The ongoing issues related to the prevention, diagnosis and treatment of the Zika virus are still emerging, however the policy implications have certainly taken shape. The President’s recent budget includes an $1.8 billion request from Congress to respond to the Zika virus, which is a mosquito-borne illness discovered in Uganda in 1947 but has since spread across Asia and to the Americas. Recent outbreaks of Zika in pregnant women have been found to be linked to very serious health conditions such as microcephaly (a birth defect resulting in tiny heads) and Guillain-Barre Syndrome (an immune-mediated neurologic condition). The virus has been declared a pandemic which according to the World Health Organization refers to the worldwide spread of a disease. There is no vaccine and no treatment for Zika; only an antibody test to find out if you have it, which is far from perfect.
The implications of Zika in the United States are still unfolding; while there might have seemed like an increased succession of potentially deadly viruses over the past decade (H1N1/Avian Influenza, Chikungunya, Ebola), the policy response is complex: overshooting the response results in potentially wasted dollars and misaligned resources. But underestimating the need is not only a health crisis, but potentially even more expensive as resources usually need to be marshaled quickly and with little planning. The current budget request proposes money across many of the agencies which deal with healthcare as well as the State Department, given the global implications of the pandemic and worldwide scale of the virus.
From a policy perspective, there are still so many unknowns, but it is helpful to try to focus on three key areas and understand how we can learn from past epidemics/pandemics to best inform the unfolding Zika pandemic.
Vaccine Development: There is currently no advanced vaccine for Zika in development. This stands in contrast to the Ebola virus which had several vaccines in the pipeline when it reached pandemic status and a funding mechanism in place through the National Institutes of Health and other global agencies, along with private-sector life sciences companies. The population of interest is pregnant women which makes vaccine development even more complicated (since a live vaccine is usually contraindicated in pregnant women). Developing a live or inactive vaccine for the Zika virus might take as long as 10 years but the declaration of the pandemic and the White House request for funding will be geared towards accelerating that timeframe; perhaps the best place to draw upon policy lessons might be from how best to build on efforts across other countries’ investments; our dollars in research alone, in synergy with others, may have a stronger impact. Additionally, given the limits of vaccines, any vaccine development dollars must be accompanied with responsive public health measures to promote public awareness.
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