When Congress decided it was more important to take its summer break than work out a bipartisan deal to fund Zika testing and prevention efforts, they effectively put the health of tens of thousands of people at risk.



By now we know that this disease, carried by certain types of mosquitos, can cause devastating birth defects – primarily microencephaly – by attacking the brains of developing fetuses. We also now know that the virus can be transmitted through sexual contact, potentially threatening the health of even more pregnant women, or those hoping to become pregnant. Because symptoms vary so widely, or are nonexistent, testing pregnant women is vital.

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The CDC wants any pregnant woman who has traveled to a Zika hotspot, or whose partner has, to get tested. But they say further expanding Zika-specific screenings could provide more people, especially pregnant women, with a definitive diagnosis, which helps direct medical evaluation and care. Florida took it one step further by offering to test to any pregnant woman who wants it.

But most of this desired testing just isn’t happening, allowing the virus to potentially spread undetected. And if testing does speed up, it’s unclear who will pay for it all.

The National Institutes of Health says its limited available funding will be exhausted in just weeks. Lack of dollars hamstring local, state and federal efforts to rapidly and effectively test thousands of women and their partners. Even fewer funds are earmarked for mosquito testing, which help local officials pinpoint abatement efforts more effectively and conduct more coordinated community outreach. Testing mosquitos is complex, and it can take weeks to find out whether control efforts are working.

In cities like Miami, Houston and New York, with large populations who have ties to “Zika zones”, public health officials, clinic directors and doctors are scrambling to educate and screen at-risk women. They rightly worry about who will pay for testing, that demand will overtake supply of available test kits, and that an inability to hire more personnel at all levels will mean missed opportunities for diagnosis. In Texas, the state health commissioner worries that public health capabilities could become overwhelmed.

There’s only one commercially available test, and it’s only available at certain CDC-approved labs. The rest of the samples are sent to public health labs or the CDC, who have the sophisticated equipment necessary to run the complex analyses. The testing process is cumbersome and the wait for results is often agonizingly long.

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Because of the delays and confusion, some women are paying out of pocket (some with help of private insurance) for the commercial test, which must be ordered by their physician. The cost can easily exceed several hundred dollars. One recent report cited a private lab charging $500 for an insured individual and a “discounted” fee of $120 for someone without health insurance.

For low-income individuals, who either rely on Medicaid or have no health insurance, this isn’t an option. Instead, they must turn to overwhelmed clinics, overburdened public health labs and doctors who may still be unclear on exactly who should be tested – or when. And if you don’t fit into that narrow window, and you’re poor, too bad. Our dysfunctional political system is putting people’s health at risk and leading to a two-tiered system of testing. Without more funding, those who may be at most risk will have the most difficulty getting screened or accessing appropriate preventive services.

The NIH channelled $589m in leftover funding from the Ebola crisis to help some states with their testing and abatement efforts. But time, and money, are quickly running out. CDC director Thomas Frieden described the situation as “unprecedented” and an urgent public health threat. Shifting funds from a previous health crisis to the current one is no way to manage major public health menaces.

Members of Congress need to stop pointing fingers at each other, return to Washington and pass a clean Zika funding bill so more people can get tested before this threat turns into a full blown disaster.