Public health infrastructure in the U.S. is in dire need of investment over the next decade, according to a Healthcare Information and Management Systems Society (HIMSS) report released earlier this week. To exactly nobody’s surprise, the report concluded that all levels of government – local, territorial, state and federal – would need some $36.7 billion in funds to modernize public health infrastructure over the next decade.

Valerie Rogers, director of government relations at HIMSS, believes the pandemic shed a light on gaps in the public health system – and, as a result, this type of funding is needed more than ever. She pointed to the Prevention and Public Health Fund, which was established to invest in preventive healthcare, as a prime example. Since 2012, the fund has been slashed repeatedly, shedding an astonishing $1.35 billion.

“A key component to moving forward in this now-digital world is modernizing the public health system,” Rogers stressed. “We’ve seen sustained cuts over the past 10 years to the Prevention of Public Health Fund, which is specifically dedicated to public health. That left us with a system that, as it was operating pretty much on a shoestring, was not able to pivot and be nimble enough to fully address the issues that arose during the pandemic.”

Rogers characterized the current state of the healthcare system as “moving at the pace of a bullet train, with public health hanging onto the back of it.”

Securing the needed $36.7 billion in funds, however, presents quite the challenge, especially given that Congress can’t agree on extending further pandemic relief. After lawmakers dropped a proposed $15.6 billion COVID-19 funding package from the government’s spending bill in March, the additional aid has remained in flux.

Public health experts and the Biden administration have called on Congress to secure more funding, noting that the federal government will soon lack the money to purchase enough booster shots and antivirals. In addition, a federal program that reimbursed healthcare providers for testing, treating and vaccinating uninsured Americans has already been paused after it ran out of money.

While COVID-19 funding remains on the national radar, it has been pushed to the side in favor of providing aid to Ukraine. This week, lawmakers agreed to another $39.8 billion in additional support for the country, while shifting COVID funding into a separate package.

In a statement, however, President Biden underscored the importance of securing additional money to fight COVID-19.

“Without timely COVID funding, more Americans will die needlessly,” Biden said. “We will lose our place in line for America to order new COVID treatments and vaccines for the fall, including next-generation vaccines under development, and be unable to maintain our supply of COVID tests. In the fall, if we are hit by new variants, it will be too late to get the tools needed for protection – critical treatments that will be available in Europe, but not the U.S.”

In short, the country is locked into a familiar holding pattern: Until there’s a crisis, public health is forever a low priority. But without stable, long-term funding, the U.S. public health infrastructure will buckle under stress.

“It has to be part of health departments’ core missions … to use the most cutting-edge tools to do their work,” Dr. Amesh Adalja, a senior scholar at Johns Hopkins Bloomberg School of Public Health, said in a previous interview with MM+M. “There have been some improvements, but they have to be sustainable and not just tied to one moment in time.”

The HIMSS report outlines several areas in need of investment, including electronic case reporting and contract tracing. Improving the process through which clinics and HCPs submit disease reports to government health departments would also streamline the tracking of COVID cases, contacts and isolation periods.

Whether the country’s pandemic experience will spur sustainable federal funding is anyone’s guess. Still, Rogers further emphasized its importance by pointing to health equity, noting that disparities (such as ones related to maternal mortality) cannot be adequately addressed by a dated and underfunded public health system.

“Governmental agencies have to be equipped to analyze and share electronically transmissible visualized data and insights that would support the plethora of health equity-related issues,” Rogers said. “Whether it’s the pandemic response, or any emergency response – including natural or man-made disasters – it would be super helpful to have modernized data systems that are talking to each other and equipping policymakers, strategists and practitioners with the information they need.”