The Zika Fight of 2017

By Chrissie Juliano, Director of the Big Cities Health Coalition

Last year’s high profile infectious disease outbreak of the Zika virus is still fresh in our minds. While official announcements last week told Americans that the outbreak is waning in the U.S., all of the same conditions that created a Zika emergency last year are still present today. And just like then, the consequences of inaction are very real for those at risk, especially pregnant women and their babies. Unlike last year, we are also dealing with an Administration proposing an absurdly large –$1.2 billion – cut to the U.S. Centers for Disease Control and Prevention’s (CDC) budget in a way that would severely hamper its ability to fight, not to mention prevent, disease.

Last year the virus spread to at least 58 countries and territories, and local outbreaks occurred in Puerto Rico, the U.S. Virgin Islands, American Samoa, Florida, and Texas. Zika preparedness and response activities, however, were not simply confined to states where the Aedes Egypti mosquito (the host of the disease) is present. Travel to and from places where the mosquito is common also helped to spread the disease, and those localities and states through which travelers entered were called into action as well. Pregnant women infected with Zika virus due to travel were identified in 44 states.

A recent CDC report found that one in 10 pregnant women with Zika gave birth to a child with serious birth defects. Another CDC study found that a Zika infection increased the chances of delivering a baby with certain birth defects 20-fold. This virus has, and will continue to have, long lasting effects.

We must remember that the stakes for getting the prevention and response activities right are very high. Last year in the U.S., 77 Zika babies died in the womb, while 51 babies were born with Zika-related birth defects. Beyond the loss of life and the toll on families, the fiscal damage caused by these cases is also enormous: the care for each child born with Zika birth defects will cost an estimated $10 million during their lifetime.

After a year of learning hard lessons about this virus, we must ask ourselves, “Are we ready for another round of the Zika virus?” The answer is unfortunately no. Federal Zika funding was slow to arrive the first time and is running out soon.  In 2016, states and localities fought the virus largely with their own scarce resources for 233 days before the federal government appropriated “emergency” dollars. Although the Obama Administration requested Zika funding in February 2016, Congress did not approve the $1.1 billion Zika funding package until September, at the tail end of what is known in many parts of the U.S. as “mosquito season.” (It should be noted that in some states and localities mosquito season lasts much of the year.)

This funding was crucial to stopping the spread of the disease and focusing resources on those already affected. Local health departments used the funds to track Zika-associated birth defects, educate women and doctors about the virus, and follow up with families of Zika babies after their birth.  To find out more about how one local health department used the funds in its community, read this blog by Boston Public Health Commission’s Executive Director, Monica Valdes Lupi. 

The dollars that CDC provided, which funded crucial programs like the creation of a birth defect registry, will start running out in July, and much of the targeted funding will be gone by the end of September. The uncertainty of whether, and how much, additional funding will be provided by the Congress makes it incredibly difficult for health officials to make hiring decisions, prepare for a wave of infections, or to provide services for babies with Zika-related birth-defects.

Zika resources were funded as a one-time, one-year investment, like so many other governmental public health efforts. Instead of operating in this way, Congress needs to think ahead and follow the lead of many American families who set aside funds in case of an emergency. The American people – and the first responders who serve them – should not have to wait 233 days for the federal government to respond if Zika – or any other disease – strikes again. The time to plan for the next outbreak is right now.