Eight months after President Barack Obama requested emergency funding to support the US response to the Zika virus outbreak, Congress finally passed a $1.1 billion funding package. The funding, though welcome, is only about half of what the nation’s top health experts believe is needed to combat this new global health emergency.
During the months that Congress debated the merits of a Zika funding bill, the virus rapidly spread north from Latin America to multiple locations in Florida, throughout the Gulf Coast, and beyond. In the wake of Hurricane Matthew, the emergency response may become even greater if flooding and standing water interfere with mosquito-control efforts in Florida and other Gulf Coast states.
As CDC Director Dr. Thomas Frieden said in August, “What we know about Zika is scary. … But in some ways what we don’t know about Zika is even more unsettling.”
As infectious disease researchers who have seen the devastating impact on a baby’s brain of Zika infection acquired during pregnancy, we want you to know why additional funding is needed now. We and other experts worry about the long-term effects of the Zika virus on the brains and other organs of adults and children. In their race to understand this mysterious virus and end the epidemic, Zika researchers face several major challenges that cannot be adequately addressed with the current level of funding.
The first challenge is an urgent need for faster diagnostic tests and increased laboratory capacity. Because most adults who are infected do not develop symptoms, tracking the epidemic is difficult. Diagnostic tests are available to determine if a person has been infected, but testing laboratories are so backlogged that the wait for results is often a month or more. As a result, every pregnancy in areas with local Zika virus transmission, and all people living there, should be considered “at-risk.”
Second, lower-income Americans often lack access to family planning services. As a result, they may not be able to obtain contraceptives to prevent a possibly Zika-affected pregnancy. To prevent a surge of brain-damaged newborns, whose care is estimated to cost from $1 million to $10 million per child over a lifetime, it is essential that we fully fund family planning clinics serving this population. Preventing undesired pregnancy in the face of the Zika virus epidemic is not only a humanitarian issue but also a matter of national economic security.
Research we are doing at UW Medicine in Seattle suggests that a therapy to prevent fetal brain injury must either be a vaccine or a drug taken close to the time of exposure in order to effectively neutralize the virus. While we are glad that Congress has allocated money to vaccine efforts, it’s important to be realistic about the timeline for success. A typical vaccine takes years, if not decades, to develop, and there are unique challenges to creating a safe Zika virus vaccine that may complicate and delay development. For example, a vaccine for Zika’s cousin, dengue virus, is now 20 years in the making.
A more rapid solution could come from the development of antiviral compounds that we and others are testing. They have been shown to block infection by Zika-like viruses. But with the bulk of the congressional research funding focused on vaccine efforts, development of non-vaccine approaches to treat and control the infection is seriously underfunded.
Winning the war against Zika will require investments in public health and a broad research portfolio of solutions. The time is now for Congress to fully fund a multi-pronged response to this global health emergency.
Kristina Adams Waldorf, MD, is professor of obstetrics and gynecology at the University of Washington School of Medicine. Michael Gale Jr., PhD, is professor of immunology and global health at the University of Washington School of Medicine and director of the Center for Innate Immunity and Infectious Disease at UW Medicine/Seattle. Lakshmi Rajagopal, PhD, is associate professor of microbiology and global health at the University of Washington School of Medicine and Seattle Children’s Research Institute.
The funding logjam would probably disappear if the House and Senate finance committees were required to stay in session in a Zika infection zone until adequate funding is approved.