Everyone agrees that the Zika virus poses a threat, not only to pregnant women, but possibly to everyone. The virus attacks fetal brains. But scientists don't know the long-term consequences of carrying the virus. That's worrisome, since the virus can be transmitted by mosquitoes and then by those infected through sexual contact and transfer of bodily fluids.
Are we prepared to effectively tackle the Zika threat?
The Centers for Disease Control (CDC), The Federal Drug Administration (FDA), and the National Institute of Health (NIH) do stellar jobs in carrying out their mandates. But they face formidable obstacles for dealing with pandemic threats. While these and other agencies have resources for initiating research, funding research by others, and mobilizing national and international resources, with each threat they almost have to start from scratch to crank up the global response engines, which are widely dispersed and fragmented.
According to a White House sponsored report in 1994 about worldwide responses to disease outbreaks, "the U.S. Government response to international epidemics occurs on an ad hoc basis... The authority of CDC, for instance, does not cover international disease control and prevention, and USAID, provides aid for improving the lives of the citizens of the developing world, has limited technical and financial resources in this area..." Despite more recent CDC policy initiatives starting in 2010 to address global health, in practice little has changed. That was evident in the widespread criticisms of the slow U.S. response to the Ebola outbreak in 2014. One scathing report criticized the U.S. for focusing on travelers from affected areas passing the virus on to others at home rather than addressing the virus at its source.
In 2014 Doctors Without Borders (Medecins Sans Frontieres) called the international response to the Ebola outbreak "lethally inadequate."
A January 2016 United Nations report, Protecting Humanity from Future Health Crises, lamented that "Too often global panic about epidemics has been followed by complacency and inaction." The report warned that future epidemics could be far more devastating than the West African Ebola outbreak and that "a highly pathogenic influenza virus could rapidly result in millions of deaths and cause major social, economic, and political disruption."Nevertheless, despite alarm and warnings, the current mobilization for combating the Zika virus limps along. A June 2016 Bloomberg article, "The World Can't Even Find Pocket Change to Fight Zika," charged global inertia in response to this epidemic. Punctuating the point, on August 30th Tom Frieden, Director of the CDC, announced that his agency was running out of money to fight Zika. Although an African ambassador once called the CDC "the 911 for the world," its ambitious efforts are hampered by inadequate funding.
Why don't we have an adequately funded organizational infrastructure ready to respond to pandemic disease threats with a primary focus on treatment, cure, and prevention (vaccines)?
Although the World Health Organization (WHO) aims to be a central body to mobilize and coordinate global actions in response to pandemic threats it may be too underfunded and too physically dispersed to accomplish that role, with a staff of "more than 7000 people from more than 150 countries working in 150 country offices, in 6 regional offices and at our headquarters in Geneva." An independent international panel of experts concluded that the WHO moved too slowly in response to the deadly Ebola outbreak in West Africa: "...there was strong, if not complete, consensus that WHO does not have a robust emergency operations capacity or culture."
The Zika virus was first identified in Uganda in 1947 and later in East Asia. Because it seemed to be confined to those regions there was no sense of emergency on the part of the industrialized world to find a cure or vaccine. An investment for the treatment or cure of Zika by pharmaceutical companies was deemed too expensive for too little return on investment for a confined disease remote from the industrialized world. As Bruce Lehman, President of the International Intellectual Property Institute, explained: "The extensive cost required to produce a new pharmaceutical product has meant that private sector investment in pharmaceutical innovation has been disproportionately directed to products meeting the needs of patients in developed countries, particularly in the United States, which combines strong patent protection with a market free of price controls."
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