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Friday, October 20, 2017

As Congress continues to stall on funding Zika research, local health departments are bearing the brunt of their inaction.

Earlier this month, the Centers for Disease Control shifted $44 million of its federal funding towards research on the mosquito-borne disease after Congress failed to allocate any funds itself.

But since this money is normally funneled down to local health departments for emergency preparedness, city and statewide offices have lost critical funds they need in order to prevent the spread of Zika at the local level.

New York City, home to a confirmed 310 cases of the infectious disease, lost $1 million in emergency funds from the CDC — a number that deputy commissioner of emergency preparedness Marisa Raphael predicts could impact the city’s capacity to conduct lab testing as well as surveillance activities like tracking and interviewing Zika patients.

“It’s very painstaking, time-intensive work, but so critical for the ultimate goal of spreading disease,” she said in an interview. “You need people with that technical expertise to investigate outbreaks on any given day.”

Raphael added that the “highly problematic” cut could affect the department’s ability to sustain its existing Zika monitoring networks while also addressing the competing demands of other potential outbreaks.

House Republicans have repeatedly stalled a bipartisan Senate bill that sought to allocate $1.1 billion towards research on the virus. When the House passed another $1.1 billion plan in June, Senate Democrats objected to “poison pill” provisions that would have prohibited allocating funds to Planned Parenthood for fighting the virus, weakened pesticide restrictions, and, curiously, ended the ban on displaying Confederate flags in national cemeteries.

Louisiana, meanwhile, experienced a $700,000 slash in its CDC allocation — known officially as Public Health Emergency Preparedness, or PHEP. In past months, about a quarter of the state’s PHEP money has been used towards fighting the virus, through measures like a “Tip and Toss” campaign meant to keep mosquitoes out of residential areas.

Dr. Frank Welch, Louisiana’s medical director for community preparedness, said the reduction in funding means that the state’s already cash-strapped health department is struggling to fill empty positions.

“Before Zika, we were already really strapped with our ability to respond ourselves with boots on the ground,” Welch said. “When you’re already down to just a few and you can’t fill those positions you had before — when you’re down to nine instead of 11 — that’s really just a critical amount.”

While the private sector has taken up some work in treating cases, Welch explained that these medical providers tend to focus only on treating patients. Louisiana’s plan, on the other hand, looks to educate travelers returning from Zika-stricken countries and keep mosquitoes at bay in the state’s swampy terrain.

And when it comes to testing pregnant women twice for the virus—a federal recommendation—Welch said it would impossible for the Louisiana health department to carry out this measure on its own.

Dr. Oscar Alleyne, a senior adviser at the National Association of City & County Health Officials, conducted a survey in May that found the CDC reallocation would cause a majority of departments to lose between 5 and 10 percent of their funding. Survey respondents said that preparation measures, supplies, and staffing would be most adversely affected by the cuts.

“We’re still dealing with the fact that there hasn’t been any movement from the congressional side on providing necessary resources,” Alleyne said. “So that still maintains a degree of concerns.”

True to the survey, the Florida Health Department — which serves over half of the nine U.S. cities estimated to be at highest risk of an outbreak — lost over $2.3 million as a result of congressional inaction. It’s now unable to implement enhancements to its preparedness measures, a spokesperson said.

South Carolina, meanwhile, lost about seven percent of the budget for its Office of Public Health Preparedness, which is tasked with preparing for and responding to emerging infectious diseases like Zika, according to a spokesperson.

“You have infrastructure cuts and then you have to modify infrastructure to deal with the pending threat — which we are sure is not a matter of ‘when,’” Alleyne said. Mosquito season is now in full peak.

Some local health departments have received money to fight Zika from alternative sources: New York’s mayor, for instance, announced a three-year, multi-million dollar plan to address the virus. But Alleyne said that these amounts are “a drop in the bucket” compared to the $44 million that they have lost — not to mention the $1.1 billion in federal research funding.

For his part, Louisiana’s Welch said that the congressional stall shows that public health emergencies like Zika cannot wait for politicians to observe a threat and then fund it.

“Things like this will continue to happen,” he said. “We might be better served if we had a more global view, realized the importance beforehand, and funded it in a way where we were prepared.”

 

Photo: Aedes aegypti mosquitoes are seen inside Oxitec laboratory in Campinas, Brazil, February 2, 2016. REUTERS/Paulo Whitaker/File Photo

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