Centers for Disease Control and Prevention

May 20, 2004

Julie L. Gerberding, MD, MPH

Director

Centers for Disease Control and Prevention

1600 Clifton Road, NE, Mail Stop D-14

Atlanta, Georgia 30333

Dear Dr. Gerberding,

On behalf of the state of ______, I am writing to express my deep concern over the recent decision by CDC to cut approximately $2 million from the Division of Viral Hepatitis’ (DVH) FY2004 budget and, as a result, to eliminate the Viral Hepatitis Integration and Intervention Project (VHIIP) program. A cut of this magnitude to a Division with an annual budget of approximately $25 million is substantial, and its impact will be felt in our state.

We have worked hard over the past several years to develop a strong viral hepatitis program with limited resources, relying on partnerships with multiple public health agencies and community organizations. Together, we have begun to build the capacity and infrastructure needed to effectively address these diseases in our communities. We feel that the decision by CDC to pull back on funding dedicated to state and local public health programs is both short-sighted and untimely. We have generated considerable interest and momentum around viral hepatitis in our state; scaling back funding now sends the wrong message to our communities about public health’s commitment to addressing these important diseases.

We value CDC’s and the National Center for Infectious Diseases’ (NCID) national and international leadership in addressing both emerging and existing infectious diseases through surveillance, epidemiologic research and disease investigation. We feel that NCID and DVH are well placed to provide similar leadership to the development of strong viral hepatitis prevention programs in the United States. Hepatitis A, B and C impact millions of Americans, yet there remains to be a federal grant program which provides consistent, sustainable funding to state and local public health agencies to support prevention, surveillance, detection and care. Without greater leadership and resources from CDC, we fear that the local public health response will continue to consist of a patchwork of services that are unable to address the growing need.

We urge you to reconsider this funding decision and to dedicate greater resources within CDC to combat these diseases.

We remain committed to working with CDC to mount an effective public health response to viral hepatitis. We appreciate your attention to this matter and welcome opportunities to work with you on this issue.

Sincerely,

CC: James M. Hughes, MD, MPH, Director, National Center for Infectious

Diseases

Harold Margolis, MD, Director, Division of Viral Hepatitis