1. United States
2. N.C.
3. Letter

I am writing to urge immediate action to restore federal public health capacity to 2024 levels. The 2025 budget cuts to the CDC, NIH, and state and local public health programs have severely compromised our nation's ability to detect and respond to disease outbreaks. The multistate cyclosporiasis outbreak demonstrates the direct consequences: when leadership, personnel, and surveillance capacity are cut faster than the system can adapt, public health effectiveness collapses. Effective cyclosporiasis management demands timely clinical testing, rapid case reporting, sustained fieldwork, and confirmed laboratory diagnosis—all impossible without adequate staffing and infrastructure. When CDC and state/local departments lose personnel and laboratory capacity, outbreak investigations start later, proceed slower, and fail to identify early signals that allow officials to pinpoint contaminated food sources and enforce targeted risk reduction. The impact worsens when insurance subsidy expirations leave patients unable to seek prompt care or obtain diagnostic testing, creating an "undercount" that masks outbreak severity and delays decisive action. I urge Congress to restore CDC and public health budgets to 2024 levels, including full funding for laboratories, epidemiologists, data systems, and outbreak investigation capacity. Second, reverse 2025 cuts to NIH-linked biomedical capacity that have undermined translational support for diagnosis and surveillance infrastructure. Third, make health insurance broadly available and affordable to eliminate coverage gaps that delay case detection and outbreak reporting. Public health infrastructure is not discretionary—it protects every household. Restored funding and affordable coverage are essential to detecting the next outbreak earlier and managing it with full operational capacity.