Fixing US public health infrastructure for 1% of annual military budget

In the wake of the COVID-19 pandemic, the appearance of monkeypox, and the re-emergence of polio, US national reports¹ and journalism2, 3 are increasingly focusing on the long-standing, woeful underfunding of US public health infrastructure and its lethal consequences. At issue are the insufficient personnel, insufficient core funding, inadequate and antiquated data systems (both software and hardware), and dismal integration of data across local, state, tribal, and federal levels. The deadly consequence is persistent major gaps in urgently needed, timely, and complete data on who is getting ill, tested, hospitalised, treated, recovering, and dying from myriad ailments and exposures.1, 2, 3

The solution to this dire situation is consistently framed as a being a very expensive overhaul and integration of data systems from local to federal.1, 2, 3 Estimated costs for such data modernisation are reported to range from US$7·84 billion over the next 5 years (ie, $1·6 billion per year)² to $37 billion over the next decade (ie, $3·7 billion per year)² to $4·5 billion per year.¹ These indeed appear to be large sums, dwarfing the US Centers for Disease Control and Prevention's $100 million budget for data modernisation² and the $862 million allocated for public health emergency preparedness programmes.¹

However, some perspective is warranted. To wit, expenditure on the order of $1·6 billion to $4·5 billion per year was equivalent to 0·2–0·6% of the $740 billion US federal military budget for 2021, according to the National Priorities Project. In the context of a COVID-19 pandemic that has already killed nearly 1·1 million people in the USA³ (ie, ten times the total US military casualties in the Korean War, the Vietnam War, and the wars in Iraq and Afghanistan combined—or a quarter of the military fatalities in World War 2), the duty to protect the public includes protecting the public's health. Surely the US public health infrastructure is worth fixing for less than 1% of the annual US military budget.

For the National Priorities Project see https://www.nationalpriorities.org

For US military casualties see https://www.statista.com/statistics/1009819/total-us-military-fatalities-in-american-wars-1775-present/