Testimony of the Infectious Diseases Society of America’s (IDSA)
Pediatric Infectious Diseases Society (PIDS)
prepared for the
U.S. Senate Committee on Appropriations Hearing:
“U.S. Government Response – Fighting Ebola and Protecting America”

Submitted by
Stephen B. Calderwood, MD, FIDSA,
IDSA President

 
The Infectious Diseases Society of America’s (IDSA) Pediatric Infectious Diseases Society (PIDS) thanks the Committee for convening this hearing and inviting stakeholder input on the Administration’s request for emergency funding to combat Ebola virus disease (EVD).

The world has witnessed and responded to outbreaks of EVD over the last forty years. However, the current situation in West Africa is the largest and most complex to date. Healthcare systems in the region are struggling to manage the outbreak, leading to a public health and humanitarian crisis. Children under five years may be at increased risk for illness and death. Almost one in five EVD cases from the current outbreak in Guinea are children. All babies born to mothers with known active Ebola virus disease to date have died. U.S. leadership and resources are necessary to mobilize a well-coordinated response that contains and stops EVD at its sources in West Africa—also by far the best strategy for preventing a domestic outbreak.

IDSA and PIDS strongly support the request for $6.18 billion of supplemental appropriations to respond to the EVD crisis and improve public health capacity to deal with infectious diseases. We urge that this funding not come at the expense of other infectious diseases programs, so that preparedness and response efforts for future outbreaks are not undermined.

IDSA represents more than 10,000 physicians and scientists who are devoted to patient care, prevention, public health, education, and research in the area of infectious diseases. PIDS is the world’s largest organization of professionals dedicated to the treatment, control and eradication of infectious diseases affecting children. Our societies’ members have been closely engaged in the EVD crisis and many are lending their time and expertise to help prevent new cases and treat those already sick.

IDSA and PIDS are providing support to members who wish to volunteer in West Africa, and engaging in multiple other activities to contribute to the broader response, including:
  • Collaborating with other experts to develop standard protocols for supportive care for patients with EVD;
  • Working with the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) to provide our members across the country with authoritative resources for managing institutional and clinical situations involving EVD;
  • Providing the CDC with IDSA member volunteers to participate in Rapid Ebola Preparedness (REP) team visits to assess US health care facilities’ readiness;
  • Collaborating with others in the scientific community to establish research protocols and common case report forms (CRFs) for use in studying biomedical interventions for domestic EVD patients and post-exposure prophylaxis for exposed healthcare providers, e.g., needle stick;
  • Serving as a resource in the media to provide the public with scientifically sound information, including issuing a recent statement in opposition to mandatory involuntary quarantine for asymptomatic healthcare workers returning from West Africa; and
  • Partnering with sister organizations the Society for Healthcare Epidemiology of America (SHEA) and the HIV Medicine Association (HIVMA) to provide coordinated expert feedback and support to leading federal responders.
These efforts, and those of other nongovernmental organizations, must be complemented by a robust federal government response. The U.S. has already taken many promising steps to address this outbreak both here and abroad. In particular, IDSA and PIDS support the guidance and recommendations from the CDC and the National Institutes of Health (NIH), including for monitoring of heath care workers who have cared for patients with EVD and regarding restrictions on travel to and from affected West African countries. But it is critical that we remain vigilant in our response and provide the additional resources necessary to stop this deadly outbreak at its source if we are also to have the best chance to minimize its impact here at home.

We ask that the $2.43 billion contained in the request for the Department of Health and Human Services be provided as soon as possible. The CDC has highlighted the need for funding to support prevention, detection, and response activities for EVD within the U.S. and in West Africa. The request provides necessary training and personal protective equipment (PPE) for healthcare workers, increases capacity for states and localities to deal with EVD patients through more than 50 Ebola treatment centers, as well as targets EVD in West Africa with necessary interventions such as enhanced infection control practices and increased surveillance.

The outbreak of EVD in West Africa demonstrates the tremendous threat posed by infectious diseases around the globe. We are pleased that the Administration’s request includes $1.98 billion to USAID to support global health security activities. These funds promote health at home and abroad by establishing a base level of public health infrastructure in countries most vulnerable to the outbreak of infectious diseases.

The federal government plays an important role in catalyzing the research and development (R&D) of new tools necessary to address infectious diseases. Our ability to prevent and respond to outbreaks of EVD relies on this work. We urge the Committee to also advance the funding requested to speed R&D for new vaccines, therapeutics, and diagnostics through the Biomedical Advanced Research and Development Authority (BARDA), National Institutes of Health (NIH), Defense Advanced Research Projects Agency (DARPA), and the Food and Drug Administration (FDA).

The response necessary to control EVD largely resembles that required for outbreaks of other infectious diseases. With adequate resources and guidance, we will stop the spread of this outbreak and improve our ability to deal with infectious diseases in the future. We appreciate your attention to the EVD crisis, encourage you to advance the Administration’s emergency funding request, and offer IDSA and PIDS as resources to assist in your efforts.