Sunday, April 17, 2016

Robbing Ebola to Pay Zika: Are you cool with that?

Summary of the response to Zika virus in 2016 from the scientific community, World Health Organization, U.S. National Institutes of Health, U.S. Centers for Disease Control and Prevention, U.S. President, and U.S. Congress.

This here is Aedes aegypti.

Or just a mosquito, as many would see it.

Actually it is one of over 3,500 different types of mosquitos that exist around the world. It is in the news right now because it is known to transmit the Zika virus, and it lives in South and North America. It wasn’t always in the Americas – it was native to Africa. But it immigrated its way across the Altantic some time ago. It is now migrating northward into the United States. So far, more than half of the 50 states have this mosquito in them. Anywhere this mosquito is found, there is potential for Zika virus to spread (among other diseases).

The Zika virus was first reported in 1952. We still don’t know very much about it. But here are a few things we have learned about it since the World Health Organization declared it a "public health emergency" on February 1 this year.

Zika virus can be transmitted sexually, from men to women or between men.

Zika virus can be transmitted in utero, from pregnant women to the fetus.

Zika virus can infect brain cells during early development.

Zika virus can cause microcephaly and other brain disorders in affected infants.

Zika virus can cause eye problems or blindness in affected infants.

Zika virus can retard or abolish fetal development.

Zika virus can cause miscarriage or prematurity.

Infants are susceptible if the mother is infected by Zika virus during the first or second trimester of pregnancy.

Zika virus can cause autoimmune disorders including acute disseminated encephalomyelitis (ADEM) and Guillain-Barre syndrome in adults.

This is quite alarming, particularly if you are a woman who is pregnant, or planning to become pregnant soon. And it raises many more questions that do not yet have answers.

But as we learned from past epidemics like SARS and Ebola, the best way to stop a public health emergency is to nip it in the bud. This is also the most economical way, because an emergency response can cost a lot of money. But how much?

On February 15, the World Health Organization (WHO) requested $56 million in funding from its member nations (including the U.S.) to coordinate a detailed emergency response plan.

One week later, President Obama requested 1.9 billion from Congress to fund surveillance, prevention, vaccine development, foreign aid, and domestic aid to the U.S. territory Puerto Rico. The Caribbean island is in the midst of a debt crisis, and does not have the infrastructure or the resources needed to implement an effective mosquito control program. Incidentally, it has become a hotbed for the spread of Zika.

This is a section of El Yunque National Forest in Puerto Rico that I photographed while hiking there in 2015. Like much of the infrastructure elsewhere in Puerto Rico, many ramadas and other features of the park are no longer maintained due to the economic downturn (it is still a beautiful park). Evacuated buildings and unmaintained land are left to rot and become breeding grounds for mosquitoes.
The U.S. Congress has so far declined to act on the funding request due to a lack of support from the Republican majority, with the exception of Florida senator Marco Rubio. Instead, Congress directed the President to divert the funds that were allocated for the Ebola response at the end of 2014. Those funds originally amounted to $5.4 billion and were intended to be used in various ways over a 5-year period.

Although Ebola is no longer considered a global health emergency, it is still a concern in West Africa. Outbreaks continue to occur in some regions there, just like they did before 2014 when Ebola wasn’t a buzzword and the WHO allegedly wasn’t responding quickly enough to prevent it from spreading.

As per the suggestion (or demands) of Congress, on April 6 the White House announced it would pull $510 million from Ebola funding and scrape together another  $79 million from other sources in order to mount an immediate $589 million response to the Zika virus.  

This amounts to less than a third of the $1.9 billion originally requested by the President. Will it be sufficient? According to the U.S. Centers for Disease Control and Prevention, and National Institutes of Health, the answer is No.

Meanwhile, as of March 22, the WHO has only received $3 million of the $56 million it is seeking to confront the spread of Zika virus before this summer when the 2016 Summer Olympic Games will take place in Rio de Janeiro Brazil. About 500,000 spectators and athletes from around the world are expected to attend. So far this year, 91,387 cases of Zika have been reported in Brazil, and 35,505 of those were in Rio.

Are you cool with that?

If not, you can let Congress know here.
A mosquito advisory in Puerto Rico from early 2015 - before Zika would have been added to the list.