Hodge is Professor of Public Health Law and Ethics at the Sandra Day O'Connor College of Law at Arizona State University
A recent poll suggested 77% of Americans are not significantly concerned about Zika, and Congress went on summer recess without authorizing President Obama’s emergency Zika appropriation. Apathy in the midst of an emerging public health crisis is dangerous. Zika prevention, in fact, is a matter of national security.
Zika is already spinning out of control in Puerto Rico, while thousands of Zika cases in the continental U.S. represent an early warning of what is to come. Local mosquito transmission in Miami is only one of many potential “hot zones” in a large swath of the South and Gulf Coast. If a widespread epidemic emerges, low-income pregnant women will be at greatest risk, often living without screens or air conditioning.
Up to 6% of Zika-infected women will miscarry or have stillborn deliveries. Actual rates may be higher. Surviving infants have as much as a 10% chance of microcephaly, a physically and mental debilitating lifetime condition. Zika-related microcephalic infants are already showing up in hospitals from New York to California. Many more may be impaired in less obvious ways. Zika infection at any stage of pregnancy can lead to physical and mental impairments later in a child’s development. If widespread transmission becomes a reality, we could witness a “Zika generation,” much like the thalidomide generation in the 1960s.
Zika is an unprecedented public health crisis leading to first-ever public health responses. Latin American governments, as well as Puerto Rico, advised women to delay pregnancy. The Centers for Disease Control and Prevention’s (CDC) warned pregnant women to avoid travel within a one-square mile area north of downtown Miami. Never before had CDC advised against travel within the continental U.S. It also counseled at-risk women to get tested despite the absence of effective vaccines, treatments or accessible testing services.
Basic public health services can make a huge difference in diminishing the repercussions of Zika. Yet essential funding for prevention and research is dwindling. Congress’ refusal to compromise over the President’s funding request forces CDC and the National Institutes of Health to divert resources from other essential public health priorities.
Late last week, President Obama pleaded with Congress to “do its job.” But the job has changed. Fighting Zika is no longer just a public health crisis. Zika is a threat to national security just like other global diseases such as AIDS, SARS, multidrug-resistant tuberculosis and MERS. In 2014, for example, the President spearheaded a U.N. Security Council resolution calling Ebola a threat to international peace and security, and then sent the military into Liberia to combat it.
From early January 2016, President Obama has been meeting with national security advisors to strategize on Zika. In February, Health and Human Services Secretary Sylvia Burwell declared that Zika has a significant potential to “affect national security or the health and security of U.S. citizens.” Navy Admiral Kurt W. Tidd noted on March 22 that working with global partners on Zika preparedness is essential “to promote a peaceful, prosperous, secure and resilient Western Hemisphere.” On July 5, Vice Presidential candidate Tim Kaine classified Zika a “national security issue.”
They are all right. While the continental U.S. is unlikely to experience the explosive spread seen in the Caribbean and Latin America, Zika could have major impacts on a new generation of American infants, the economy and the stability of international governments. Costs to treat hundreds of thousands of impacted infants globally over their lifetimes reach into the hundreds of billions of dollars. Untold fears and hardships on families and caregivers defy measurement.
As public apathy over Zika shifts to fear, reproductive choices could lower pregnancy rates, with future impacts on productivity and the economy. Direct economic losses from downturns in tourism and other related industries are already being measured in Puerto Rico and Florida. As cases emerge in other Zika hot zones across the U.S., losses in tourism and travel industries will escalate.
Characterizing Zika a national security threat requires Congress to act. State and local governments have their own priorities in battling Zika. Florida Governor Rick Scott allocated millions of state dollars into mosquito abatement in Miami and surrounding areas. But federal authorities alone have the constitutional duty to safeguard national security.
Funding Zika preparedness and response is not just a moral imperative, or something that can pushed off to states. The federal government is responsible for protecting the public from disease threats that compromise its security. It is time for Congress to designate major new funding to mitigate further public health impacts that threaten the nation’s security and the public’s health.