June 23, 2016

Hey Congress: More Meat, Less Filler

Policymaking in Washington, D.C. is often compared to sausage-making: a slew of ingredients from various stakeholders are stuffed together before the final product emerges. Legislation is frequently riddled with non-germane amendments, which take away from the true need and purpose behind the policy, or is delayed altogether until the ratio of ingredients are tediously negotiated.  The emergency supplemental for Zika is no exception.  As the clock ticks, the looming threat of rapid spread becomes real.  Although there is much to consider with this bill, one key ingredient is missing on Capitol Hill:science.  While the executive branch has the vast scientific enterprise of the U.S. federal agencies and beyond, there are only three members of Congress with degrees in “hard” sciences, only one of whom holds a doctoral degree in the sciences. One physicist (Rep. Bill Foster, PhD), one microbiologist (Rep. Louise Slaughter), and one chemist (Rep. John Mooleynaar) must act as the face of science in all U.S. policymaking. You certainly don’t need to be a scientist to ensure evidence-based policymaking, but given the challenges we face, ranging from climate change to emerging infectious disease, an understanding of fundamental science should be an essential ingredient for a body as important and powerful as the U.S. Congress.

The Obama administration requested $1.9 billion in emergency funding for Zika response efforts on February 22nd, right after the WHO announced Zika as a Public Health Emergency of International Concern (PHEIC). At the time, there had only been one case of Zika in the U.S., sexually transmitted from someone who had recently returned from Venezuela. As of mid-June, nearly 700 cases of Zika have been reported in the continental U.S., 234 of which occurred in pregnant women. Although local transmission of Zika has yet to occur on U.S. mainland, as all 700 cases thus far have been contracted elsewhere, health officials warn that it is only a matter of time.

As the number of Zika cases and the threat of its spread continue to grow, why has Congress yet to respond? The White House’s request has remained in holding at the congressional level with the House and Senate in disagreement over the amount of funding to allocate and from where the funding should come. On May 18th, the House put forward a bill for $622 million, less than a third of Obama’s initial request, a proposal which also involves spending cuts rather than Obama’s request for Zika emergency funding that would add to the current budget deficit. The next day, the Senate approved a $1.1 billion emergency funding allowance for Zika efforts, leaving the House and Senate divided. As the disagreement continues, the Obama administration has moved $510 million of money originally set aside for Ebola to instead help combat Zika. This move has also sparked criticism as many health experts are concerned about reallocating Ebola funds for Zika when we have yet to finish efforts related to the 2014 Ebola response and ensure prevention of future outbreaks. Health and Human Services director Sylvia Burwell warns, “we have two global health crises, Ebola and Zika, and we can’t set one aside to deal with the other.” As Zika’s presence in the U.S. continues to grow, the government needs to step up and react through allocating new funding and resources. It has been 122 days, and this is “emergency” funding. Clearly Congress needs to brush up on its vocabulary: no “emergency” should wait idle for over a hundred days with no firm action. Would this delayed response to public health emergencies be the same if there were more scientists in Congress?

Perhaps the response to Zika would look vastly different if Congress better understood the risk of major health security threats and the urgent need for further research, surveillance, and response efforts. By waiting to react rather than listening to the overwhelming concern from scientists and health experts, Congress is enabling Zika to move through the U.S., putting more pregnant women at risk of giving birth to babies with Zika-related birth defects. Unfortunately, the same was the case for Ebola. In 2014, the U.S. government faced much criticism from scientists over its slow response to Ebola. Two years later, we are in limbo once again, waiting to overcome indecision and act. As a recent New York Times article postulated, “had the American government moved more quickly to help Guinea, Liberia and Sierra Leone fight that virus [Ebola] early in 2014, the disease may not have killed more than 11,000 people or caused a global panic.”  As the burden of yellow fever grows internationally, threatening to rise to PHEIC level, will it take three consecutive PHEICs for the U.S. government to realize they need to change the way funding decisions are made for health crises?

The U.S. must learn from its past mistakes when it comes to major health security threats and rely on scientists for evidence-based congressional appropriations decisions with regard to the Zika crisis. Due to the consistent, overwhelming lack of scientists in office, however, we can’t help but wonder: Why aren’t there more scientists in Congress? Are scientists deterred from the dysfunction and lack of evidence-driven decisions in government? Or do scientists lack the political prowess to successfully be elected by the general public? To politicians and voters, we urge you to support and participate in rational discourse. To scientists, we challenge you to run for office, offer your voice on the front lines of decision-making, and help bridge the gap between science and policy. The nation and world can benefit from your vote in Congress. In the meantime, as the weather continues to heat up, so should the discussions in Congress for a final Zika bill resolution. Mosquitos won’t stop biting this summer just because Congress can’t come to an agreement on which ingredients to stuff into this sausage of a bill. Perhaps if they had listened to the scientists from the get-go, Congress would have already come to an agreement. Bottom line: The Zika bill needs more meat and less filler.

About the Authors

Kate Consavage is a Program Associate at HSP. She holds a B.S. in Biology from Emmanuel College, and she currently attends Georgetown University in pursuit of a M.S. in Global Health.

Jason Rao, PhD is an Advisory Board Chair at HSP.  He also teaches global health security and diplomacy at Georgetown and Cornell Universities. From 2009 to 2011, he was a Senior Policy Advisor to President Obama at the White House Office of Science & Technology Policy.