​​​​​​​​​The Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement (ELC) provides crosscutting and disease-specific funding support for public health laboratories through the CDC. The crosscutting portion of ELC funding is part of the Prevention and Public Health Fund (PPHF), a mandatory expenditure under the Affordable Care Act (ACA). Disease-specific funding is appropriated annually by Congress.

The ELC program was established in 1995 with $2 million serving eight grantees. In 2010 the program significantly expanded when it began receiving a $40 million annual infusion from the PPHF, the first and only mandatory public health funding program in the United States. This broadened the ELC’s scope and increased the number of public health laboratories able to receive funding for capacity-building. Currently all 50 state health departments, six of the nation’s largest local health departments (Chicago, the District of Columbia, Houston, Los Angeles County, New York City and Philadelphia), and eight territories or US affiliates, including the US Virgin Islands, Puerto Rico and Guam, receive some sort of ELC funding.

ELC: Building Crosscutting and Disease-specific Lab Capacity

Crosscutting Funding

ELC crosscutting funding supports activities that strengthen epidemiology capacity, laboratory capacity and health information systems for rapid disease detection and outbreak response. It funds critical services throughout the lab: scientists who can work across various areas of a laboratory; staff liaisons between laboratory and epidemiology programs; laboratory equipment and maintenance contracts; courier services to safely transport potentially hazardous specimens or materials for testing; and electronic lab reporting systems. Crosscutting funding is a mandatory expenditure of the PPHF, part of the ACA.

Disease-Specific Funding

ELC disease-specific funding supports rapid surveillance, detection and response for threats such as foodborne diseases, seasonal influenza, vector-borne diseases, antimicrobial resistant infections, and vaccine preventable diseases. Additionally, this source provides emergency funding for emerging infectious diseases such as Zika and Ebola, allowing the response to be scaled-up based on need. Disease-specific funding is appropriated annually as needed by Congress.

Crosscutting Funding Ensures Lab Readiness

As people become more mobile, emerging infectious diseases have the potential to quickly escalate from isolated incidents to major epidemics. Public health laboratories must have the capacity to protect the public with diligent monitoring and rapid responses to small outbreaks. Yet they cannot perform these functions without specialized equipment, testing materials, logistical support and trained staff.

One way crosscutting ELC funding plays a critical role is as a stop-gap measure between the beginning of an outbreak and Congressional appropriation of disease-specific funding. For example, during the emergence of the Zika virus outbreak in 2016, crosscutting ELC funds allowed state and local laboratories to initiate surge testing long before Zika-specific funding was appropriated. Labs needed proper equipment, scientists with the expertise to operate the equipment, systems for receiving samples and communicating results, and more. Without this crosscutting funding, the response to Zika would have been delayed by months.

Learn More About the ELC Program

APHL Resources 

ELC Factsheet
Overview of the ELC program and APHL's budget and policy recommendations

APHL's Lab Culture Podcast

  • Ep. 1: Critical Consequences
    Explore the public health impact of repealing the Affordable Care Act, including the ELC program
  • Ep. 2: Hill Day 2017
    Members who participated in our annual Hill Day talk about their meetings on Capitol Hill and their priorities for the FY2017 budget

ELC in the News

The Tiny Trump Budget Cut That Could Blind America to the Next Zika
By Ed Yong  | The Atlantic  |  March 18, 2017

Critical Public Health Fund Would Be Lost With ACA Repeal 
By Scott Becker, MS  | Boston University's Public Health Post  |  February 17, 2017

Related Advocacy Efforts 

Protect the ACA and PPHF 
Letter to Congressional Leadership from 14 public health associations

Protect Nondefense Funding
Letter to Congress from over 2,000 public health organizations