There’s a thing that happens with infectious diseases, public health crises, and the United States. When they originate in the Global South, the country doesn’t pay much attention — until it thinks that an epidemic might hit US soil, jumping from the bodies of people who are deemed lesser to the bodies of the electorate in the United States. See the delays, for example, on funding for Ebola, where the global community stood by unconscionably long as the WHO and health agencies begged for funding to halt the virus. And see how quickly the scene changed when a handful of Ebola cases cropped up in the United States.
When cases of Zika began appearing, the United States took notice in a rather lethargic way, primarily deeming it a problem of South America’s, not ours. That began to shift, though, as the public realised that those going to the Summer Olympics could be affected, and as Zika crept further and further up into the United States. Infected mosquitos took advantage of warming weather and standing water to move across the border, and suddenly the public wanted action, especially with the CDC documenting a growing number of cases in pregnant women.
Public health officials, of course, had been addressing the Zika problem for months. They’d also been begging for funding — not just on the global level, addressing the intrinsic need to protect public health, but also because infectious disease does not respect national borders. Preparing allows nations to be ready when viruses do hit, to have the framework in place for dealing with them. That includes preventative care, mosquito control measures, treatment protocols, and fast-tracked vaccination research. To do that, though, agencies like the CDC need money.
The Obama Administration turned to Congress, which holds the purse strings, to request that money. Thanks to the structure of the Constitution, we ask Congress to write an annual budget and decide how our funds should be allocated. And what happened next highlighted the problems within Congress, as Congressional Republicans decided to turn Zika funding into yet another political football, rather than firmly dedicating funds to a public health issue as quickly as possible. Republican obstructionism has become more and more severe in the last eight years, from blocking Supreme Court nominations to obstinately refusing to consider legislative issues, and this is just the latest example.
The thing is that while people in Washington play games, real lives are at stake. Every day that went by without adequate funding left public health officials more vulnerable, and the health of the public at risk. Viruses can move swiftly through a population that isn’t ready for them. Should agencies be unprepared, of course, Congressional Republicans will be quick to blame ‘big government’ and complain that the CDC ‘did nothing’ to stop the spread of the virus, even though they’re the ones to blame for the fact that the CDC and other agencies couldn’t do anything.
It’s a brilliant scheme: They can refuse to provide funding, thereby looking good for the party and constituents who like to scream and moan about Washington elites. Then, when agencies fail or lag behind because they don’t have enough money to do their jobs, Republicans can point at them and say ‘see?!’ Of course, what this neatly ignores is the lives of the people affected by such grandstanding. Real people got sick with Zika and real people will experience health complications, including neurological illnesses and foetal anomalies. But those people don’t matter in the eyes of Congress.
With Democrats and Republicans sparring over funding availability, public health grew more and more at risk. Members of the public, now convinced that Zika was waiting around every corner thanks to media scaremongering and ominous maps on CNN, agitated more and more for someone somewhere to do something, but the agencies in a position to do that were helpless. Instead of educating people and creating lines of defense, they had to sit by and watch, scraping out funds here and there in a valiant attempt to have some kind of plan in place.
The thing with new and poorly understood viruses is that we don’t just need funding to address immediate public health problems, although we do. We need funds for mosquito control, prevention, screening, treatment, and short-term issues that are not being addressed. But we also need to have access to research funding to learn more about where Zika came from, what it is, how it works, how it acts in the body. We need funding to develop an effective vaccine, and to determine if we can develop medications that might counteract its neurological and developmental effects. These kinds of things take massive amounts of money and collaboration, something not available in a country where a petulant Congress thinks it’s fun to play games with people’s lives.
In the US, patients enjoy a number of privileges, with a robust health system for wealthy residents and a lot more access to care. The country could be pioneering Zika research and treatment, and it should be, not just for its residents but for the world at large. Developing a line of attack in the US helps us, but it also helps in the Global South, which has fewer resources, but also has populations who deserve access to good health care. And, for the self-interested, addressing Zika in the Global South can prevent future spread and reinfection.
Public health is a complex subject and many constituents don’t understand all of its ramifications. They repeatedly see what happens when the government refuses to engage with it, though — HIV/AIDS being perhaps the most striking example — and yet they don’t listen to public health officials when they attempt to articulate the nature of a problem and why they need funding. Zika isn’t going to magically vanish, leaving no health effects behind. We need to take it on, because this won’t be the only outbreak.
Image: Mosquito, Macroscopic Solutions, Flickr