One of the main reasons the United States did not stop the killing of babies by syphilis — ProPublica

In public health, a “sentinel event” is an example of preventable harm that is so serious that it warns of a system failure. The alarm is ringing.

An increasing number of babies are born with syphilis after their mother has a sexually transmitted disease and the bacteria have passed through the placenta. These cases are 100% preventable. When a mother with syphilis is treated with penicillin during pregnancy, the baby is often born without evidence of illness. But if the mother does not receive treatment 40% probability Their babies either miscarriage, stillbirth, or die shortly after birth. Survivors can be born with deformed bones, damaged brains, and suffer from severe anemia, deafness, and blindness.

I have spent the past few months Countries such as Belarus, Cuba, Malaysia and Sri Lanka are trying to understand why they have succeeded in clearing congenital syphilis while the United States faces the highest incidence. In almost 30 years: Last year, 2,022 cases were reported, including 139 deaths.This is because the US Centers for Disease Control and Prevention is in the US On the verge of exclusion A centuries-old tragedy for babies as well as adults.

What was wrong here?

My report has led me to one major factor: according to the various experts I spoke with, the CDC’s funding practices are not only anomalous and prevent it from responding to an increase in sexually transmitted diseases. , Not ready for the COVID-19 pandemic that left us.

State and local health departments receive a lot of money from federal agencies that have the best bird’s-eye view of all the insects, viruses, and diseases that are endemic in the United States. However, CDC scientists do not have the power to determine how much to spend fighting each.

Instead, Congress has given the CDC item-by-item to combat a single public health threat from a wide range of categories, including emerging infectious diseases and Alzheimer’s disease, in a unique and unusual way not found in many other institutions. Tells you exactly how much money you can spend on more niche conditions such as interstitial cystitis, neonatal withdrawal syndrome, Tourette’s syndrome. Although the preventive tactics for HIV and other STDs overlap considerably, there is another section for HIV prevention, which is allocated about six times as much as the sexually transmitted disease category.

The decision was politically driven and the overall health needs were promoted as lobbyists and patient advocates landed in Washington and insisted on legislators that their particular illness of interest should get a larger pie. May be separated from. The cause of the lack of a large army of compelling spokespersons can be ignored. Sexually transmitted diseases have an extra layer of stigma to deal with and few dedicated advocacy groups. A few lobbyists who focus on sexually transmitted diseases may not even be able to meet with lawmakers.

“The CDC needs to have more money and more flexible money,” former CDC director Dr. Tom Frieden told me. The political nature of institutional funding is part of the country’s failure to monitor the virus before the coronavirus pandemic. The 2014 Ebola epidemic is “Global wakeup call, ”Still in 2018, CDC Shrink I’ve run out of money, so it’s an epidemic prevention job.

This means that public health in the United States has always been what Frieden calls “a deadly cycle of panic and negligence.” Scramble to throw money in the latest emergencies and lose the attention and motivation to complete the task when fear diminishes. May, President Joe Biden’s administration Presentation We will secure $ 7.4 billion over the next five years to hire and train public health workers. However, some officials are worried about what will happen when these five years have passed. “We’ve seen this movie before, haven’t we?” Frieden said. “Everyone is worried when an outbreak occurs, and when it stops, headlines stop, and a recession occurs, budgets are cut.”

Jo Valentine, a former program coordinator for the CDC’s 1999 promotion to eradicate syphilis, said one of the reasons the campaign failed is that public health usually works to “fix things with parachutes in rescue mode.” It is said that it is because of it. This is effective in acute situations such as stopping the explosion of new outbreaks, but long-term such as financial stability, safe housing and transportation, which are all important elements of chronic and preventive care. It does not deal with structural problems. The last part of the case in public health efforts can be the most difficult to resolve, as it often involves vulnerable populations experiencing these barriers to access to care. They are also the easiest group to ignore.

The local health department does not have sufficient resources to investigate cases of syphilis with contact tracing to track patients, ask questions about sexual partners, and ensure that everyone is being treated. A disease intervention expert I cast a shadow over in Fresno, California, traveled six times to a rural town and drove an hour one way in an attempt to prevent a case of congenital syphilis. Patients are not detained, are patrolling, and have so far hesitated to visit local clinics for treatment.

With the ever-increasing interest in public health, how much money does public health make to tackle these unpopular but necessary challenges, and which CDC prioritizes. It’s worth reconsidering whether you just get the authority. After five or ten years, we have not yet reported on the COVID-19 hotspots that remained after diminished attention, indicating that there is still a place for the disease to burn due to the difficulty of testing and treatment. hoping. Also, I hope I haven’t written about the baby who died of syphilis yet.

Read the story of ProPublica and NPR..