The public health community is watching in astonishment as Congress continues to drag its feet on funding to fight Zika, a disease that threatens one of the most basic human functions — the ability to produce healthy babies.
The usual political gridlock is playing a role, but there’s something else that few people acknowledge: Zika is perceived as a disease of the south, mostly affecting people of color. The media have bombarded us with images of brown babies with microcephaly who live in the Caribbean and Latin America. Our Congress, which is dominated by an increasingly anti-immigrant party, may not feel a sense of urgency to respond to this evolving tragedy.
With nearly 3,200 cases diagnosed in the 50 states, more than 700 pregnant women in the continental U.S. diagnosed with Zika, and local mosquito transmission occurring in South Florida, additional federal funding finally seems likely.
But it has already taken too long to release the funds. Emergency funding will take months to reach jurisdictions that are already struggling to stop the spread of Zika. In addition to the anticipated Zika funding, Congress should go further and restore the long underutilized Public Health Emergency Fund.
From my perspective, the unspoken narrative of Zika is about who is deserving of protection. I was forced to consider this narrative when the first baby with Zika-related microcephaly was born in New York City. With its birth, the theoretical threat became real.
Questions, which tend to reflect society, immediately came: Is the mother undocumented? Had she come from the Dominican Republic or Mexico? The question was not whether she was from the Upper East Side or Upper West Side.
To protect the family’s privacy, we offered no personal details. But we worried. Would a disabled baby and its mother confront unfriendly speculation because of their background, even as they faced such tragedy? This didn’t happen, but it pained me to realize that some mothers might face scrutiny, while others would not.
Let me say it plainly: a white, affluent, educated mother would be able to count on more sympathy and support.
The idea that Zika is a concern for “them” and not “us” is misguided thinking rooted in the same xenophobia and racism that have tainted our national conversation and have no place in public health. Similar foot-dragging hampered the response to Ebola in West Africa. It took Congress about six months to provide funding. It’s distressing to see these same factors threatening a response just two years after that crisis.
Resurrecting the Public Health Emergency Fund would help protect us from poisonous politics about who deserves protection while cutting through bureaucratic red tape. The fund, created by Congress in 1983, allows money to be released immediately to jurisdictions to aid emergency response efforts.
It has been underfunded and rendered unusable for decades, causing public health experts to rely on Congress to draft, debate and pass new legislation for every new emerging disease, whether it’s H1N1 influenza or Ebola. Setting aside this money would ensure that our critical public health programs have the resources to act with agility and speed to protect us when the next unforeseen emergency arises. The slow wheels of bureaucracy can turn faster with smarter funding mechanisms.
I am lucky to work in a city that has both the financial ability and the political will to allocate $21 million in new funding to combat Zika. Not all jurisdictions, or nations, have these crucial resources. That is why federal action is so critical, and a true Public Health Emergency Fund is needed. Federal lawmakers need to respond to this public health emergency and future ones with real urgency, regardless of who is affected.
Bassett is the New York City health commissioner.
