Ebola. Zika. Could a rapid-response fund help the US address crises faster?

WASHINGTON — Wouldn’t it be easier to respond to the next public health crisis if the federal government didn’t have to wait for Congress?

That’s the lesson that top lawmakers have learned from the seemingly endless standoff over emergency funds for the Zika virus. Now, there’s a reasonable chance that the next health spending bill will include a reserve fund that the Centers for Disease Control and Prevention can use the next time there’s an infectious disease crisis.

The House version of the bill, which would fund the federal health agencies for the fiscal year that starts in October, has a $300 million “rapid response reserve fund” for infectious diseases. It’s a smaller version of an idea that Democratic lawmakers and current and former Obama administration officials have been promoting for months, ever since it became clear that Congress was incapable of anything close to a rapid response to Zika.

It’s not guaranteed to become law. House Republicans would have to convince their Senate counterparts to accept it, since it’s not in the Senate version. They’d have to reach a broader agreement on the health spending bill, which is full of other provisions President Obama would likely consider veto bait.

And they’d have to settle an internal disagreement among Republicans about whether to even finish the spending bill before Obama leaves office, or take their chances with the next president.

That said, top House Republicans are optimistic that they can get some version of the fund signed into law. They believe it would establish the precedent that, having dealt with Zika and Ebola outbreaks in the last three years, federal health officials should always have an emergency fund at hand so they can respond quickly to the next infectious disease crisis.

“I really think this one of those ideas whose time has come,” said Representative Tom Cole, the chairman of the subcommittee that produced the spending bill. He said the Zika and Ebola crises “demonstrated the need for something like this, to allow the CDC to respond quickly while Congress tries to get its arms around the full dimensions of the problem.”

CDC’s response: Bigger would be better, but sure, anything helps.

“I think the big picture is, we definitely need something like this,” CDC director Tom Frieden said in an interview with STAT. “It’s crucially important that we have resources to respond rapidly. Epidemics move at one speed — Congress clearly moves at a different speed.”

Frieden insists, however, that his agency still needs the emergency Zika funding that Obama asked for six months ago — the one that is still stuck in Congress, with no sign that either party will budge even after Congress returns in September.

Cole said the idea for the reserve fund came from conversations between House Appropriations Committee Chairman Hal Rogers and Frieden, who called for the creation of a reserve fund in a May speech. The top Democrat on Cole’s subcommittee, Rosa DeLauro, has been pushing her own proposal for months.

So far, the general idea appears to have broad support in both parties. The main debate is about whether $300 million is enough, and whether it should be taken out of other health programs.

DeLauro has called Cole’s version “a step in the right direction,” but criticized it for being too small and for not being classified as emergency funding, which allows Congress to get around its spending limits. There’s a huge gap, between Cole’s proposal and what DeLauro wants: She proposed a $5 billion fund.

Public health advocates want a larger reserve fund, too. Cynthia Pellegrini, a lobbyist for the March of Dimes who has helped to coordinate the push for emergency Zika funds, said the $300 million amount is “woefully inadequate” and would require taking money away from other important health priorities.

Cole, however, said it’s important to get some kind of fund written into law, and that “experience would tell us what the appropriate amount should be over time.”

“Let’s build the mechanism. $300 million seems like a good place to start. We might find out later, you know, maybe we need more,” Cole said.

He also says it’s important, however, to pay for it and not just add new spending at a time of rising deficits — a condition that has been important to House Republicans in most other spending battles this year, including the fight over the stalled emergency Zika bill.

Frieden said he has “no special perspective, other than to say we need a fund, [and] we would like for politics not to get in the way of establishing it, because we’ve heard from both house of Congress, both sides of the aisle, that they agree that something like this is necessary.”

He added, however, that a $300 million fund could only give the agency a running start in a typical infectious disease crisis — not cover the whole bill.

“If you were going to do something like create a vaccine, $300 million would be entirely used up by that,” Frieden said. “If you were going to do something like a rapid response while you kind of assessed the disaster … that obviously is enough to get started. It’s not going to provide all of the funding, but it would allow you not to be so stuck.”

Frieden added that it will be important to make sure CDC has the authority to move quickly with those funds, the way the Federal Emergency Management Agency does when it’s responding to a natural disaster. Still, he’s encouraged that there’s finally a version of the reserve fund moving through Congress.

“It’s always good to get started on something. Because right now we don’t have this in place, and people are suffering because of that,” he said.