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Omnibus Expected to Include Funding to Fight Ebola

Appropriators are expected to include significant extra funding in an omnibus spending package to help agencies continue responding to the Ebola outbreak, but the final number will be less than President Barack Obama requested.

The president renewed his call for the emergency funding with a visit last week to the National Institutes of Health, following positive news about an Ebola vaccine candidate. Last month, Obama requested nearly $6.2 billion in emergency funding for the Ebola response, including $420 million to support advanced clinical trials, manufacturing, and review and regulation of potential vaccines and treatments.

House and Senate appropriators said they expected the fiscal 2015 spending package, which they plan to be unveil this week, to include less money for Ebola than the president requested — but they did not say how much less.

Jack Kingston, chairman of the House Appropriations subcommittee on Labor, Health and Human Services, said, “$6.1 billion is a lot of money, particularly since the agencies that it goes to often have efficiency problems. We’re really going over that with a fine-toothed comb.”

The Georgia Republican said he expected a big part of the cut would come from a requested contingency fund, which would give $751 million to HHS and $792 million to the State Department and U.S. Agency for International Development. The administration said the fund would help provide flexibility in responding to the evolving situation, and could support expanded monitoring or enhanced global health security efforts. If a vaccine is found to be safe and effective, the contingency fund also could support a limited vaccination campaign for health care workers treating Ebola patients.

Iowa Democratic Sen. Tom Harkin, chairman of the Senate Appropriations subcommittee that oversees HHS, also said he expected the Ebola request to be cut, but did not know by how much.

Because the extra funding would go to many different departments and agencies — HHS, USAID, State and Defense — any agreement on a final level will need the support of multiple lawmakers.

If leaders cannot come to an agreement on a spending plan, or if their package does not win support from the White House and a sufficient swath of lawmakers, they will have to resort to a backup plan of a government-wide short-term continuing resolution. Such a bill could include an “anomaly” that would provide some additional funding for the Ebola response, but it would likely be significantly less than the request.

Speaking at the NIH, Obama called on Congress to provide the emergency funding before adjourning for the holidays, and said he has been encouraged by bipartisan support for the plan in visits with lawmakers. He also asked Congress to maintain ongoing investments in biomedical research.

“No potential Ebola vaccine has ever made it this far, so this is exciting news. But it’s also a reminder of the importance of government-funded research and our need to keep investing in basic research,” he said to applause at the NIH.

Currently, there are no therapies or vaccines certified as safe and effective for treating or preventing Ebola. Last week, the NIH announced successful results from a phase one clinical trial for one of the five Ebola vaccine candidates that HHS is supporting, known as cAd3. Results from phase one clinical trials for another vaccine candidate are expected sometime this month, and the other three candidates are still a few months away from phase one trials, according to the White House.

Obama warned that more money will be needed to continue the progress. “We cannot beat Ebola without more funding. If we want other countries to keep stepping up, we will have to continue to lead the way,” he said.

The NIH is continuing its accelerated plans for wider testing of the cAd3 vaccine candidate, according to Anthony Fauci, director of the NIH’s National Institute of Allergy and Infectious Diseases. But despite multiple agencies’ fast-tracking, it could easily be several months before a vaccine candidate is ready for distribution.

Trials of some of the vaccine candidates are happening in other countries, and the NIH, Department of Defense and the Biomedical Advanced Research and Development Authority are supporting production of tens of thousands of doses of vaccines for planned trials, the administration says.

The NIH and Centers for Disease Control and Prevention are discussing with West African governments about planning large phase two and phase three clinical trials to test vaccine candidates in communities there. “These trials are anticipated to begin in the near future,” the White House said in a fact sheet.

Targeted Funding

Given the results and planned next steps, “there’s something to be said for funding that targets this Ebola vaccine,” said Ellie Dehoney, vice president of policy and advocacy at Research!America. She noted that convincing people in at-risk nations to participate in the trials could be challenging, and that the cost of doing such testing in the real world can be dramatically higher than in laboratory settings.

The president’s emergency funding request includes $238 million for the NIH to support advanced clinical trials evaluating the safety and efficacy of investigational vaccines and therapies, and $157 million for BARDA to manufacture those products for use in clinical trials. In addition, the FDA would receive $25 million to help develop, review, and regulate Ebola vaccines and treatments.

Dehoney says that even a one-time funding boost could help researchers who are working on developing Ebola treatments and vaccines. But she warned that lawmakers also need to focus on “reinvigorating” the NIH so it can be able to respond to all kinds of diseases and public health threats. Disruptions in research funding come at the cost of lives and time, she said.

Several Democratic lawmakers have also used the Ebola crisis to push for increasing overall funding for the NIH.

Tamar Hallerman contributed to this report.

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