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Officials detail Zika funding allocations, discuss ramifications of delayed funds

Officials on Monday outlined how they intend to allocate the $1.1 billion in Zika response funding approved last week, but they reiterated concerns about how long Congress took to pass the measure, the Los Angeles Times' "Science Now" reports (Healy, "Science Now," Los Angeles Times, 10/3).

Background

The Zika virus is not easily diagnosed, and it does not have a cure or vaccine. It is linked to microcephaly, a sometimes fatal anomaly in which a fetus develops an abnormally small head and brain. The virus is most commonly transmitted by a bite from an infected mosquito, but it can also be spread through sexual activity.

According to CDC, there have been 3,625 laboratory-confirmed cases of Zika in the United States as of Sept. 22, including 808 pregnant women. In U.S. territories, CDC said it has received reports of 22,069 cases of Zika, including 21,609 cases in Puerto Rico. According to the agency, the overall total of Zika cases in U.S. territories includes 1,490 cases involving pregnant women (Women's Health Policy Report, 10/4).

In February, the White House called for $1.8 billion to combat the virus (Women's Health Policy Report, 9/29). After several months of delay over provisions that would deny Planned Parenthood funds meant to increase contraceptive access, Congress last week passed and Obama signed a short-term spending bill that includes $1.1 billion in funds for Zika response efforts (Women's Health Policy Report, 10/4).

The legislation includes funding for research on a vaccine for the virus and allocations for health care services in affected regions. It also removes restrictions that would have blocked funding from being allocated to Planned Parenthood's partner organization in Puerto Rico, ProFamilias. The legislation authorizes the Centers for Medicare and Medicaid Services to allocate the funding via reimbursements for providers offering Zika-response services in the United States, while the Department of Health and Human Services (HHS) would be authorized to do so for health care providers in Puerto Rico. However, the funding remains subject to federal law, which currently restricts the use of federal money for almost all abortion care (Women's Health Policy Report, 9/29).

Officials detail funding allocations

Officials said the funds would be used to develop diagnostic tests, further vaccine research and aid mosquito control efforts at the state and local level (Muchmore, Modern Healthcare, 10/3).

Specifically, the Biomedical Advanced Research and Development Authority (BARDA) will receive $245 million to work on vaccine development. The National Institute of Allergy and Infectious Diseases (NIAID) will receive an additional $152 million, most of which will be used for vaccine development.

Another $394 million will be allocated to the Centers for Disease Control and Prevention (CDC), which intends to award $50 million in grants to fund collaborative partnerships between health organizations and universities working on prevention and response strategies for vector-borne diseases. CDC plans to allocate much of its remaining funds by December to states and localities to combat the virus. CDC Director Tom Frieden said, "In terms of the time frame, it will be as fast as government procurement allows," adding, "Most of the money will come ... in the coming couple of months" (Sun, "To Your Health," Washington Post, 10/3).

According to Frieden, some of the money also will be used to fund long-term research into how Zika affects infants exposed to the virus, including asymptomatic infants, after birth. He cited one study that is already underway in Colombia, which is monitoring 1,000 pregnant women and the infants they deliver.

Frieden said there were many unknowns about how infants exposed to the virus might be affected in the long term. "The biggest unknown in terms of the epidemiology is what will become of the infants born to mothers who don't have microcephaly at birth," he said.

Ramifications of delaying fund approval

According to "Science Now," federal officials also criticized Congress' delay on approving Zika response funds. Several months ago, HHS reallocated money from programs aimed at addressing malaria, tuberculosis and Ebola to Zika response efforts, including vaccine development, mosquito control efforts and diagnostic testing.

Officials noted that if Congress had approved funding earlier this year, researchers would be closer to developing a vaccine. Nicole Lurie, assistant HHS secretary for preparedness and response, said because of lawmakers' delay, some vaccine developers "walk[ed] away from negotiations with us because they weren't sure if the money was going to be there." She added, "We are behind where we should be on vaccine development and diagnostic test development" ("Science Now," Los Angeles Times, 10/3). Nonetheless, Lurie said HHS hopes to get "some of [the companies] ... back" ("To Your Health," Washington Post, 10/3).

NIAID Director Anthony Fauci said five potential vaccines are moving toward safety testing among human subjects, while BARDA is working on another four potential vaccines. However, Fauci cited the costs of using reallocated funding for vaccine development, noting, "The money that [HHS Secretary Sylvia Mathews] Burwell gave us from the other institutes, namely cancer, heart disease, diabetes and mental health, none of that money is going to come back" ("Science Now," Los Angeles Times, 10/3).

Burwell echoed those concerns, noting, "The damage that occurred because we took those funds will continue." She added that the time and energy spent on approving the funding could have been better used to determine how best to allocate the funding (Modern Healthcare, 10/3).

According to federal officials, the delay underscores the need for the United States to have an emergency fund in place to enable health officials to respond quickly to situations like the Zika outbreak ("Science Now," Los Angeles Times, 10/3).