The Afghan Air Force Gets More Money Than Infectious Disease Prevention
There are certain moments in history that are so disastrous that they force a nation to think long and hard about its priorities. What truly matters to the health, welfare, security, and prosperity of the United States? Is taxpayer money being spent wisely? Is it being allocated to the right things? How could we have been so unprepared for a threat that was staring us all in the face?
The coronavirus storming the United States is just such a moment.
The virus is nothing short of a global health epidemic. As of this writing, it has claimed the lives of nearly 38,000 people in over 160 countries and sickened hundreds of thousands. Approximately 165,000 cases in the United States have been reported, with over 3,100 Americans having succumbed to the disease. Forty-one percent of those cases are in New York State, where the virus taken a horrifying toll. Between March 30 and 31, an additional 332 New Yorkers died from complications.
The deaths are, of course, tragic. But just as disturbing is the state of America’s health care system. It is completely overwhelmed and may have already reached a breaking point.
Doctors in the New York City area are venting to journalists about the apocalyptic scenes in their hospitals, where dozens upon dozens of patients are overflowing the waiting rooms, with multiple COVID-19 victims hooked up to single ventilators and entire hospital wards repurposed to treat the disease. Health care professionals are working multiple 12-hour shifts with little to no sleep in order to keep pace. For weeks, New York Governor Andrew Cuomo and New York City Mayor Bill de Blasio have been candid about the lack of hospital space and ICU beds—so much so that state authorities, the Army Corps of Engineers, and private medical organizations are all scrambling to build temporary field hospitals in Central Park, the Javits Center, and the Billy Jean King tennis center in Queens. Some hospitals in Brooklyn and Queens are de facto war zones, with doctors doing their best despite a gap in the most basic of medical supplies.
An emergency room physician at Brookdale Hospital in Brooklyn couldn’t have been any clearer: “We need gowns, we need gloves, we need masks, we need more vents [ventilators]. We need more medical space. We need psychological support as well.” Translation: we don’t have the resources to continue treating patients. And if we don’t get them soon, doctors will have to make painful choices about who to save.
All of which is to say that if the coronavirus teaches policymakers anything, it should be that America’s priorities need a deep and systemic reset. There is not much the federal government can do about staffing or equipment shortages at individual hospitals. But what it can do is begin to re-evaluate the nation’s priorities at a macro-level. It’s inexcusable that the Afghanistan national security forces receive predictable funding while America’s health professionals are literally making their own personal protective gear at home and borrowing ventilators from animal hospitals.
Budget numbers don’t tell the whole story, of course. And side-by-side comparisons can be iffy. But they can also be an effective way of demonstrating just how atrocious the United States has become at prioritization.
Consider the budget for the National Institute of Allergy and Infectious Diseases, the branch of the National Institutes of Health that Dr. Anthony Fauci directs. The Trump administration requested $5.4 billion in its FY2021 budget request for Fauci’s department, about 14 percent of NIH’s total budget request ($38.694 billion). On the surface, this sounds like a lot of money. But it’s peanuts compared to what the Pentagon receives on an annual basis. The Defense Department is freighted with overhead, questionable spending practices, and failed audits, yet its budget continues to increase as senior officials convince lawmakers that anything less would be risky.
This is the same department whose former secretary, Jim Mattis, admitted to Congress that it’s been forced to spend taxpayer dollars on facilities that simply aren’t needed anymore. This is also the same department that has a $400,000 toilet problem aboard the U.S. Navy’s two newest aircraft carriers. The Pentagon spent more money in a single month in 2018 ($61 billion) than the Food and Drug Administration, Health Resources and Services Administration, Centers for Disease Control, and National Institutes of Health were legally entitled to spend in an entire year—a combined $59.2 billion.
Or consider another comparison: in fiscal year 2019, Congress appropriated $4.9 billion for the Afghanistan Security Forces Fund. That fund covers the costs of everything from ammunition and aircraft maintenance to personnel and salaries (the Afghan government is almost completely dependent on U.S. and foreign donor support). This $4.9 billion figure is more than three and a half times what Congress appropriated that year for combating opioids, which continue to ravage cities and small towns alike. Indeed, Washington devoted more taxpayer money to the Afghan Air Force in FY2019 ($1.728 billion) than to the research and prevention of emerging infectious diseases ($624 million).
Or consider this: the Centers for Disease Control received $834.86 million for public health preparedness and response—the very capabilities the United States is now so desperately in need of. Egypt, meanwhile, was the beneficiary of $1.4 billion in U.S. foreign assistance, more than 90 percent of which went to a military that has proven incapable of snuffing out a disorganized cluster of jihadists in the Sinai desert.
Critics will look at these numbers and blithely dismiss them as an apples and oranges comparison. This is exactly what Richard Haass, the president of the Council on Foreign Relations, did on Twitter when former FBI special agent Ali Soufan noted the immense disparity between the financial resources dedicated to forever wars versus domestic needs.
But this itself is a too-clever-by-half argument. It ultimately defends a status quo whose dismal and depressing results we’re seeing in real time. Once this public health crisis is over, more Americans will feel the same way—if they didn’t already.
If there is a silver lining to the coronavirus tragedy, it’s that the physical and psychological scars of the disease will compel Washington to look in the mirror and engage in some uncomfortable but absolutely necessary reflection about how the nation got so sidetracked. It would be a loss of epic proportions if we didn’t learn from this opportunity.
Daniel R. DePetris is a columnist at the Washington Examiner and a contributor to the National Interest.