Failing on Zika
August 17, 2016
Any sentient American, you might assume, would believe that the United States should be doing everything humanly possible, on an urgent basis, to protect women in their child-bearing years, along with their sexual partners—in America and the hemisphere—from infection by the mosquito-borne Zika virus that can lead tragically to brain damage and other birth defects among infants.
It is difficult to imagine a more compelling human scenario, especially for poor marginal women, who lack screens, air-conditioning, and health services and who live in mosquito-saturated environs. There are indeed significant numbers of women in this dire predicament living in our southern coastal communities, in barrios in Puerto Rico, and across Latin America.
And it is not at all difficult to grasp how to protect these acutely vulnerable women and their partners. We need to accelerate the development of a safe and effective vaccine; intensify local control of mosquitoes; expand family planning and reproductive services; and provide ample repellent, condoms, and protective clothing. These tools are not perfect, and vaccines will take a few years, but we know the basic game plan and should be able to put the pieces into motion. At home and abroad.
Yet we are failing conspicuously. Though the president first went to the U.S. Congress with an emergency request of $1.9 billion in early February, then appeared willing to bargain at a lower $1.1 billion level, Congress could not rise above partisan squabbles and went into recess in mid-July having passed no emergency measure, forcing the Obama administration to borrow and divert almost a billion dollars from various worthy purposes, in a frantic, ad hoc scramble. In the meantime, the reality of the threat has become steadily more visible, as imported cases of Zika infection surpass 2,000, home-grown transmission predictably commenced in Florida, and the crisis in Puerto Rico reached a point where the White House just declared the Zika epidemic there an emergency.
Why then are we failing? I see four fundamental reasons.
First, Congress is in meltdown. Whatever systems of leadership and hierarchy, due process, respect, and accountability, which allowed forward progress in the past, even under high stress, and which permitted common sense and common purpose in times of emergency to prevail, appear at least for now to have expired, replaced by internal chaos, deep distrust and polarization, shared pettiness, ineptitude, and no apparent sense of shame.
Second, once the executive branch recognized this grim reality and shifted into unilateral, stopgap administrative actions—emergency steps that rob Peter to pay Paul—that compromise inherently relieved pressure on the Congress to come to its senses and behave honorably. Paradoxically, dysfunction on Capitol Hill became more comfortable, not less, in the wake of responsible actions by the executive.
Third, in a system built like ours, which does not budget routinely for health security emergencies, which does not adequately plan ahead and put in place contingency funds, and in which health security threats are typically second- or third-tier priorities, there is little if any insulation from politics. And when our politics turned especially toxic in this current electoral season—cynical, bigoted, antiscience, antihumanitarian, and antiestablishment—bad politics readily trumped compassion and common sense, resoundingly.
Fourth, it is exceedingly difficult at any time to convince Americans to act early to meet an uncertain, unproven threat. That is part of human nature, and Zika has been no exception. Until recently, the threat posed by Zika has been remote and largely hypothetical. The last epidemic of birth defects experienced by Americans was rubella in 1964–1965. Before Zika, there had never been a case of a mosquito-borne pathogen that caused birth defects and no reason to believe we might see such a thing in our lifetime. The spread of Zika infection is often not visible or even known: men can be infected, be asymptomatic, and unknowingly spread the infection. Victims, women who find themselves carrying severely damaged infants, make with their partners private choices on whether to carry on or terminate their pregnancies, and they understandably choose to suffer privately, not on 24/7 cable. Zika is an unfolding human tragedy that is quiet, not deafening.
J. Stephen Morrison is senior vice president and director of the Global Health Policy Center at the Center for Strategic and International Studies in Washington, D.C.
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© 2016 by the Center for Strategic and International Studies. All rights reserved.