By Chrissie Juliano, MPP, Director of the Big Cities Health Coalition
Congress left for recess last week without providing funding for the latest public health emergency, the Zika virus. Let’s give them the benefit of the doubt: until recently, the Zika virus was a moving target. The science was straining to catch up with the threat, and therefore, the costs of failing to prepare and respond were more vague. We weren’t 100% sure if Zika caused microcephaly in babies. We hadn’t seen the maps showing where the mosquito vectors lived. We didn’t know it could be sexual transmitted. Now, the facts are clear. Alexandra Phelan and Lawrence O. Gostin (Georgetown University public health/law professors), writing in Health Affairs last week, got it exactly right, saying “It is one thing to fail to prepare for an emerging infectious disease if the risks are uncertain. But it is quite another to fail to act when the facts are clear.” It is time for the U.S. Congress to allocate dollars to prepare for, and respond to, what could become a major public health disaster.
Let’s review the facts.
To begin with, the virus is here and spreading, even before the onset of mosquito season, and it is infecting pregnant women and their unborn babies. As of April 29th, at least 426 people have been diagnosed with the virus, including 18 pregnant women in the continental U.S, though we know the Zika virus has not struck with equal ferocity across the nation. In Puerto Rico alone, 570 people have been diagnosed with the virus, including 48 pregnant women, and late last week, the first Zika-related death occurred in the United States. These numbers are sure to grow, as we are still in the early phases of the outbreak. The Americans diagnosed to date have been infected through travel to affected countries or through sexual transmission. The virus is not yet spreading among local mosquitoes on the mainland, but it is expected to do so soon. Though the mosquitoes that carry the virus are not present everywhere, and the threat in not evenly distributed, cities like Miami, Houston, Dallas, Orlando, and New Orleans are expected to be hit the hardest. Why? Because they are home to the main vector, the Aedes Aegypti mosquito.
In terms of the science, the medical community is now certain of the connection between Zika and the debilitating brain defect that it causes in fetuses, called microcephaly. This is a severe defect that can prevent a child from ever walking or talking. Anne Schuchat, the principal deputy director of the Centers for Disease Control and Prevention (CDC), acknowledged the rapid development of the federal government’s knowledge base when she said in a press conference last month that Zika, is “scarier than we initially thought.”
The White House reacted by requesting $1.9 billion from Congress in early February to invest in developing a vaccine as rapidly as possible, monitoring the spread of the disease, enabling states and localities to eliminate mosquito breeding grounds, and educating residents about the threat of the virus in their communities. Congressional leaders suggested the Administration demonstrate they had skin in the game. The Administration did so by reprogramming dollars from the Public Health Emergency Preparedness (PHEP) grants, which go out to cities and states, and are meant to fund “on the ground” activities to prepare communities for potential terrorist attacks and outbreaks like Zika. One of the deepest cuts was in Florida, where Zika is expected to hit hardest. In addition, the Administration redirected money originally meant to fight the Ebola virus to the Zika response. However, this amounts to only a small portion of what is needed to address the new virus.
Now that the scientific evidence has mounted and the cases of Zika have increased, there should be more than enough information for Congress to act upon. The outstanding questions that remain should only be what’s the best funding vehicle and how quickly can we get dollars out to localities and states. While some movement has been made, particularly in the Senate, the House has been slower to act, with some suggesting providing the funding through the annual appropriations process, which, in a best case scenario, would provide new dollars on October 1, and more likely, sometime in 2017. This is problematic – mosquito season will be wrapping up by October, and many more Americans will already be infected. Allocating funds in the fall or winter is like planning to board up the windows months after the tornado’s already raged through the town. We can’t wait to act until we’re literally cleaning up the mess.
Upon their return from their communities, where everyone will be celebrating Mothers’ Day, Congress must prioritize addressing the Zika virus. Emergency dollars are needed to provide the resources necessary to protect our nation, and in particular pregnant women and their children, from this devastating infection.