“There are a number of infectious disease testing programs for which our sole source of funding is a CDC cooperative agreement,” said Rich Harris, manager of the Wyoming Public Health Laboratory. “So to have an advocate in Washington who is able to skillfully address these issues is absolutely critical to sustaining a number of public health diagnostic programs.”
For example, well before Andrew Speaker’s intercontinental air travels dramatized the danger of drug-resistant tuberculosis (TB), APHL was working behind the scenes to bring the issue to the attention of the US Congress.
In 2007 APHL members and key staff members were familiar with the myriad facets of the TB threat and with the most promising and prudent strategies to stop a TB resurgence, thanks to the work of a member task force. As with many public health problems, the single, major obstacle constraining the implementation of expert recommendations was limited federal funding—in this case, stagnant funding that represented a decline in real dollars for TB control.
In typical fashion, APHL’s advocacy work involved members, association policy staff and targeted partners with a stake in the issue; in this case the National TB Controllers Association, the American Thoracic Society, the World Health Organization and a private vaccine developer.
APHL’s public policy director, Peter Kyriacopoulos, describes the effort as a “constant process of building connections and furnishing information to parties that could make a difference on the Hill.” Said Kyriacopoulos, “It was a very dynamic process with me getting word that partners had scheduled appointments with legislative staff and then having (APHL) members, in very short order, send detailed information that we could use to communicate the importance of TB diagnosis by grounding it in what happens in legislators’ home states.”
Wyoming’s Harris—a constituent of Michael Enzi (R-WY), the ranking member of the Senate Committee on Health, Education, Labor and Pensions—contributed to the process. Harris, said Kyriacopoulos, “expeditiously forwarded information to me for my visit with Enzi’s staff to establish APHL’s expertise in the area of TB testing and to help us explain the benefits Wyoming would realize if a proposed TB bill became law.”
Advocacy for TB funding is ongoing, but now centers on four bills pending in the U.S. Congress for domestic (H.R. 1532 and S. 1551) and global (H.R. 1567 and S. 968) TB control. Three of the bills were introduced in March 2007, roughly two months before Andrew Speaker made the news.