Fixing Our National Infrastructure Requires Fixing Our Science Infrastructure

Congress has finally approved a stop gap spending bill that provides funding -- $1.1 billion - to fight the Zika virus. The money comes at the same time that new Zika transmission zones have been found in Florida and the first group of babies of mothers in Puerto Rico known to have been exposed to the virus in their first trimester are being born.

Beyond the funding, the Zika epidemic has exposed a major national weakness that must be converted to a strength. That can happen, if we now use lessons from Zika to advance our preparedness for this and other infectious diseases that are sure to come.

Simply put, our political system could not respond rapidly enough to combat the virus in a timely fashion. President Obama proposed $1.9 billion in emergency funding in February, and only this week, seven months later, did funding emerge from Congress. Only through creative accounting - borrowing from one disease to pay for another - could the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) combat Zika as best they could.

It may seem as though we got away with it in the short term, but we have yet to see the toll the rapid spread of Zika will take in Puerto Rico, and globally our delay is unconscionable. And even if we do escape the brunt of the Zika epidemic, as an expert in infectious disease I know well that waiting for politicians to respond to epidemic threats is a very dangerous game that the greatest nation in the world cannot afford to keep playing.

Infectious diseases tend to emerge suddenly, as do biosecurity threats. We cannot wait for the give-and-take of an intentionally deliberative legislative body to work an emerging threat into its protracted agenda. I've seen the need for expediency first-hand, as Chair of the National Science Advisory Board on Biosecurity and as President of Stony Brook University, a major research institution and healthcare provider.

We must provide our public health and healthcare professionals with the resources that they need to keep Americans safe. We must also correct the weakness that we have now publicly exposed: our inability to provide vital funding within even half a year. It's time to design and implement an expanded national infrastructure for infectious disease defense. That infrastructure should include the following:

First, a fund should be created that would give the CDC and NIH sufficient financial resources to respond to emergencies. This would protect both the American people and Congress. As an institution, Congress does not benefit from its inability to respond quickly to threats of this nature.

Second, as a nation we must invest more aggressively in the science of vaccine development. We have the strongest scientific community in the world, yet it's left without sufficient funding to keep our nation ready for threats that arise. We were dramatically unprepared for the Ebola virus. We were not properly prepared for Zika, which was not even on our radar a year ago. What will we be unprepared for next?

One cannot predict the precise nature of each likely threat, but we can advance our understanding of the science of vaccine development and work to bring more innovation to this vital medical need.
In the case of Zika, there is reason to hope that a vaccine could be available in 18 months. The fundamentals for a successful vaccine are strong (effective vaccines against other similar viruses have been developed, protective immunity appears to develop naturally after infections, and protection from Zika infection after vaccination with experimental inactivated virus and viral DNA-derived vaccines has already been achieved in mice and non-human primate models of disease). But the lack of resources is limiting the basic science and clinical studies needed to test these vaccines both in laboratories and in the field where they can truly be assessed.

Third, we need to streamline the regulatory process for innovative treatments, vaccines, and other responses to global infectious disease threats. This does not mean weakening the regulations, just expediting their application. This applies to two main areas: development of Genetically Modified Organisms such as a Zika-fighting genetically modified mosquito; and the deliberations of Institutional Review Boards, which review and approve research involving human subjects. Those could allow for a rapid expansion of sites, for instance, or more rapid enrollment of patients.

Finally, we need to refine our public health delivery systems, through which we inform and protect the public during a crisis. These include, in the case of Zika for example, our capacity to remove standing water and to perform efficient spraying of mosquitoes. As The New York Times has reported, the most effective aerial spraying in Miami, "seems to have come from combining sprays that kill adult mosquitoes with sprays that kill larvae" - an outcome that "goes against conventional wisdom."

At a time when global air travel makes us more susceptible than ever to newly threatening diseases, the need for further research to transform the field of vaccination technology and to develop new therapies for infectious diseases has never been greater. New infectious disease threats will continue to present in unexpected ways and at unpredictable times. It's the reality of a world drawn ever closer together and changing weather patterns that are altering the range and thus the dangerous collision between microbes, their insect vectors, and animals, including, of course, humans.

What we know for certain is two things: threats will arrive, and we are more capable of combating them than any nation in the world. It's time to give our scientific community the infrastructure that's needed and not expose Americans unnecessarily to threats that can be significantly reduced if not prevented.

Dr. Samuel L. Stanley, Jr., MD, is president of Stony Brook University, Long Island, NY.