Senate passes Zika funds as groups brace for readiness cuts

Capitol Hill
Capitol Hill

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The US Senate yesterday passed a $1.1 billion compromise measure to fund the Zika virus response, with the House expected to vote on a much smaller $622 million package this week that President Barack Obama has said he will veto because it is too small and diverts funds from Ebola activities.

In other new Zika developments, public health groups said a federal funding shift to keep key Zika response steps moving forward shrinks state preparedness resources at a time when they need to gear up to handle Zika virus.

And the World Health Organization (WHO) today issued a risk assessment for Europe, emphasizing areas likely to see disease spread and urging that groups and individuals take steps to prepare.

Senate OK's $1.1 billion, House offers much less

Senators yesterday approved an amendment to provide $1.1 billion in emergency funding for mosquito control, public education, and vaccine development. The amount is below the $1.9 billion that Obama had originally requested back in February.

The amendment passed yesterday will be attached to two unrelated spending bills that still require final passage, USA Today reported.

Meanwhile, on May 16, House appropriations chair Rep. Hal Rogers, R-Ky., introduced legislation for the full House to consider this week, that would provide $622.1 million to federal agencies to cover the response over the next 5 months, according to an appropriations committee statement. It said the amount is funded by offsets in existing funds and $352.1 million in unspent resources that have already been approved for the Ebola response.

The committee said its legislation is intended to control spending, and it knocked Obama's request for allowing broad authority for federal agencies to spend the resources on a variety of programs without oversight.

The proposed House bill includes $170 million for the Centers for Disease Control and Prevention (CDC), $230 million for the National Institutes of Health for vaccine developments, $103 million to the Biomedical Advanced Research and Development Authority (BARDA) for the development of tests and vaccines, and $119 million for the US Agency for International Development (USAID) for mosquito control activities. The House measure also factors in $2 million for oversight and reporting on the use of the funds.

Rogers criticized the Obama administration for not giving House members enough specifics on Zika funding needs. "Given the severity of the Zika crisis and the global health threat, we cannot afford to wait on the Administration any longer. We have made our own funding determinations, using what information is available and through discussions with federal agencies, to craft a proposal to fight the spread of this damaging disease," he said in the statement.

At a White House press briefing yesterday, press secretary Josh Earnest said the administration has several concerns about the House bill, the first that it is "woefully insufficient" in the face of the threat posed by Zika virus—an assessment he said is shared by Obama's public health advisors.

Congress, specifically the House, is 3 months late and $1 billion short of doing what's needed to protect the American people, he said.

Earnest said the Administration's other major concern about the House bill is that it would take away from Ebola resources. The CDC still has 100 experts on the ground in West Africa, who are helping process 10,000 samples each month in the three outbreak counties to help quickly spot any disease recurrence.

"So it is a bad idea for Republicans to move forward with a proposal that would gut our efforts to follow through in the fight against Ebola and it's a bad idea for Republicans to further delay the emergency funding that's necessary to protect the American people from the Zika virus," he said.

Impact of redirected preparedness funds

In other fallout from slow-to-come and uncertain Zika funding approval in Congress, four major public health organizations this week published the results of a survey to gauge the expected impact of $44.2 million in funding that the CDC has directed away from the Public Health Emergency Preparedness (PHEP) grant program to fund national Zika response efforts.

The groups warned that the loss of funds erodes their resources at a time when they need to effectively respond to Zika virus. They include the National Association of County and City Health Officials (NACCHO), the Association of State and Territorial Health Officials (ASTHO), the Council of State and Territorial Epidemiologists (CSTE), and the Association of Public Health Laboratories (APHL).

The results are based on an electronic survey of a random sample of emergency preparedness coordinators; 349 surveys were completed, 94% from groups that receive PHEP funding.  Preliminary findings were that although the impact is still uncertain, 55% know if and how their PHEP funding will be affected, with about two-thirds expecting a cut of at least 1% to 10%.

Nearly half expected reduced staffing capacity, and about 50% expected the cuts to have some or a significant impact on their jurisdiction's ability to prepare for and respond to Zika virus and other emergencies.

Administered by the CDC, PHEP cooperative agreements support preparedness of state, local, and territorial health systems, as well as four metropolitan health departments. In early April the Obama Administration announced it would temporarily shift $589 million, most of it from Ebola funding, toward critical activities such as mosquito control, building lab capacity, and developing tests and vaccines. The move prompted a warning from Senate Democrats that the shift would result in a 9% loss in federal preparedness money to states.

WHO calls Europe's risk low to moderate

Elsewhere, the risk of Zika virus to the European region over the spring and summer months is low to moderate but is highest in limited areas where the Aedes aegypti mosquito is found, the WHO said today.

If no steps are taken to reduce the transmission, the threat is moderate in 18 countries where A albopictus mosquitoes are found and high on the island of Madeira and on the northeastern coast of the Black Sea where A aegypti—the main driver of Zika transmission—is found. That area includes Black Sea coastal areas of Georgia and Russia.

In its assessment of mosquito control in the region, the WHO said a survey of countries revealed that 79% have good or very good capacity, though the data revealed substantial variation among countries.

Along with its assessment, the WHO included a list of recommendations for countries facing moderate or high threat. They include strengthening mosquito control activities to reduce density, giving healthcare workers the tools to quickly identify Zika infections, making sure testing systems and protocols are in place, encouraging the public to reduce mosquito breeding sites, and arming those at risk—especially pregnant women—with the information they need to protect themselves.

Other developments

  • Belize reported its first local Zika virus infection, according to a May 16 statement from the country's health ministry. The patient is from Belize district and is a citizen of the country. The illness was detected during heightened surveillance for Zika virus, and the sample was confirmed by the Caribbean Public Health Agency. Further investigation is under way, and the ministry said several actions have been taken to contain the threat.

  • Inovio announced that a preclinical trial of its DNA-based Zika virus campaign prompted robust antibody and T-cell responses in monkeys, the company said in a May 16 statement. After two doses were given either intramuscularly or intradermally, detectable antibodies were found in all the animals. The company said it expects to launch its first human trial of the vaccine by the end of 2016. In February Inovio reported promising findings for the vaccine in mice.

See also:

May 18 USA Today report

May 16 House appropriations committee statement

May 17 White House press briefing transcript

May 16 NACCHO, ASTHO, CSTE, APHL impact assessment on PHEP funding redirection

May 18 WHO statement and risk assessment

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