive large, temporary funding for emergency situations like COVID. (By the way, they've received NOTHING yet to fight monkeypox.)
And even those emergency funds are broken down into smaller piles that must be spent in certain ways. This means that if you have leftover $ from COVID response, you can't spend it on monkeypox. Even $ you didn't spend on one aspect of COVID cannot be spent on another aspect.
And when the emergency is over, the $ disappears. While public health is supposed to be about prevention of all sorts of chronic, environmental, behavioral, and infectious conditions (most of which don't go away), as a country we forget about public health until the next crisis.
Dr. Arwady describes a much better approach: fund public health more consistently at a level where we can always be prepared for both the daily and emergency needs. Provide flexibility so the $ can be spent where the need is.
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