House, Senate bills show widely divergent views of time, money needed for Zika, future threats

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Draft of a House bill that would provide roughly a third of the amount requested by the Obama Administration in February for an emergency response to the spread of the Zika virus.

//UPDATE: SENATORS MOVED TOWARDS APPROVING A ZIKA FUNDING PLAN THAT WILL PROVIDE $1.1 BILLION FOR PUBLIC HEALTH AND RESEARCH ADDRESSING THE SPREAD OF THE VIRUS AND ITS EFFECTS.

THE PLAN REPLACES SOME BUT NOT ALL OF THE FUNDING ADVANCED EARLIER, AND DOES NOT REQUIRE CUTS TO OTHER PUBLIC HEALTH PROGRAMS

AN INITIAL VOTE FOUND SENATORS  68-29 IN FAVOR OF PLAN, WITH BIPARTISAN SUPPORT. A FINAL VOTE IS EXPECTED THIS WEEK. THE HOUSE IS EXPECTED TO ACT LATER THIS WEEK ON THE BILL INTRODUCED THERE OFFERING A THIRD OF FUNDING WITH TIMING AND USE LIMITS//

What does it take to confront a shape-shifting, fast-moving, unpredictable infectious health threat that, in its latest form, continues to spread among large populations and demonstrate increasingly dire consequences? This has been the question legislators have apparently pondered since February, when the World Health Organization declared the spread of the Zika virus with accompanying rising rates of neurological birth defects and crippling disorders an international public health emergency and President Obama asked for $1.9 billion to respond to it.

It is also a question that had come up a little more than a year earlier when the West Africa Ebola crisis reversed course following an infusion of emergency funds, but then lingered, with unanticipated continued infections, health impacts and a decimated health workforce continuing to require support.

In the time since the President’s request, some answers to questions surrounding Zika and the response necessary to fight it have surfaced, including with confirmations that it is a cause of microcephaly, and that a Zika-related case of the birth defect in Puerto Rico is the first to result from the spread of the virus in a U.S. territory.

But with no answer yet to the President’s request, and the diversion of $589 million in funding for continued Ebola and other public health responses in the meantime for immediate Zika responses, four proposals being considered this week put forth very different views of the present and future of public health protection.

The Senate considers three of those today, one providing the full funding requested by the White House, and two omitting the funding already diverted, with one of those also diverting money from future public health readiness. The fourth came in a House bill released by Rep. Hal Rogers (R-Ky) Monday offering about one third of the Administration’s request and with restrictions that would simultaneously both delay and necessitate speed in using the money.

Physicians and medical associations, health coalitions and nonprofits, and groups fighting birth defects, including the March of Dimes are urging support for “at least $1.1 billion and ideally the President’s full request of $1.9 billion.”

That would be the bipartisan proposal put forth by Florida (right now home to more cases of Zika than any other state) Senators Bill Nelson and Marco Rubio that answers the President’s request in full. That proposal, as outlined months earlier by the Administration, would provide funding that would include roughly $600 billion for domestic and international efforts by the U.S. Centers for Disease Prevention and Control for surveillance, mosquito control, outreach, workforce building, support the National Institutes of Health to track, and prevent vector-borne diseases including through vaccine development, test and monitor the health of pregnant women, and meet needs of increased Medicaid expenditures in Puerto Rico.

In their letter to Senators last week pointing out that the expense of a further delayed response greatly exceeds the amount proposed in that bill, and includes the projected millions of dollars that would be needed for support and services for each child born with microcephaly, signers also urge Senators to oppose efforts to divert funding from other health responses. While the bill proposed by Senator Roy Blunt (R-Mo) that would not replace the money already diverted from Ebola responses, a proposal by Republican Sen. John Cornyn of Texas (a state also confronting high risks of locally transmitted Zika in the coming summer months) would not replace that funding and also would divert the entire amount provided from Department of Health and Human Services programming for public health preparedness.

What the Senate decides among these three approaches to current and future health threats will offer a divergent approach in any case from the one proposal currently offered to House members. That draft bill, announced Monday, would provide less than a third of the funding for the CDC, restrict the availability of funding for studies at the NIH, and allow no funding for family planning and other preventive health measures. The House bill also stipulates that while the specific use of all funding must be approved in advance, all funds must be spent by Sept. 30, restrictions, medical associations and other of the above-mentioned groups say, “places unwarranted and counterproductive constraints on its use.”

Stay tuned. The Senate is expected to choose its response to Zika this afternoon.

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