America’s Job Exchange Address
America's Job Exchange Address
Budget Cuts Threaten Emergency Preparedness
States Score high on readiness to deal with disease, disasters, terrorism
Local and state health departments are better prepared than ever to deal with public health emergencies, but recession-related budget cuts threaten to reverse hard-won gains, a newly released analysis finds.
The readiness of individual states to handle large-scale public health emergencies was assessed in the eighth annual report, "Ready or Not? Protecting the Public's Health from Diseases, Disasters, and Bioterrorism," commissioned by the health advocacy groups Trust for America's Health and the Robert Wood Johnson Foundation.
Fourteen states met at least nine of 10 key indicators of emergency preparedness, while three states -- Arkansas, North Dakota, and Washington -- met all 10.
Iowa and Montana had the lowest scores, meeting just five of the 10 indicators.
"These scores reflect nearly 10 years of progress to improve how the nation prevents, identifies and contains new disease outbreaks and bioterrorism threats and responds to the aftermath of natural disasters in the wake of the September 11, 2001 and anthrax tragedies," Trust for America's Health Executive Director Jeffrey Levi, PhD, said in a Tuesday morning press conference.
Budget Cuts Threaten Post-9/11 Gains
More than three-quarters of states met at least seven of the 10 indicators, but Levi warned that budget cuts at the national, state, and local level may have already impacted readiness to respond to public health emergencies such as disease outbreaks, natural disasters, or acts of terrorism that impact public health.
Among the ominous signs:
- 33 states and Washington, D.C., cut funding for public health last year, and 18 states cut funding for the second year in a row. Georgia decreased funding the most by almost 35%, followed by Arizona and the District of Columbia, which cut funding by 23% and 18%, respectively.
- Since 2008, 15% of public health work force has been cut at 2,700 health departments across the country.
- In addition to cutting staff, many state and local governments have instituted work furloughs, hiring freezes, and shorter workweeks to address budget shortfalls.
- Nearly three-quarters of Americans live in areas where local health departments have fewer employees than they did before the recession began.
Levi points out that the cuts would have been much worse without one-time funding infusions to public health from the 2009 stimulus bill and emergency appropriations for the H1N1 outbreak.
He added that the cuts are now hitting home and their potential impact cannot be overstated.
"The combined federal, state, and local budget cuts constitute an emergency for emergency health preparedness in the U.S.," he said.
State-by-State Breakdown
In addition to maintaining funding for public health programs, the 10 indicators included in the analysis examined the ability of state and local health departments to gather and share information and respond to a prolonged emergencies affecting public health, among other measures.
Among the major findings:
- Seven states are not able to share data electronically with health care providers: Alabama, Montana, Nevada, New Hampshire, New Mexico, Ohio, and South Carolina.
- Ten states do not have an electronic surveillance system in place to report and exchange information: Alaska, Idaho, Illinois, Iowa, Kansas, Montana, Nevada, New Mexico, Oregon, and South Dakota.
- Half of the states do not mandate all licensed child care facilities to have a written evacuation and relocation plan in the event of an emergency: Alaska, Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, Oregon, Rhode Island, South Dakota, Tennessee, and Wyoming.
- Three states -- Hawaii, Iowa, and Montana -- and the District of Columbia reported not having enough staffing capacity to work five, 12-hour days for six to eight weeks in response to an infectious disease outbreak such as a flu pandemic similar to H1N1.
H1N1 Response Praised
James S. Blumenstock, who is chief program officer for the Association of States and Territorial Health Officials, said the response to the 2009 H1N1 swine flu outbreak highlights the progress that has been made in emergency preparedness during the past decade.
"The response showed that the country was much better prepared to respond to a pandemic than it would have been just a few short years ago," he said. "In a short period of time the vaccine was developed and we were able to vaccinate 80 million Americans."
Blumenstock echoed Levy's concerns about the impact of budget cuts on public health emergency readiness, noting that federal funds for public health preparedness have been cut by 27% since 2005.
He called on federal lawmakers to resist slashing public health funding even further.
"Cuts in federal support are putting more than a decade of gains at risk at a time when the states are trying to cope with daunting and formidable budget shortfalls of their own," he said.
About the Author
Gold and Silver Report - "The Italian Job"
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America's Job Exchange Address
President Obama and Vice President Biden Address National Governors Association
Africa is the final investment frontier
Africa is the last place on earth where investors will be able to make ‘super' returns. Over time, GDP growth in Africa is expected to outpace that in most developing economies, including the BRICS (Brazil, Russia, India, China, and South Africa) countries. And the ‘middle market' - where companies are usually too small to attract institutional investors and too big to be of interest to donor organisations - is growing faster than any other.
There was consensus on both these points at the inaugural Super Returns Africa 2010 conference (29th November to 3rd December 2010), held in Fairmont Nile City, Cairo, Egypt, and attended by Limited Partners, including international institutional investors (pension plans, funds of funds, etc), Middle Eastern family offices and sovereign wealth funds, direct foreign investors, a wide spectrum of General Partners active on the continent (including pan-African and pan-emerging markets funds based in Europe, North America, and the Middle East), Africa-based specialist General Partners with a regional, country or sector focus, and South African buyout funds.
As pioneers in Africa's middle market during the past 15 years, we were delighted to see conference delegates realising that that's where creativity and the willingness to innovate are most evident. It's also the area in which the greatest impact can be made on job creation and skills development, thereby contributing to GDP growth, improving the relevant country's development and, in turn, attracting more investment.
In other words, it's where investors can do best while doing the most good.
There's a but, though. Capital isn't enough. As Sir Bob Geldof said in his closing keynote address, for investors to achieve the phenomenal returns that are possible, they have to do some handholding of the portfolio companies. Talent has to be pro-actively nurtured. Skills have to be transferred.
Any enterprise wanting to move into a bigger league faces challenges it's not encountered before. At the simplest possible level, there's a vast difference between managing five people and managing 200 or 2,000, while still focusing on the fundamentals of business - delivering value.
In Africa, however, there are additional complications. These were highlighted by conference delegates asking pointed questions about political stability, nationalisation, the legislative environment, currency risk, exchange controls, ease of doing business, and exit mechanisms.
They're valid questions. But, they do indicate the kind of traditional, first world approach to investment that isn't prepared to engage with Africa's realities and, therefore, won't be able to capitalise on the continent's potential for exceptional returns.
To get those returns, investors have to do just a little more work than they're used to. Yes, traditional financial analysis is essential. It's also necessary, however, to approach each investment opportunity and engagement with a set of guidelines that assesses the overall economic value added, and resolutely pursues answers to investment challenges in order to maximise the impact in value creation, profitability, and job creation.
An example is the relationship we facilitated between African Dynamics, a South African wholesaler and manufacturer of school and hospital meals, and Mafori, a non-bank lending and financial products institution.
As a supplier to micro-enterprises holding government contracts, African Dynamics was constantly confronted by delays in payment – and, therefore, cash flow problems - caused by long government payment cycles. We introduced African Dynamics to Mafori Finance, which funds entrepreneurs like African Dynamics' clients. Mafori now provides capital and bridging finance to African Dynamics' clients, keeping both sets of businesses functioning.
Aside from benefiting all the enterprises involved, the interwoven business relationships ensure that underprivileged children and hospital patients are fed.
That's the magic of investing in Africa. It makes a difference.
About the Author
William Jimerson, founder and executive director of Musa Capital, was born in Mississippi in the United States, studied at MIT, and worked on Wall Street as a financial analyst, before forming Musa Capital with college friends from Harvard and Boston University. Believing their skills could make more of a difference to a broader population if they applied them in the middle market in Africa, they have a fifteen-year track record of growing small to medium sized businesses that want to expand but are too big for donor organisations and too small to interest large investment firms. www.musacapital.com