For Emerging and Continued Threats Supplemental is Good, but Sustained is Better. . .

Those of you tracking what’s in the President’s FY2017 budget may have overlooked the Administration’s request for $1.8 billion in emergency supplemental funding dedicated to “preparing for and responding to the Zika virus at home and abroad.”

The scope of this public health problem has grown significantly over the past few months. Today’s headlines on this have reached alarming heights, ranging from “The Zika virus may actually be worse than we thought” to “$1.8 billion to fight Zika: CDC moves to highest alert level,” to “Hope Solo would boycott Olympics over Zika pregnancy fear.”

With Zika identified in 13 states and DC as well as China, the fear is not going to subside. The panic will only grow. So what is the Administration proposing? What is the public health system doing?

Of the $1.8 billion requested, $1.48 billion would go to the Department of Health and Human Services. Of that $1.48 billion, the bulk of it–$828 million–would be allocated to the CDC for prevention and response activities; $250 million is for CMS to ensure that those pregnant women covered by Medicaid in Puerto Rico have access to health services if they are at risk of infection or diagnosed with Zika, as well as for children at greater risk; $200 million would go to the NIH for vaccine research as well as diagnostic development and procurement; and the remaining $210 million is to establish an “Urgent and Emerging Threat Fund” that specifically addresses Zika.

Outside HHS, money would go to the US Agency for International Development for mosquito control and transmission activities, maternal health and education on prevention in other countries, while $41 million would lend support for US citizens in affected countries via the State Department.

Congress may move quickly to respond to this request given its emergent nature. CQ has reported that appropriators will work first on this in a bipartisan manner, although not without potential controversy surrounding abortion services.

Public health surveillance and prevention are essential services of the federal government. One thing that many of CRD’s clients have urged Congress and the Administration to consider is the need for continued funding for these types of activities – regardless of the actual public health threat. The Council of State and Territorial Epidemiologists’ statement on the issue can be found here, while the Society for Maternal-Fetal Medicine has urged Congress to consider the bigger picture. As new threats emerge and others continue, there should be activities that are underway to address them regardless of the specificities of that threat. As Congress shoulders its way through the appropriations process, we’ll all be keeping tabs, and making the argument that while immediate priority needs to be given to Zika, beyond that, we need to have our arsenal ready to fight these types of threats.

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