{"id":45988,"date":"2021-11-21T12:31:12","date_gmt":"2021-11-21T20:31:12","guid":{"rendered":"https:\/\/www.politicsplus.org\/blog\/?p=45988"},"modified":"2021-11-21T12:31:12","modified_gmt":"2021-11-21T20:31:12","slug":"everyday-erinyes-293","status":"publish","type":"post","link":"https:\/\/www.politicsplus.org\/blog\/2021\/11\/21\/everyday-erinyes-293\/","title":{"rendered":"Everyday Erinyes #293"},"content":{"rendered":"

Experts in autocracies have pointed out that it is, unfortunately, easy to slip into normalizing the tyrant, hence it is important to hang on to outrage. These incidents which seem to call for the efforts of the Greek Furies (Erinyes) to come and deal with them will, I hope, help with that. As a reminder, though no one really knows how many there were supposed to be, the three names we have are Alecto<\/span><\/strong>, Megaera<\/span><\/strong>, and Tisiphone<\/strong><\/span>. These roughly translate as “unceasing,” “grudging,” and “vengeful destruction.”<\/p>\n

So, this is what happens when people don’tpay attention toevery little detail. I was intrigued by the title (and certainly suspected something else.) It certainly never occurred to me that the answer would lie in obscure budget practices and requlations.<\/p>\n

I’m not allowed to republish phpts from ProPublica, and the ones I could find on Google were too gruesome to even consider … so no pictures.j
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One Major Reason the U.S. Hasn\u2019t Stopped Syphilis From Killing Babies<\/h1>\n

by Caroline Chen<\/p>\n

ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter<\/a> to receive stories like this one in your inbox<\/em>.<\/p>\n

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Series:
\nA Closer Look<\/h3>\n

Examining the News<\/p>\n<\/div>\n<\/div>\n

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In public health, a \u201csentinel event\u201d is a case of preventable harm so significant that it serves as a warning that the system is failing. The alarms are now blaring.<\/p>\n

A growing number of babies are being born with syphilis after their mothers contract the sexually transmitted disease and the bacteria crosses the placenta. These cases are 100% preventable: When mothers who have syphilis are treated with penicillin while pregnant, babies are often born without a trace of the disease. But when mothers go untreated, there is a 40% chance<\/a> their babies will be miscarried, be stillborn or die shortly after birth. Those who survive can be born with deformed bones or damaged brains, or can suffer from severe anemia, hearing loss or blindness.<\/p>\n

I\u2019ve spent the past few months<\/a> trying to understand why countries including Belarus, Cuba, Malaysia and Sri Lanka have managed to wipe out congenital syphilis while the United States faces its highest incidence in nearly three decades<\/a>: Last year, 2,022 cases were reported, including 139 deaths. That\u2019s a shocking reversal from 1999, when the Centers for Disease Control and Prevention declared that the United States was on the verge of eliminating<\/a> the centuries-old scourge for adults as well as babies.<\/p>\n

What went wrong here?<\/p>\n

My reporting led me to one major factor: the unusual and \u2014 according to various experts I spoke with, problematic \u2014 way that the CDC is funded, which has not only hampered the response to a rise in sexually transmitted diseases, but also has left us ill-prepared for the COVID-19 pandemic.<\/p>\n

State and local health departments get much of their money from the federal agency, which has the best birds-eye view of all of the bugs, viruses and illnesses circulating in America. But CDC scientists don\u2019t have the power to decide how much money to spend fighting each one.<\/p>\n

Instead, Congress dictates to the CDC, in an uncommonly specific manner not seen with many other agencies, exactly how much money, by line item, it can spend to combat any single public health threat, from broad categories like emerging infectious diseases and Alzheimer\u2019s disease, to more niche conditions like interstitial cystitis, neonatal abstinence syndrome and Tourette syndrome. Though prevention tactics for HIV and other STDs significantly overlap, HIV prevention has a separate line item and is allocated about six times as much money as the category for sexually transmitted infections.<\/p>\n

The decisions can be politically driven and detached from bigger-picture health needs, as lobbyists and patient advocates descend on Washington to make the case to lawmakers that their specific disease of interest should get a bigger piece of the pie. Causes that don\u2019t have large armies of compelling spokespeople can get ignored. Sexually transmitted diseases, which have an extra layer of stigma to contend with, have few dedicated advocacy groups. The small number of lobbyists focused on STDs sometimes can\u2019t even get a meeting with lawmakers.<\/p>\n

\u201cThe CDC needs to have more money and more flexible money,\u201d former CDC director Dr. Tom Frieden told me. The political nature of the agency\u2019s funding is part of what led the country to neglect virus surveillance before the coronavirus pandemic. The 2014 Ebola epidemic was supposed to be a \u201cglobal wakeup call<\/a>,\u201d yet in 2018, the CDC scaled back<\/a> its epidemic prevention work as money ran out.<\/p>\n

That means public health in the U.S. is constantly in what Frieden calls \u201ca deadly cycle of panic and neglect\u201d \u2014 scrambling to throw money at the latest emergency, then losing the attention and motivation to finish the task once fear ebbs. In May, President Joe Biden\u2019s administration announced<\/a> it would set aside $7.4 billion over the next five years to hire and train public health workers. But some officials worry about what will happen when those five years are up. \u201cWe\u2019ve seen this movie before, right?\u201d Frieden said. \u201cEveryone gets concerned when there\u2019s an outbreak, and when that outbreak stops, the headlines stop, and an economic downturn happens, the budget gets cut.\u201d<\/p>\n

Jo Valentine, former program coordinator for the CDC\u2019s 1999 push to eliminate syphilis, says one of the reasons the campaign failed is because public health is usually working \u201cin rescue mode, parachuting in and fixing things.\u201d That\u2019s effective in acute situations, like stopping a new outbreak from exploding, but it doesn\u2019t address long-term structural issues like economic stability, safe housing and transportation, which are all key factors in chronic and preventive care. The last fraction of cases in any public health effort can be the hardest to solve because they often involve vulnerable populations experiencing these barriers to accessing care. They are also the easiest populations to ignore.<\/p>\n

Local health departments don\u2019t have nearly enough resources to investigate cases of syphilis with contact tracing, which involves tracking down patients, inquiring about sex partners and making sure everyone is treated. One disease intervention specialist I shadowed in Fresno, California, has made six trips to a rural town, driving an hour each way, trying to prevent a single case of congenital syphilis. The patient is unhoused and itinerant, and so far has been hesitant to visit the community clinic for treatment.<\/p>\n

With interest in public health now at an all-time high, it is worth reexamining how much money public health gets to take on these unpopular but necessary challenges, and how much authority the CDC gets to set its priorities. I hope that, five or 10 years from now, I\u2019m not still reporting about COVID-19 hot spots left behind after attention wanes, creating places where the disease still flares because testing or treatment is hard to come by. And I also hope I\u2019m not still writing about babies dying from syphilis.<\/p>\n

Read ProPublica and NPR\u2019s story<\/em><\/a>.<\/p>\n<\/div>\n