While Congress Dithered, the Zika Virus Flourished in Puerto Rico

While Congressional approval last week of $1.1 billion in funding to combat the Zika virus was welcomed far and wide, public health officials themselves admitted that the long-delayed funds — nearly $1 billion shy of the figure originally requested by President Obama — will likely prove too little, too late for at least some women whose babies are at risk of developing microcephaly.

“Because we’ve had to wait these seven months,” Tom Frieden, director of the U.S. Centers for Disease Control and Prevention told Reuters, “we haven’t been able to get a running start on some of the critically important studies to understand more fully the impacts of Zika, to establish better diagnostic tests, to improve our way of controlling mosquitoes.”

While Congress delayed approving Zika funding for over seven months, Zika flourished in Puerto Rico.

Visual: iStock.com

Among the biggest losers in that waiting game are likely the women of Puerto Rico, the Caribbean island and U.S. territory now considered the epicenter of America’s looming Zika problem.

In the absence of federal funds, philanthropic efforts – including one organized by the CDC’s charity arm, the CDC Foundation, and funded in part by Pfizer and the Bill & Melinda Gates Foundation – put experts on the ground in Puerto Rico to help contain the epidemic there by providing contraceptive access and education to women. The results so far have been promising, experts say, but pregnant women on the Zika-besieged island are just now giving birth, so the number of cases of microcephaly — the neurological condition in newborns associated with Zika infections in mothers — is still unknown.

What is clear is that Puerto Rico currently has over 20,000 cases of Zika infection, with more than 1,000 of those in pregnant women. To contain the spread of the virus, the CDC Foundation raised private funds to launch the Zika Contraception Access Network (Z-CAN), an initiative that is providing Puerto Rican women with Zika education and free contraceptives, and clinics with training.

“In Puerto Rico, 65 percent of all pregnancies are unintended,” said Cynthia Harper, a professor at the University of California at San Francisco’s Bixby Center for Global Reproductive Health who is working on Z-CAN. Because contraceptives are very expensive on the island and there’s little public funding for family planning, Harper believes providing free access to contraceptives is one way — beyond advising people to stop having sex — to avert cases of microcephaly. “One of the scientifically-proven technologies we have to reduce birth defects from Zika is to reduce the unintended pregnancies,” Harper said.

Evidence of the Z-CAN program’s impact has yet to be published, but Harper says it’s been demonstrably successful at curbing unintended pregnancies — an outcome she attributes in part to the CDC Foundation’s nimble efforts. “But it’s also thanks to private foundations for responding to the public health emergency,” she added, “when our government was in gridlock.”

The CDC Foundation, for its part, says private funds can be successfully put to work to complement government public health strategies, but they in no way should replace federal funding.

“Based on our experience, it’s essential for government funding to play the primary role in emergency responses and for philanthropic and private sector funding to extend and complement the work of government,” CDC Foundation spokeswoman Claire Greenwell told Undark in an email.

Greenwell added that external funding will continue to be needed when government funding may not be available or not available in the needed timeframe. “We know from emergency response work with CDC over many years, including the Haiti earthquake and Ebola before Zika, that it takes multiple funding sources to build and sustain response capability,” Greenwell said.

Still, despite the rapid mobilization of private funds and the early success of Z-CAN, contraceptives may nonetheless be arriving too late to prevent a spike in microcephaly cases in Puerto Rico, according to  Harper.

“It’s still up in the air how many babies will have microcephaly and how many will have development problems later that you don’t see at birth,” she said. “It can be a terrible surprise too late.”