TO:                Members of the Zika Conference Committee
FROM:          Dr. Leana Wen, Baltimore City Health Commissioner
RE:                 Local Jurisdictions Need Emergency Funding to Respond to the Zika Virus

Dear Members of the Zika Conference Committee:

Congratulations on your appointment to the conference committee considering emergency funding to respond to the Zika virus.

This funding is vital to protect the health and well-being of our nation.  In the absence of federal funding, Congress has forced the Centers for Disease Control and Prevention (CDC) to shift $44.2 million from state and local public health emergency preparedness (PHEP) grants to pay for Zika response. Local jurisdictions across the country now face a substantial cut to emergency preparedness funds that allow us to respond effectively to outbreaks and other emergencies. Without additional appropriations, our residents will be vulnerable in times of greatest need, including disease outbreaks and natural disasters.

Furthermore, Zika is a disease of poverty. The experiences in Brazil and Puerto Rico have demonstrated that areas of concentrated population and concentrated popular will be the most heavily affected. Vacant properties, lack of screens and air conditioners, and existing poor access to health make concentrated urban areas a haven for the container-dwelling mosquitoes carrying Zika.

All public health is local, and the necessary role of local public health is to implement effective, agile strategies to address emerging threats to public welfare regardless of any limitations.  Despite cuts to our emergency funding, Baltimore has put forth a three-pronged approach to address Zika.  First, the Health Department has initiated a mosquito surveillance program and is focused on preventing mosquitoes from breeding by identifying and eliminating standing water. Second, the Health Department is investigating all reported cases of Zika through home visits to counsel patients and family members and conducting targeted spraying within the area.  Third, the Health Department is collaborating with city agencies, healthcare providers, and community-based partners, to educate residents on the disease and how to mitigate the spread of the virus.  Baltimore will work diligently to provide all services necessary to support these efforts, even with the diminutive resources made available to support these efforts. This comprehensive strategy is necessary to adequately respond to the threat of the Zika various and it necessarily involves significant city resources. 

Without funding appropriated directly to local agencies and urban areas, we are falling short of implementing the kind of proactive and robust prevention efforts that residents across the country deserve.   Unfortunately, the lack of funding to support Zika response is impacting Baltimore’s ability to address other health priorities such as opioid overdose and chronic disease prevention.  Protecting the public health is a mandate on all government bodies and it is unacceptable address on health risk at the expense of failing to address another. 

I urge you to act quickly in providing adequate emergency funding, including:

1. Provide adequate emergency funding to respond to Zika that extends beyond the current  fiscal year and fully fund President Obama’s request for $1.9 billion;
2. Restore public health emergency preparedness funding necessary to respond to other emergencies;
3. Directly fund local jurisdictions with the highest need

Funding for Zika is a matter of health and justice. It is unscientific and inhumane for us to watch silently when we know the consequences to our most vulnerable children who are yet unborn. The cost of action is minimal compared to the burden of inaction.

Thank you for leadership on this issue. I am extremely grateful for your advocacy on behalf of the nation’s most vulnerable and I stand ready to act as a resource to you and your staff.  Please do not hesitate to contact me at 410-396-4387.

Sincerely,

Leana Wen, MD, MSc 

Commissioner of Health

Baltimore City