Is the U.S. Ready for Zika? No.

Could this be the summer of Zika? This mosquito-borne virus has spread to 37 countries and territories in Latin America and most experts believe it will arrive in North America in the next few weeks. Almost 1,000 cases have already been reported in Puerto Rico, and doctors have diagnosed more than 500 cases of Zika in travelers who carried the virus to the United States.

Although Zika causes only mild illness or no symptoms in most people, scientists have linked the virus in pregnant woman to a potentially severe birth defect called microcephaly, defined by unusually small head size, as well as other fetal brain defects. The virus may also cause Guillain-Barré Syndrome, causing muscle weakness or paralysis.

Despite this looming danger, our nation is not well-prepared for a Zika outbreak, or the many other infectious diseases threatening the population, from emerging viruses like MERS-CoV to longtime threats like flu and HIV/AIDS that sicken millions and cost the U.S. billions annually. Special funds for public health preparedness in states and communities have been cut by more than 30 percent over the last decade, and hospital preparedness funds by more than half. Without enough public health staff to set and retrieve mosquito traps, test the mosquitos, and screen vulnerable people who may have been exposed, it will be hard to keep the Zika virus under control.

Even more troubling, the burden of a Zika outbreak will fall disproportionately on poor and minority communities, who already have difficulty accessing health care. Abandoned buildings, lack of screens and air-conditioning, trash strewn-vacant lots, standing water – all are breeding grounds for the types of mosquitos that can transmit diseases. A Baltimore study found that the number of disease-carrying mosquitoes in the city’s poorer Harlem Park and Franklin Square neighborhoods during peak mosquito season was roughly three times the number in wealthier areas. Those neighborhoods are also overwhelmingly African-American.

Meanwhile, summer bears down, and Congress is still debating President Obama’s February request for $1.9 billion in emergency funding to fight Zika. The Senate is expected to vote this week on a $1.1 billion dollar  proposal, while the House has introduced a bill to provide $622 million in funding, shifted in part from money unspent to fight the Ebola outbreak of two years ago. The Centers for Disease Control and Detection (CDC) and the National Institutes of Health have come up with $589 million in redirected funding, but those agencies say it is not enough.

Two research projects funded by the Robert Wood Johnson Foundation highlight the nation’s lack of preparedness: the report Outbreaks: Protecting Americans from Infectious Diseases, by the Trust for America's Health (TFAH), and the National Health Security Preparedness Index. Both determined that Southern states with high rates of poverty, particularly those along the Gulf Coast, scored poorly on measures for preventing, detecting, diagnosing, and responding to infectious disease outbreaks. These states are also the ones most likely to harbor mosquitoes carrying the Zika virus.

Earlier this month, at a TFAH briefing on the Outbreaks report, panelists agreed that the best defense against Zika and other infectious diseases is a robust public health and preparedness system. The U.S. instead tends to react to “the disease of the day,” said Umair A. Shah, executive director of the Harris County (Texas) Public Health & Environmental Services. “We should be investing in a proactive fashion with a broad-based platform of public health emergency funding.”

This is no time to be complacent.  Community groups, health providers, employers, local officials – we all need to come together to help reboot our approach to public health, in every region.  As Senator Marco Rubio of Florida said recently about Zika, “the money is going to be spent, and the question is do we do it now before this has become a crisis or do we wait for it to become a crisis?”

Please share in the comment any ideas you may have, or efforts already in place in your community, for improving our ability to respond to public health threats. And click here to see how your state measures up on an interactive map of the nation’s public health preparedness index.