Fundamental research into the effects of the disease, and into vector control for this and other diseases is welcome, but it will not address the immediate lack of a vaccine, writes Cecile Vernant.
Cecile Vernant is head of EU advocacy at DSW (Deutsche Stiftung Weltbevoelkerung).
Having been on the cusp of announcing an end to the Ebola outbreak in West Africa at the end of 2015, we have been plunged into another public health emergency, as the scale and spread of the Zika virus has grown.
As with Ebola, the Zika outbreak in Brazil, and its growth across Latin America, has been slow to garner public and political attention since the first recordings of the outbreak, in April 2015.
International attention has grown only in recent months. Concern over the spread of the virus has risen, because of its specific and pernicious effects – a suspected link to malformations in newborns – and as the disease has spread beyond low-and middle-income countries to North America and Europe. In following this trajectory, the coverage and response to Zika echoes the well-worn path of neglected infectious diseases.
The WHO has labelled the outbreak a public health emergency. Government advice from some countries has been (to avoid getting pregnant for the next two years. This, in a region that is notorious for its restrictive family planning laws and where it is estimated that more that more than 50% of pregnancies in the region are unintended.
A response to Zika that does not respond to the particular needs of women may force them to seek unsafe abortion services, deepening a health emergency that already disproportionately affects maternal and newborn health. What, then, is the European Union doing in response? And can it do more to prepare for outbreaks like Zika?
The European Commission’s response looks like a case of “old wine in new bottles”. In an announcement on 29 January, Commissioner for Research Carlos Moedas identified several funding lines from Horizon 2020 and its predecessor FP7 that the Commission plans to use to fund the fight against Zika.
In particular, he committed DG Research and Innovation to “mobilise €10 million for urgently needed research” on how to combat Zika and investigate the links between the disease and newborn malformations.
Commissioner Moedas also referenced €40 million in funding available for research aimed at vaccine development for malaria and neglected tropical diseases, and Commission co-funded research in Latin America on preventing the spread of infectious diseases.
Fundamental research into the effects of the disease, and into vector control for this and other diseases is welcome, but it will not address the immediate lack of a viable treatment or a vaccine for Zika.
In addition, much of the funding mentioned above has previously been announced and is not specifically dedicated to Zika. It is in fact a reallocation of money that had been set aside for one of the EU’s few programmes intended to support research into vaccines for malaria and other diseases, and which will now be diverted for use as emergency funding for Zika.
From reactive to proactive
The Commission’s announcement makes clear two things. The EU’s funding for research into disease of poverty remains limited; developing innovative responses to these diseases is not a policy priority for the EU under Horizon 2020.
It also shows that a failure to prioritise global health innovation in recent decades has meant that the policy response to outbreaks is reactive; what funding that is there is reallocated rather that added to, stretching already limited resources.
How can the EU improve its response to public health emergencies like Zika? It needs to become more proactive in how it uses global health innovation to deal with diseases of poverty.
We need to invest in research for new and improved diagnostics, vaccines, and treatments. The EU needs to introduce flexibility to this funding, making it easier for researchers globally to access it and deliver the next breakthrough drug or vaccine.
We need to build on the firefighting efforts of recent years and make permanent a commitment to R&D. In doing so, we need to be smart in how we invest, and support innovative mechanisms that can deliver new health solutions where the market has failed.
A holistic approach
Diseases like Zika do not emerge in a vacuum, and require a holistic approach. A warming planet means we will have to face more outbreaks like Zika, as well as the spread of diseases like malaria or dengue fever to previously unaffected regions. A person’s health is closely connected to their environment, as is to their ability to access and exercise their rights (health, gender, reproductive).
We need to start doing all of this now. The public health rationale is clear. And so is the value for money argument. Not only is it cheaper to invest in a holistic approach and the development of vaccines and other preventive measures that it is to respond to emergencies, but every euro spent on R&D in this field brings an additional €1.64 in return.
There is a belated recognition that this is the way forward – see the Commission’s €2 million ‘birth day’ prize for new health solutions reducing death and illness of mothers and babies around the world for evidence.
If we achieve all of this in the next couple of years – and the mid-term review of the EU’s multi-annual financial framework, slated for next year, could be the first step in this process – we can be better prepared to deal with the global health challenges we face now and emergencies we are sure to face in the future.