Commentary: Support needed for public health programs here and abroad

By Teresa Rugg

I believe the time is now. Despite the crushing overdose of election coverage, now is the time to talk about policies and financial issues that face us every time we turn on our water, eat out at our favorite Snohomish County restaurant, and respond to an infectious disease.

Although our Snohomish County RESULTS group is squarely focused on global poverty issues, we often find that there are parallels between the investment in health in our local community and health investments in parts of the world where people are living on less than a dollar a day. This has recently come to light as we recognize that our very own public health system is under great financial strain. With financial strain comes layoffs, and thus the elimination of public health knowledge and wisdom from those who have served in the field for decades.

It seems that Snohomish County residents have been silent on reports that our Snohomish Health District could deplete our budget reserves by 2018. I say “our budget reserves” because these are the funds that go toward our collective public health. It is surprising to us that no community member who drinks our clean water, eats out at restaurants, has had a family member who has been impacted by a infectious disease has expressed their concerns for our collective health in the form of a letter to the editor or some viral social media post. Our concern is that when we don’t invest in public health and health system strengthening, we are simply on a short-sighted course to knee-jerk responses to situations that impact human health and have great financial implications.

As a cautionary tale, we could learn a lot from what is happening in some developing countries where health care systems are not healthy. The 2014-15 Ebola outbreak in West Africa took it’s toll on over 11,000 people and health care workers. But the health care systems in Sierra Leone, Guinea, and Liberia were further damaged in terms of the diagnosis, and treatment of endemic diseases such as HIV/AIDS, Tuberculosis (TB), and malaria. Prior to Ebola, these three diseases were the most prevalent infectious diseases in West Africa. For decades, the health systems in these countries have been fragile, posing many layers of challenges such as: not enough health care providers, limited access to care and medicine shortages. When Ebola hit, the sparse health care staff did their best to handle the epidemic but with an interruption in routine health delivery services, this led to other diseases flourishing.

Halting the spread of these infectious diseases by health systems strengthening is a U.S. priority through the Global Fund for Fight AIDS, TB and Malaria. The U.S. recently pledged $4.3 billion over the next three years to the Global Fund. This follows on the heels of the entire Washington state congressional delegation sending a letter requesting President Obama to make this investment. Our state congressional delegation understands the importance of strengthening health care to combat disease and ultimately poverty.

Yet, it is up to our local community to invest in our public health system right here at home. Currently, the Snohomish Health District ranks 34th out of 35 health districts in the state in per capita spending. Towns and cities throughout Snohomish County are being requested by the Snohomish Health District to pay $2 per resident for public health services that we all utilize. Out of all of the possible resources we should be investing into our community, $2 a year is a bargain. The positive benefits of investing in public health in every community of the world is clear.

Not unlike developing countries, if we don’t have a strong public health system that includes staff with invaluable knowledge of infectious diseases, grounded outbreak response strategies, and a strong focus on prevention, we are not anticipating the inevitable. By the end of 2016, someone in Snohomish County will get TB from simply breathing in TB bacteria. Someone will get sick from eating at an unsanitary restaurant. Someone will need assistance with their septic system. But all of these scenarios can be minimized by a solid public health system. We all are the faces behind public health so let’s be part of the global solution to protect that which is most important to our communities — health.

Teresa Rugg, MPH, is the co-leader of the Snohomish County RESULTS group and was a Peace Corps Volunteer in Cameroon. RESULTS creates long-term solutions to poverty by supporting programs that address its root causes: lack of access to health, education, or opportunity to move up the economic ladder. Learn more at and on Facebook at RESULTS in Snohomish County.

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