The Obama administration is all but certain to ask Congress for more money to fight the Ebola virus — the questions are how much, and when.
The Office of Management and Budget is evaluating the budget needs of the the Centers of Disease Control and Prevention and other agencies on Ebola’s front lines, and President Obama discussed the crisis in a series of phone calls to congressional leaders last week.
Health experts say the government could boost funding to a number of areas. Here are five possibilities that could be key in a new request.
Expand outreach in West Africa
Public health experts say this should be the administration’s top priority because it would prevent the disease from spreading overseas.
That makes it a likely candidate for more funding.
“If we eliminate the epidemic there, then we won’t have cases in the U.S.,’’ said Alison Galvani, professor of epidemiology at Yale University’s School of Public Health.
The U.S. has already deployed more than 500 troops to Liberia, one of the worst-hit nations, and the CDC has deployed teams to the region to provide assistance.
Several congressional committees recently approved a reprogramming request to shift $750 million in Pentagon funds toward the Ebola response. As of last Friday, that funding had not been touched yet.
Ashish Jha, professor of health policy at Harvard University, said he’s worried this funding is taking too long to turn into tangible aid. Jha said his colleagues based in Liberia are not seeing enough evidence yet that the aid is arriving.
“That’s a problem,” he said. “If it takes several months for the stuff to really start flowing, we might find that by that time the money that was allocated was not enough.”
Develop Ebola vaccines and treatments
No vaccine to prevent Ebola exists, and drugs to treat already infected patients are in short supply.
The administration has approved new funding grants to several companies that are developing this medicine, but these researchers will likely need more money.
“It isn’t that the private sector can’t do it, but it takes a long time,” Jha said. “If the government is going to intervene and wants this stuff more quickly,” he said it would be a “pretty smart use of resources.”
Jha explained companies go through a multi-year process to develop these drugs, but he said the government should help them deliver them to the market more quickly. Entering these vaccines and treatments into clinical trials also costs tens of millions and hundreds of millions of dollars, he said.
Only four hospitals with biocontainment facilities that specialize in treating victims of Ebola and other infectious diseases exist in the United States.
Dallas’s Texas Health Presbyterian Hospital isn’t one of them and is considered to have flubbed the recent case of Thomas Eric Duncan, who died after becoming the first patient diagnosed with Ebola in the U.S. Two nurses that treated Duncan have also been infected with Ebola.
Richard Hamburg, deputy director at Trust for America’s Health, said hospitals need to improve their training to healthcare workers and be better prepared for future outbreaks.
Funding for the federal Hospital Preparedness Program, which helps improve planning and coordination between hospitals, dropped from $358 million in 2013 to $255 million this year, so this could be another area where the administration looks to bolster resources.
“If you put some resources into the public health system, it’s going to help you in whatever the next emergency might be whether it’s a hurricane coming through or an act of bioterrorism or another pandemic flu, or food-borne illness. You have to be resilient,” Hamburg said.
“You can’t just turn on the switch and provide these funds after an outbreak. You can’t stop everything from happening. But the key is you can mitigate the effects.”
The federal government should improve education efforts to better inform the public, experts say.
Once the Ebola outbreak entered the U.S., there appeared to be confusion about how the disease can be contracted. Some people have even been spotted in public places wearing their own hazmat suits.
“We need to make sure there’s better public information. That’s a place that we’re lacking. There’s been a lot of misinformation out there,” Hamburg said.
Hamburg said the administration should work to at least communicate the right information to the public to explain what people should and shouldn’t be worried about.
Money for a public education effort? It’s a possibility.
Stockpile protective equipment
The CDC is revising guidelines for how healthcare workers should cover up when treating an Ebola patient.
Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said Sunday that the new guidelines will require healthcare workers to cover up “with no skin showing.”
“Personal protective equipment and training of the use of it is probably the most important area of need,” said Eili Klein, assistant professor in the Department of Emergency Medicine at Johns Hopkins University.
Healthcare observers, in fact, questioned how the nurses in Dallas contracted the disease if they had covered up properly. Obama administration officials say the degree to which they were covered varied.