One day in 1976, two workers at the Centers for Disease Control in Atlanta left work feeling sick. Both had contracted spotted fever, a rare disease being studied there. Both later died of the disease.
For the next six years, CDC officials pushed for a new virology laboratory to replace their temporary facilities and to provide better protection against the release of infectious organisms. This week, they succeeded in winning the Reagan administration's support.
The odyssey of the lab from the first request to a $15.6 million item in President Reagan's fiscal 1984 budget parallels the path of thousands of other government programs. As described by several officials at the CDC and its parent Health and Human Services Department, it meant battles lost, abandoned, renewed and eventually won.
The agency's first big loss came when it thought it had the battle won. The Carter administration's fiscal 1982 budget proposal included funds for the lab, but when Reagan revised the budget, the money disappeared.
Last year, CDC officials tried again, scaling back their request to about $15 million. They got support from their superiors at the Public Health Service and from HHS Secretary Richard S. Schweiker.
But when the Office of Management and Budget passed back the HHS budget, funds for the lab were gone. OMB suggested charging user fees for some of CDC's diagnostic services, with the money going to the lab. CDC officials argued that user fees would undermine the agency's basic function and would barely begin to pay construction costs.
The OMB also suggested using existing facilities at Fort Detrick, Md., or Pine Bluff, Ark.--facilities that CDC officials said were too old and too far away for any give-and-take among researchers.
When the final fiscal 1983 budget was released, the lab was gone.
CDC Director William H. Foege and key aides had all this on their minds when they caucused last summer over this year's budget strategy.
At the time, the CDC's 1983 budget was the focus of intense congressional wrangling, thanks to proposed cuts in the program for immunizations against childhood diseases. No one wanted more suggestions that the administration was not concerned about children's health and so a large amount had to be set aside for immunizations this time.
Also, the CDC's venereal disease research program faced opposition within the administration. Was another go-around on the virology lab worth it, they asked?
But Foege and his associates persisted, sending a proposal to Assistant HHS Secretary Edward N. Brandt Jr. that included $13 million for the lab. Brandt sent it on to Schweiker. Schweiker's staff decided the job couldn't be done for that amount, and increased it to $15.6 million. Then they sent the entire HHS budget request to the OMB.
When OMB's passback arrived Nov. 23, the virology lab was gone--and the same arguments were back. Worse, budget-cutters had sliced 20 percent from the overall CDC budget, although immunization funds had been increased.
From Nov. 24 through Nov. 29, HHS officials tried to decide which items to fight for.
Early Nov. 29, Brandt and Schweiker gathered the heads of the PHS agencies to go over drafts of HHS's proposed appeal. Brandt hadn't included the virology lab.
"When you respond to the OMB passback, you have to ask if you should water down your argument by saying everything's important," CDC executive officer James D. Bloom explained.
When Brandt finished discussing his proposed appeal, he invited Foege to elaborate. Before Foege finished, the former missionary doctor added his own plea for the lab. Foege was "straightforward, low-key, but intense," Bloom said.
Impressed, Schweiker said he'd try again.
Unimpressed, OMB officials didn't discuss this or many other issues with their counterparts at HHS. When Schweiker and his aides appeared before the Budget Review Board--OMB Director David A. Stockman and presidential advisers James A. Baker III and Edwin Meese III--they carried a thick stack of issues, including the lab.
According to sources who heard accounts of the meeting from HHS participants, Meese looked at the number of items in dispute and told the HHS and OMB to do some more talking.
In those conversations, the lab was finally approved.