House action on Zika split on party lines, views of public health protection

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While the Zika virus freely crosses national boundaries and territorial lines alike, the U.S. Representatives stuck pretty much to party lines Wednesday, when more than three months after President Obama requested $1.9 billion to respond to the spread of the vector-borne disease and its impacts, they voted to supply less than a third of the amount, to come out of existing funding, and with strict limitations on spending, including on preventive measures. The measure requires both advance notice on specific spending, and requires all funds be used by the end of September.

Of the 241 Representatives voting for the measure, which the White House called woefully inadequate and had already promised to veto, all but three were Republicans. Of the 184 voting against the bill all but four were Democrats. Of those four, three — Ileana Ros-Lehtinen, Vernon Buchanan, and Carlos Curbelo, represent districts in Florida, the state with more Zika cases than any other. Rep. Justin Amash (R-Michigan) also voted against the bill.

Providing a total of $170 million for the CDC, and $230 million for the National Institutes of Health, allocations in the bill diverge radically from the request by the Obama Administration in February. That request outlined needs that included $600 million for domestic and international efforts by the U.S. Centers for Disease Prevention and Control for surveillance, mosquito control, outreach, workforce building, as well as support for the National Institutes of Health to track, and prevent vector-borne diseases including through vaccine development, and for efforts to test and monitor the health of pregnant women, and meet needs of increased Medicaid expenditures in Puerto Rico.

Within the funding for the CDC, the House measure allots a budget for maternal and child health in response to the virus of $50 million “only for the following activities related to patient care associated with the Zika virus: prenatal care, delivery care, postpartum care, newborn health assessments, and care for infants with special health care needs.” With approximately two of every three pregnancies are unintended in Puerto Rico, the U.S. territory hardest hit by the virus so far and where last week the birth of a baby with Zika-related microcephaly was confirmed, the unmet need for family planning there alone is considered high. Life-long costs of care and support for one child born with microcephaly  can run as high as $10 million, experts have said.

The measure extends restrictions under the fiscal 2016 omnibus to the Zika funding, prohibiting the use of funds to pay for abortions. Some health groups have urged the Obama administration to use its executive authority to grant exceptions for women who contracted Zika and fear giving birth to babies with microcephaly.

The announcement of the bill, earlier this week noted that “insects know no borders,” and for that reason, the bill provides $100 million for global health programs responding to Zika —  with existing funding. Local Zika transmission is ongoing in 46 countries that have never before experienced an outbreak. In 10 countries, person to person (sexual) transmission of the virus has taken place. More than 1400 babies have been born with apparently Zika related microcephaly across 10 countries,  with most — 1384 — in Brazil where the virus first began to spread widely in the Western Hemisphere, and two in the United States where the virus has yet to be transmitted locally. Zika-related cases of Guillain-Barre syndrome have been reported in 14 countries.

Accompanying the activity on Zika spending the House also revisited a measure introduced a year ago to suspend Clean Water Act provisions and allow use of pesticides in waterways, under the auspices of a “Zika Vector Control Act.” The measure, Rep. Jim McDermott (D-WA) told members, “does nothing about Zika, It doesn’t do anything with the research that the President has asked the money for. What it does simply is turn the applicators and the pesticide manufacturers loose on this country again.”

The measure failed to win sufficient votes to pass.

The House acted on Zika spending one day before a scheduled meeting of a World Health Organization emergency panel on the spread of Yellow Fever, which, following an outbreak in Angola’s capital city has appeared in China, Kenya, Rwanda and the Democratic Republic of Congo. Efforts to control Ebola in the three most affected West African Countries where transmission of the virus and reemergence among survivors has continued, remain challenged by a hobbled health workforce and undeveloped health infrastructure.

While all of the funding allotted in the House bill would come from existing funds, including that targeting health system strengthening in other countries, neither the House measure, or the one set to be approved by the Senate allows a return of funding borrowed from Ebola allocations.  It remains to be seen, in any case, how the House and Senate bill, which met most of the President’s request — except the amount already taken from existing Ebola and public health resources — can be reconciled.


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