The document discusses U.S. funding to address the Zika virus internationally. It notes that as of September 2015, $2.32 billion in unobligated funds remained from previous Ebola funding allocations. In February 2016, the U.S. requested an additional $1.86 billion for the Zika response, to be allocated across agencies such as CDC, NIH, USAID, and HHS. Key issues discussed include how to reallocate leftover Ebola funds, efficiently distribute new Zika funds across countries and between bilateral and multilateral aid, and find the proper balance between preparedness, health systems strengthening and disease response, and research.

1. U.S. Assistance for International Zika
Responses
Tiaji Salaam-Blyther
Specialist in Global Health
March 5, 2016

2. U.S. Global Health Funding: FY2001-FY2017
(in constant 2016 U.S. $ millions)
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Source: Created by CRS from congressional appropriations and congressional budget justifications.

3. Share of U.S. Global Health Assistance by Disease
Category: FY2001-FY2017 Request
(in constant 2016 U.S. $ millions)
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Source: Created by CRS from congressional appropriations and congressional budget justifications.
Note: HIV/AIDS, Tuberculosis, and Malaria (HTAM)

4. USAID Global Health Funding in the Caribbean:
FY2015 and FY2017 Request
(current U.S. $ millions)
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Types of Aid Provided by
USAID in the Caribbean:
Barbados and Eastern
Caribbean Regional
• HIV/AIDS
Dominican Republic
• HIV/AIDS
Haiti
• HIV/AIDS
• Maternal and Child Health
• Family Planning and
Reproductive Health
• Nutrition
Latin American and
Caribbean Regional
• Malaria
• Maternal and Child Health
• Family Planning and
Reproductive Health

5. Zika Emergency Request: FY2016
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Agency/Activity Amount
U.S. Centers for Disease Control and Prevention
- Domestic Responses
$828
million
Puerto Rico’s Medicaid Federal Medical Assistance Percentage
- Health Services for Pregnant Women
$250
million
National Institutes of Health (NIH) and Food and Drug
Administration (FDA)
- Vaccine Research and Diagnostic Development
$200
million
U.S. Department of Health and Human Services
- Establishment of an Urgent and Emerging Threat Fund to
support domestic preparedness
$210
million
U.S. Agency for International Development (USAID)
- Support for affected countries
$335
million
U.S. Department of State
- Support for U.S. citizens in affected countries
- Support for Zika responses by the World Health Organization
(WHO) and the Pan American Health Organization (PAHO)
$41
million
Total $1,864
million

6. Unobligated Ebola Funds for International
Assistance as of September 30, 2015
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Agency/Activity Amount
U.S. Centers for Disease Control and Prevention (CDC)
- Disease Control Assistance in Foreign Countries
- Global Health Security Agenda
$920 million
- $389 million
- $531 million
U.S. Agency for International Development
- International Disaster Assistance
- Global Health Security and Infectious Disease Control
- Training and Assistance to Prevent Economic and
Government Instability
$1,399 million
- $567 million
- $207 million
- $625 million
U.S. Department of State
- Medical Support and Evacuation and Repatriation
$3 million
Total $2,322 million
Sources: Departmental spend plans and/or quarterly reports and additional departmental communications.
Note: Excludes funds for domestic responses and research and development.

7. Issues to Consider
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If Unobligated Ebola Funds are Reprogrammed:
• Resurgence?
• Containing isolated cases?
Efficient Allocation of Resources:
• Identifying country capacities across region
• Determining appropriate balance of bilateral and
multilateral support
• Concentrate resources in epicenter or vulnerable
states?
Appropriate balance of:
• Preparedness and Response Funds?
• Health Systems and Disease Response?
• Research and Development?
Reconsider Degree of Engagement in Region?

8. CRS-8
Thank You!
Tiaji Salaam-Blyther
tsalaam@crs.loc.gov
(202) 707-7677