ESA leads the charge as vector control stakeholder groups join forces
Once the Zika transmission cycle in the US was effectively controlled in 2016, the wave of attention turned to vector borne disease and our preparedness for effectively managing a major vector borne disease outbreak. To conduct an assessment of the country’s capacity, CDC commissioned the National Association of City and County Health Officials (NACCHO) and sadly, the answer they came back with regarding our preparedness was not very good.
To make headway, a group of forward-thinking stakeholders is seizing the opportunity for a more proactive approach by focusing on connectivity, communication, and the kind of solidarity that can drive real change to that outcome. While the capacity assessment brought some incongruencies to light, perhaps more importantly, it also resulted in some constructive dialogue between stakeholder groups that is only increasing as time goes on.
“Zika brought awareness to what we do and awareness is always a good thing,” says Angela Beehler, Chair of the AMCA Regulatory Committee. She says preparedness is ultimately going to vary district by district, but what the assessment also revealed was an underlying challenge based on siloed responsibility and a lack of effective communication across the industry.
“There is a need, nationwide, for communication and I think people have really identified that need,” Beehler says. “It takes a lot of work to try to get that communication flowing, especially when federal funding goes to State Health Departments, and the States need to prioritize that funding based on the current health issues. Under the current system, there isn’t enough money to support entomologists and epidemiologists on a state level. By failing to maintain vector borne disease staff and infrastructure between epidemics, we lose consistent communication nationwide.”
Beehler said AMCA decided to make a priority of doing a better job of aligning its asks to Congress with other groups, and was pleased to find that other organizations were going down the same path. In addition to NACCHO, Beehler and AMCA also connected with the Association of State and Territorial Health officials (ASTHO), epidemiologists, lab associations and numerous other stakeholders.
“Every time I made a connection with an organization, I was given two more potential contacts, so the list of public health partners grew rapidly,” Beehler laughs.
Cross Functional Strategy
The idea, Beehler says, is that when AMCA goes to Washington, its position papers should reflect what other groups are bringing to their legislators, unifying the message and giving us the best chance at success.
“What Zika brought to light is who all are involved in vector control. It’s us, it’s CDC, it’s EPA, it’s private pest control,” says Beehler, “people in different regions of the country using the limited resources they have available, taking into consideration the climate and even culture of their area – all of the local health jurisdictions that are charged with doing mosquito surveillance and/or disease surveillance on some level, and they are expected to be prepared for whatever new disease may come.”
“In order to be able to fund all of this work, we want to make sure our public health partners have similar priorities and are asking for the same amount of money; demonstrating that we’re on the same page as far as the big picture. The idea is to get that funding, get preparedness and response plans in place, so everyone understands and is comfortable in their role.”
It’s Beehler’s job, among others with AMCA, to make those connections and help key influencers understand that disease preparedness is important and that it has a public function, and that vector-borne disease case numbers in this country are not decreasing, they’re increasing. It’s a goal Beehler shares with her counterpart, Chelsea Gridley-Smith, Director, Environmental Health at NACCHO.
NACCHO is comprised of 3000 local health department-members that include vector control workers and agencies. In the past, NACCHO had more of a rodent-based vector focus. But that focus is expanding. Like AMCA, NACCHO saw the Zika crisis as a stepping stone to more concerted and collaborative work with other organizations. As the two organizations started to connect, they were invited to join the Vector-Borne Disease Network (VBDN), a like-minded collaboration started by the Entomological Society of America (ESA).
“We are thrilled that ESA has taken a leadership role,” says Gridley-Smith. “The VBDN is really about amplifying our individual efforts. If there was ever a time when it was important to communicate and lean on each other, now is the time.”
Face Time in DC
The first in-person meeting of the VBDN was in December at the offices of AMCA’s legal firm, McDermott Will & Emery. The coalition includes 24 founding members such as ESA, AMCA, NACCHO, ASTHO, The American Society of Tropical Medicine and Hygiene, The Society of Vector Ecology, and others.
The event was coordinated by ESA’s recently appointed Executive Director, Chris Stelzig and future efforts will be coordinated through the new Director of Strategic Initiatives, Erin Cadwalader. Cadwalader says the meeting was more introductory than strategic, but it served an important purpose to get things moving.
“This first meeting was very well-attended,” Cadwalader says. “It showed the level of interest in what we’re trying to accomplish. We went around the room and talked about our respective organizations, what our missions are, and agreed on a process of email communication with periodic calls.”
Cadwalader says that the VBDN can immediately start to help coordinating responses when big news like the president’s new budget came out.
“Things like that can go right into our communication channel now, so everyone’s on the same page. This enables us to draft an appropriations request on behalf of the VBDN that represents a significantly larger number of individuals and organizations with a unified message. If we all share our requests, and all of the requests are on the same page, it will give us a better chance at success.”
The VBDN will be submitting letters to Congress asking them to support $8.3 billion for CDC in the FY 2021 Labor, Health and Human Services, Education and Related Agencies appropriations bills, full funding for vector-borne disease (VBD) efforts authorized by the Kay Hagan TICK Act (see sidebar) and the Pandemic and All Hazards Preparedness and Advancing Innovation Act, which includes the language of the Strengthening Mosquito Abatement for Safety and Health (SMASH) Act to increasing vector surveillance and testing, which many members of the coalition supported.
The TICK Act
Supporting the introduction of the TICK Act is a primary focus area of the Vector-Borne Disease Network (VBDN). The legislation was introduced in the U.S. Senate on May 23, 2019 by Sens. Susan Collins (R-ME) and Tina Smith (D-MN). Sen. Angus King (I-ME) is an original co-sponsor. The full text of the legislation may be found at https://www.entsoc.org/sites/default/files/files/Science-Policy/2019/TICK-Act-introduced.pdf. In brief, the legislation would establish an Office of Oversight and Coordination for Vector-Borne Disease at the Department of Health and Human Services (HHS), reauthorize the Regional Centers of Excellence in Vector-Borne Disease for five years at $10M per year, and authorize CDC grants at $20M per year that would be awarded to State Health Departments. Leadership of the coalition had the opportunity to review an early draft of the legislation and was able to suggest changes which added more of a vector management focus. The bill was signed into law at the end of 2019.