The co-chairs of the Blue Ribbon Study Panel on Biodefense applauded action by Congress to reach a compromise on Zika funding – which took more than eight months to het pushed through Senate Democrats after the White House first asked for supplemental funding — but reasserted its desire to seek a total shift in how the US budgets for infectious disease crises moving forward.
“The compromise hammered out in Congress this week is at a reasonable funding level, and it is our hope that it will be used to put in place both prevention and response measures that will minimize local transmission of the Zika virus in the United States,” said panel Co-Chair Sen. Joseph Lieberman. “However, the members of the Blue Ribbon Study Panel remain concerned that we continue to operate on a slow, reactionary basis for quickly moving public health threats.”
“We’ve seen this before with the Ebola outbreak,” added Co-Chair Gov. Tom Ridge. “As is articulated in our National Blueprint report, we need a total shift in how we budget for infectious diseases crises, one that incorporates smart advance budgeting and a much greater focus on prevention and preparedness. Only then will we be prepared as a nation to deal with such threats.”
Richard Hamburg, interim president and CEO of Trust for America’s Health (TFAH), said in a statement, “TFAH is encouraged and grateful Congress approved emergency funding to respond to the Zika virus outbreak.”
This critical funding, first requested by the White House in February, will help bolster public health detection and prevention efforts, invest in research and development of vaccines and diagnostics, provide care for mothers and children and support the global health response,” Hamburg said.
Hamburg added that, “While we are satisfied this was the best compromise Congress could achieve at this time, the funding has been direly needed for months and is still less than the President’s request. In addition, these measures fail to repay funds that were redirected from our nation’s ongoing Ebola response initiatives—hurting efforts to prevent a resurgence of that devastating and highly infectious disease.”
We are by no means at the finish line in the race to prevent the devastating consequences of Zika,” Hamburg stressed, noting that, “Every day we learn something new about the impacts of this virus, especially on fetal brain development. The list of what we do not know about the transmission and aftereffects of the virus remains long and the delay in funding has hindered critical research efforts.”
“At the same time,” he concluded, “we know the Zika outbreak is the latest, not the last threat. Zika emerged following years of funding cuts to vector-borne disease surveillance and other programs that support core public health preparedness functions.”
“For years, the nation has relied on a cycle of providing emergency funds during a time of crisis followed by cuts to annual funding lines – which result in lost public health capacity and expertise, making it near impossible to be prepared for the full range of public health threats,” TFAH said.”
“Sadly,” TFAH said, “with each new crisis, we seemingly rediscover that we have failed to learn our lessons from past outbreaks. It’s up to policymakers to support children, parents and families by providing public health with dedicated funding and a responsible long-term plan.
TFAH said, “We call on Congress to maintain a strong and steady defense against a range of threats—and back this with adequate resources.”
In a September 26 report, TFAH said, “History is littered with examples of devastating infectious disease outbreaks—from the Black Plague to the Spanish Flu to HIV/AIDs to Ebola to Zika.
“Unlike centuries ago, however, we now havethe capabilities required to detect, prevent and treat most diseases—making our own commitment to preparedness the difference between a deadly catastrophic outbreak and a smaller scale one.
“Also, unlike centuries ago, today’s speed and frequency of international travel is making infectious disease threats more acute than ever before. Recently we saw how Ebola moved between nations and we’re seeing the same thing with Zika this year.
“And, at the same time, climate change is likely to increase threats from infectious diseases, especially those caused by mosquitos. We’ve seen this in the United States with chikungunya, dengue and other more tropical diseases growing in numbers.”
“In reality,” TFAH said, “there are many ways organisms carrying diseases can reach US shores and the rate and speed at which people and diseases travel from region to region will not be slowing down. It is beyond time that we give those charged with public health preparedness the resources to keep up and prevent epidemics.”
TFAH said, “Fighting infectious disease requires constant vigilance. Policies and resources must be in place to allow scientists and public health and medical experts to have the tools they need to: control ongoing outbreaks — such as HIV/AIDS, antibiotic-resistant superbugs and foodborne illnesses; detect new or reemerging outbreaks — such as Zika, MERS-CoV, measles and avian flu; and monitor for potential bioterrorist threats — such as anthrax or smallpox.”
TFAH further noted that, “Protecting the country from infectious disease threats is a fundamental role of government, and all Americans have the right to basic protections no matter where they live. While government is only one partner in the fight against infectious diseases — along with the healthcare sector; researchers and academia; pharmaceutical, medical supply and technology companies; community groups, schools and employers; and families and individuals — government at all levels has the ability to provide resources, set policies and establish practices based on the best science available.”
TFAH emphasized that, “It is beyond time that the nation ramp up our infectious disease prevention and response efforts. We can do so by:
- Increasing and maintaining resources over time to ensure every state can maintain and modernize basic capabilities – such as epidemiology and laboratory abilities – that are needed to prevent and respond to new and ongoing outbreaks, rather than ramping up and then cutting public health funding;
- Updating disease surveillance to be real-time and interoperable across communities and health systems to better detect, track and contain disease threats;
- Incentivizing the development of new medicines and vaccines, improving the framework for rapid, effective research and development, and ensuring systems are in place to effectively distribute products when needed;
- Decreasing antibiotic overuse and increasing vaccination rates;
- Improving and maintaining the ability of the health system to be prepared for a range of potential threats – such as an influx of patients during a widespread outbreak or the containment of a novel, highly infectious organism that requires specialty care – as well as improving basic infection control in healthcare;
- Supporting a rapid emergency response fund to bridge the gap between first detection of a potential threat and supplemental funding, thereby jumpstarting public health preparations and scientific research;
- Strengthening efforts and policies to reduce healthcare-associated infections; and
- Taking strong measures to develop resilience within communities.
“Whether it is preventing chronic illnesses, which account for seven out of 10 deaths in the United States, or strengthening national defenses against disease outbreaks, our focus should be on preventing illness, rather than accepting illness as inevitable,” TFAH said, pointing out that by, “Doing so will require a strong, effective, and responsive public health system. It’s up to policymakers to support public health with dedicated funding and a responsible long-term plan. In so doing, we can ensure that—whether it is Zika, Ebola, the flu or the everyday management of chronic disease—the United States is prepared for whatever comes next.”
Sen. Thad Cochran (R-Miss.), chairman of the Senate Committee on Appropriations, said the Senate’s final passage of the long stalled Senate passage of Zika funding finally “provides [for] the public health threat from the Zika virus.”
The legislation provides Fiscal Year 2016 supplemental appropriations to the Department of Health and Human Services (HHS), the Department of State and the United States Agency for International Development (USAID) to prevent, prepare for and respond to the Zika virus, health conditions related to the virus and other vector-borne diseases, domestically and internationally.
It also designates the funds as an emergency requirement under the Balanced Budget and Emergency Deficit Control Act of 1985 and permits the funds to remain available through FY 2017. Emergency funds are exempt from discretionary spending limits and other budget enforcement procedures.
The legislation provides:
- Appropriations to the Centers for Disease Control and Prevention for CDC-wide activities and program support;
- Apropriations to the National Institutes for the Health for the National Institute of Allergy and Infectious Diseases;
- Appropriations to the Office of the Secretary for the Public Health and Social Services Emergency Fund.
- Permits HHS, State Department and USAID to use funds to appoint candidates for positions to perform critical work relating to the Zika response, without regard to specified requirements regarding hiring preferences if: public notice has been given and HHS has determined that a public health threat exists.
- Permits funds … to be transferred between specified HHS accounts if certain requirements are met.
- Requires HHS to submit to Congress a detailed spending plan for funds.
- Funding to the HHS Office of Inspector General and the Government Accountability Office for the oversight of activities funded by the legislation.
- Appropriations to the State Department to support response efforts related to the Zika virus and related health outcomes, other vector-borne diseases or other infectious diseases.
- Appropriations for the Administration of Foreign Affairs, including: Diplomatic and Consular Programs, Emergencies in the Diplomatic and Consular Service and the Repatriation Loans Program Account.
- Appropriations to the USAID for Operating Expenses.
- Provides appropriations for Bilateral Economic Assistance for Global Health Programs.
However, the legislation, “Permits funds … to be transferred between specified accounts and sets forth requirements and restrictions for the transfers,” and, “Prohibits funds provided … to respond to the Zika virus outbreak, other vector-borne diseases or other infectious diseases from being obligated unless the State Department or USAID notifies Congress 15 days in advance of the obligation.”
It also, “Requires the State Department and USAID to submit to Congress, prior to obligating funds … a consolidated report on the anticipated uses of such funds on a country and project basis, including estimated personnel and administrative costs."