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CDC Grants Could Indicate Shift Toward More Federal Funds for Public Health Lab Construction

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NEW YORK – Recent funding from the US Centers for Disease Control and Prevention for construction of public health laboratories could indicate a new willingness to provide money at the federal level for such projects.

The CDC announced last month that it has provided $175 million to seven states and localities to either build, expand, or renovate public health laboratory space, marking the first time the agency has provided significant funding for this purpose, said Scott Becker, CEO of the Association of Public Health Laboratories.

"This is really the first time that CDC has been able to authorize funds for construction [of public health lab facilities] versus minor renovation," Becker said, noting that prior to the COVID-19 pandemic, "there has never been congressional appetite for something like this."

While the National Institutes of Health provides some public health construction grants, the bulk of such funding has traditionally come from the states, Becker said. The recent CDC funds are targeted particularly toward construction of facilities for genomic sequencing, he added.

The seven states or localities receiving CDC funding were California ($18.6 million), Georgia ($28.1 million), Houston ($8.7 million), Los Angeles County ($33.0 million), North Carolina ($3.4 million), Rhode Island ($81.7 million), and Texas ($1.5 million).

Becker said that because the CDC funding is being provided through the AMD Sequencing & Analytics COVID Award, which has a budget period ending July 31, 2024, the money went only to projects that could be finished by that time, which meant that it went by and large to states and localities with projects already being planned or underway.

"You would need to have done program planning, architecture, all of that stuff would have to have been in the works," he said.

Becker said that because of the large costs involved, funding for construction of new lab facilities was more challenging to come by than many other parts of lab infrastructure.

"It's a large amount of money, so states have to figure out how they are going to finance such a thing," he said. "Is there political will for a major infrastructure spend in the state? It has taken as long as 10 years from the pointing out that you need a new lab to getting a [funding] bill passed by a state legislature. These things take a very long time. You need the state legislature behind it. You need the governor's office behind it. And you need someone pushing from the state health official level. All of those things have to line up."

Rhode Island, which received the largest individual grant from the CDC funds, had been "searching for funding" for a new public health facility for several years, said Ewa King, associate director of health at the Rhode Island Department of Health.

She said that while funding for equipment and instrumentation is not typically an issue for the DOH, a lack of space in the state's existing lab facility has significantly limited the number of SARS-CoV-2 specimens it is able to test in-house.

"That has been a continuing concern, that lack of space and that our facility in general is very outdated," she said, noting that limitations in the building's electrical and ventilation systems have limited the number and kinds of instruments it has been able to install.

King said the state was in the process of applying for other federal COVID-19 response funds to support construction of a new laboratory, but that the dedicated funding from the CDC would let it speed up the process. She added that the plan for the facility included both space for new public health laboratories and commercial laboratory space that would be leased out to life science and medical startups in hopes of catalyzing something of a biotech cluster.

In addition to the CDC funds, the Build Back Better bill currently in Congress has money for public health infrastructure, Becker noted. As it stands, the text of the bill, which the House passed in November, would provide $7 billion through the CDC for public health lab infrastructure.

Becker said that if the bill were to pass with that funding intact, it would help public health labs move more into areas like sequencing that have become especially relevant during the COVID-19 pandemic.

"Ten years ago, sequencing was not a core function of public health labs," he said, "so it's not a great surprise that we weren't investing much in things like sequencing." He noted that while the CDC six years ago started its Advanced Molecular Detection program to boost the use of sequencing in public health labs, it was funding at a rate of just $30 million per year, which was meant to cover both the needs of CDC itself and the rest of the country's public health labs.

The COVID-19 pandemic, however, demonstrated the need for public health labs "to be on the cutting edge of laboratory science," Becker said, suggesting that this could improve the funding environment for these labs both at the state and federal levels.

"What the pandemic has done is really just brought the inadequacies [of public health lab infrastructure] to light," he said.

"Certainly, I feel the pandemic response has brought some light to the plight of many public health laboratories and the importance of public health laboratories," King said. "When people get tested frequently, and when testing really matters, people start thinking about where this testing is taking place. So we are seeing in Rhode Island and in other states that there is more of an appreciation of the need for these facilities."

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