With near constant news on the threat of Zika virus and a quickly growing evidence base detailing the virus’ devastating impact on fetal brain development, you’d think Congress could get its act together to make sure our public health system is fully prepared and equipped to confront the mosquito-borne disease. Sadly, you’d be wrong.
It’s been nearly three months since the White House submitted a request to Congress proposing $1.9 billion in emergency funding to support a full range of activities needed to prepare for, prevent, detect and respond to Zika in the United States. As of today, May 12, Congress has yet to finalize funding. According to the White House, the funding would support accelerated vaccine research; mosquito surveillance and control; education for health care providers, women and their families; improved health services for low-income women, who may be most at risk of infection; and prevention activities in countries experiencing active Zika transmission, which would help curb the virus’ spread beyond their borders.
Despite the risk and the more than 45 congressional public hearings and briefings on Zika, many Republicans, with the exception of Congress members from Florida, have actually suggested that emergency Zika funding can just wait. In fact, in mid-April, some Republican leaders suggested a decision on the funding could wait until the fall — after mosquito season. Harold Rogers, R-Ky., House Appropriations chair, actually called Obama’s request a “slush fund.” (This is the same man who consistently votes to restrict abortion services because he wants to “protect life.”) Fortunately, some news outlets reported today that Congress members are closer to hammering out a deal, though it might not match the White House’s entire request.
In the absence of congressional action, the White House in April shifted $510 million in funds from the fight against Ebola toward Zika activities, as well $79 million that had been allotted to public health preparedness activities and the national strategic stockpile of vaccines. But according to the World Health Organization, work to contain the Ebola outbreak and prevent additional cases in West Africa is still ongoing and Ebola remains a global disease threat, despite its disappearance from the U.S. front pages. So let’s be clear: The lack of congressional action is now forcing our country to choose between which horribly devastating disease we’re going to protect ourselves against, instead of providing our public health system with enough funds to fully protect Americans from both disease threats.
In April letters to leaders and ranking members in the House and Senate, dozens of health organizations — including the American Public Health Association (APHA), American Academy of Pediatrics, American Medical Association, the Children’s Hospital Association and the March of Dimes — implored policymakers to act within this “brief window of opportunity” to provide emergency funding for Zika response, instead of repurposing funding from other priority public health activities and programs. They wrote:
With emergency supplemental funding to respond to the Zika virus, state and local public health professionals would have access to increased virus readiness and response capacity focused on areas with ongoing Zika transmission; enhanced laboratory, epidemiology and surveillance capacity in at-risk areas to reduce the opportunities for Zika transmission and surge capacity through rapid response teams to limit potential clusters of Zika virus in the United States. Moreover, supplemental funding will assist the CDC and USAID in efforts to contain the Zika virus in Zika-endemic countries and ensure that there are resources for surveillance, vector control and services for affected pregnant women and children.
If we take immediate action, we may be able to dramatically slow the spread of Zika, giving scientists time to develop and test a vaccine. Without action, however, we fear the number of newborns born with debilitating birth defects will only continue to rise. In addition to the human toll on children and families, the CDC estimates that the average lifetime cost of caring for each child born with microcephaly will likely be millions of dollars per child. For hard-hit communities, an epidemic of severe birth defects could quickly overwhelm health care and social services systems, and put extreme pressure on educational and other institutions.
While Zika hasn’t yet made a substantial impact the U.S., the potential certainly exists. For example, in a research article published in March in the journal PLOS Current Outbreaks, authors used weather-driven models to simulate the potential seasonal abundance of adult Aedes aegypti mosquitoes, the species that transmits Zika, in 50 U.S. cities They found that winter conditions are largely unsuitable to the mosquito in the U.S., except in southern Florida and south Texas. However, conditions for the mosquito are suitable between July and September across the 50 cities studied — those cities ranged from New York City to Kansas City, Missouri, to Sacramento, California. The article also noted that “high poverty rates, an indicator of potential vector-human contact, are particularly prevalent in the southern U.S. where seasonal abundance of Ae. aegypti is simulated to be highest.” It’s also those southern states that tend to have lower state public health budgets.
Looking at the bigger picture, our nation’s collective need to sustain the capacity to promptly respond to serious disease threats didn’t end with Ebola and it certainly won’t end when Zika fades from the headlines. In February, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, co-authored an article in the New England Journal of Medicine, writing that the spread of Zika “has already reinforced one important lesson: in our human-dominated world, urban crowding, constant international travel, and other human behaviors combined with human-caused microperturbations in ecologic balance can cause innumerable slumbering infectious agents to emerge unexpectedly. In response, we clearly need to up our game with broad and integrated research that expands understanding of the complex ecosystems in which agents of future pandemics are aggressively evolving.”
Just yesterday, Fauci made his own plea for emergency funding in an interview with USA Today: “We have had to pull money out of other areas to get started. You can’t sustain that for much longer. That’s just a stopgap measure. If we don’t get the money that the president has asked for, the $1.9 billion, that is going to have a very serious negative impact on our ability to get the job done.”
If you’d like to urge your members of Congress to act quickly on Zika funding, APHA has made it as simple as possible for you. Visit this site, fill in the blanks, and let your representatives know that preparing for Zika is no time for political games.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for nearly 15 years.