Frieden Presses Case for Zika Funding

WASHINGTON -- "When an earthquake hits we understand the need to respond. Now imagine if you had the power to stop an earthquake," said CDC Director Thomas Frieden, MD, MPH, at a National Press Club luncheon on Thursday.

"We together, using the tools of public health, have the power to stop the health equivalent of many earthquakes," he said, referring to the Zika virus outbreak and the danger it poses in the U.S. with mosquito season beginning.

President Obama requested $1.9 billion in funding to fight the Zika outbreak in February.

When Congress failed to act, the administration redirected $589 million in funding to the Zika crisis.

The government borrowed money from the Prevention and Public Health Fund as well as dollars budgeted for fighting Ebola in Sierra Leone, Guinea, and Liberia in 2017 and 2018, Frieden said. But now those dollars need to be put back with new monies appropriated for Zika, he said, because Ebola isn't over and investments in containing the disease must continue.

"You don't stop fighting terrorism in the Middle East to fight terrorism in Africa," he said.

Last week, both the House and Senate passed bills aimed at containing the virus and preventing its spread, but neither came close to matching the president's request.

Frieden said the president's request meets every requirement for an emergency supplemental appropriation. Zika is "urgent," "catastrophic" and causes "permanent damage," he noted. However, some members of Congress are skeptical of the large ask, calling it a "slush fund" or "blank check."

But Frieden called the $828 million the CDC requested "our best, most honest estimate of what we need to fight the epidemic."

The Senate bill comes close to matching the CDC's portion of the requested emergency funds "and would allow us to have a really great start."

Frieden also supported the concept of a FEMA-like fund to cover both domestic and global public health disasters, so that in the future, the public health agencies don't have to repeatedly press Congress for resources for each emergency.

Frieden also shared what's known about the virus so far. He spoke of the 500 documented cases of Zika in the continental U.S., and repeated CDC staff estimates of "hundreds of thousands of infections" within the year in Puerto Rico.

"It's now clear that Zika causes microcephaly and other birth defects" he said, and these can occur even when the mother shows no symptoms. Most infections are asymptomatic.

And Frieden added, "Zika almost certainly causes Guillain-Barré Syndrome," which causes temporary paralysis. The disease is treatable, but can be fatal.

Frieden explained that Zika can be sexually transmitted and cited 10 documented cases of this in the U.S.

He also said it's theoretically possible to see infections through blood transfusions. But he noted, the FDA and Roche have developed a test to screen for Zika in the blood supply.

In terms of diagnostic tests, Frieden described the development of a "pretty accurate" blood or urine test used in "acutely infected" people, which has been distributed to 100 labs in the U.S. and to 100 countries.

He spoke of improvement to the CDC's antibody test, the Zika MAC-ELISA, which he admitted is "not perfect but it's the best test out there." They've also introduced a more complex test, a neutralization assay, to differentiate Zika from other similar infections and produced more than 1 million of those.

As for vaccines, he said the NIH has five candidates but it will be at least a year or two until their safety and efficacy is confirmed.

Lastly, the CDC is also making progress on strategies for vector control. It has developed new traps that can cut the spread of insect-borne diseases similar to Zika by half, that are simple and cost-effective.

It is also developing a new class of insecticides that are nontoxic and food grade."

But these efforts all require money.

Looking back at the Ebola epidemic, Frieden recalled his request in July 2014 for funding for 300 Ebola beds in West Africa. "It didn't happen and within a few months we needed 3,000 beds."

"The fact that we can today potentially prevent the dozens, or hundreds, or even thousands of birth defects makes this an enormously urgent challenge."

Ultimately, "Congress did the right thing with Ebola," Frieden said. "And I hope, in the end, they will do the right thing with Zika."

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Frieden Presses Case for Zika Funding