While state governments are cutting health programs across the board in order to balance budgets during an extended declining market, state health workers are not necessarily losing out, as federal money has been coming in for states to begin running emergency preparedness programs, many of which deal directly in health-related fields because of the threat of bioterrorist attacks. Health officials, even those being switched from one role to another, are voicing their concern that many leading diseases like heart disease, cancer, and even influenza are dropping out of the spotlight. Massachusetts, for example, has cut its adult immunization programs against pneumonia, hepatitis A, and hepatitis B, helping the state to drop its public health budget by 30 percent in just two years; yet it has gained $21 million in federal funds to expand response networks for possible bioterrorist attacks with substances like anthrax and smallpox, two diseases that have not been present in Massachusetts for a half century. As a result, state public health divisions are no longer as prepared for diagnosing outbreaks of more common diseases, such as tuberculosis or influenza, and they are more ready to deal with the unexpected, such as the threat of severe acute respiratory syndrome (SARS) and, in recent summers, of West Nile virus.