Posts Tagged ‘Congress’
By: Melissa Pegues, Ph.D.
On February 1, 2016 the World Health Organization (WHO) declared the Zika outbreak a public health emergency, meaning that the response requires the coordination of global partners to detect infections, control mosquito populations, and develop vaccines and diagnostic tests to prevent the spread of the disease. With concerns that Zika will move into the US as summer begins, there is an urgent need to contain the epidemic. Congress, however, has been slow to respond and continues to debate how exactly to fund the fight.
Zika infection is rarely fatal and is commonly accompanied by symptoms such as rash, fever, and joint pain, but some do experience more serious symptoms including Guillain-Barre syndrome, a rare form of paralysis. However, Zika gained significant publicity when medical professionals in Brazil and other Latin American countries noticed a frightening association between Zika virus infection in pregnant women and babies born with microcephaly. Microcephaly is a rare birth defect where infants are born with underdeveloped brains and smaller than average head size. Although only considered an association for many months, studies of Zika infection in pregnant mice and monkeys have found evidence supporting the link between Zika infection and microcephaly. In support of the mounting evidence, Tom Frieden, the director of the Centers for Disease Control (CDC), recently stated that “It is now clear that the virus causes microcephaly.”
While research moves quickly to demystify the Zika virus, the political system has failed to gain a foothold amongst the confusion. The White House had requested $1.885 billion towards the Zika fight in February, and in a rare bi-partisan effort, Marco Rubio (R-FL) and Bill Nelson (D-FL) topped Obama’s request with a $1.94 billion proposal that included $144 million for vaccine research that would also include funding for research into dengue fever and chikungunya. That proposal ultimately never came to a vote. The Senate has approved $1.1 Billion in emergency funds and the House of Representatives has offered a bill that would reallocate just $622 million from existing programs for the Zika response, but neither measure has been passed by both chambers.
The Capital Hill battle over Zika has revealed a number of underlying political viewpoints that each affect how politicians respond to this crisis. Republicans worry that abortions may increase due to the severe birth defects associated with Zika infections in pregnant women, and with evidence mounting that Zika can be sexually transmitted, Republicans are debating whether the better message is use of contraception or abstinence. Federal public health officials have countered that they do not believe their role is not to tell women if they should become pregnant, but rather focus on preventing spread of the disease. Pope Francis has weighed in and suggested that the use of contraception is acceptable to help prevent the spread of Zika.
On the other hand, Democrats have expressed concern over use of pesticides. In a proposal meant to help control mosquito vector populations, Senator John Cornyn (R-TX) suggested easing regulatory restrictions on pesticides. Democrats have accused Republicans of trying to exploit fears and countered that exceptions for use of pesticides already exist. The White House also commented that the Republican-led House’s proposal removes Clean Water Act protections that are not acceptable during this emergency. Democratic representatives Peter DeFazio (D-OR) and Grace Napolitano (D-CA) stated “Over the years, proponents of exempting pesticide spraying from the Clean Water Act have used the crisis of the day as the reason to support their legislation.”
While Congress debates how to best combat Zika, the CDC reports that the number of cases of pregnant women in the US with the virus has climbed to 279 as of late May, and multiple models are predicting the spread across the US. Furthermore, WHO chief, Margaret Chan, has cited a number of policy failures that allowed for lapses in mosquito control and the spread of Zika. At a recent World Health Assembly meeting, Chan said Zika took the world by surprise and revealed fault lines in the world’s collective preparedness. In addition, the spread of Zika, resurgence of dengue, and the emerging chikungunya threat are prices paid for “a massive policy failure that dropped the ball on mosquito control in the 1970s.”
With the outbreak of Zika spreading, many concerns have arisen over how to respond to Zika and prepare for other emerging threats. In a recent essay, Ronald A. Klain, the White House Ebola response coordinator from 2014 to 2015, urged Congress to put aside their differences and fund preventive measures for new epidemics. He stated that the threat of emerging disease is “not coming to the United States: It is already here.” In support of this, the Senate recently voted 93-2 to move forward with negotiations with the House of Representatives. Public officials have continued to urge politicians to focus on controlling the disease, but Chan stated that for now “all we can offer is advice. Avoid mosquito bites. Avoid pregnancy. Do not travel to areas with ongoing transmission.”
By: Kimberly Leblanc, Ph.D.
Earlier this month, the Office of Disease Prevention and Health Promotion released the new nutritional guidelines, Dietary Guidelines for Americans, for 2015-2020. Many of the guidelines are familiar from previous versions, recommending a wide range of fruits and vegetables, at least 50% of grains being whole, fat-free or low-fat dairy, a variety of lean proteins, and limiting saturated fats, trans-fats, and sodium. One of the new recommendations was a stricter limit on sugar intake, with no more than 10% of daily calories coming from added sugar. The World Health Organization (WHO) has made similar recommendations, citing evidence that lowering added sugar could reduce the risk of obesity, heart disease, Type 2 diabetes and some types of cancer. In an article for Politico, Michael Jacobson, president of the Center for Science in the Public Interest (CSPI), said that the recommended limit is “a major step forward.” The biggest surprise in the guidelines was the recommendation that men and boys “reduce their overall intake of protein foods” such as meat, poultry and eggs, and add more vegetables to their diets.
The nutritional advice is updated every five years, and it has become mired in political controversy because of its impact on how the food industry does business and how Americans eat. Recommendations from the report guide decisions on the aims of food assistance programs, the content of school meals, the labeling and advertising of food products, and the advice given by health professionals. With billions of dollars at stake, food industry groups bristle at any potentially negative mention of their products. The interest groups unhappiest with the guidelines are likely to be sugar growers and food manufacturers, as a result of the government’s new recommended limit on added sugars. However, before the recommendations could make it to the new guidelines, they were met with strong opposition from a number of corporate and agricultural interest groups, the meat industry in particular.
One of the many recommendations made by the Dietary Guidelines Advisory Committee in their report that did not make it into the final version of the guidelines was for Americans to adopt a diet low in red and processed meat, which met with strong opposition from meat industry groups. The National Cattlemen’s Beef Association, the National Pork Producers Council, and the North American Meat Institute spent hundreds of thousands of dollars last year lobbying, with a part of their goal being “to get lean beef recognized in the final health dietary patterns statement.” “Those things should be part of, and remain part of a balanced diet, and there’s no reason to cut back,” said Dave Warner, spokesman for the National Pork Producers Council. That comment stands in stark contrast to the findings of the WHO last October, which classified the consumption of red meat as “probably carcinogenic to humans” and the consumption of processed meat as “carcinogenic to humans” based on “sufficient evidence in humans that the consumption of processed meat causes colorectal cancer.” The 2015 Dietary Guidelines Advisory Committee was more conservative in their report, stating, “moderate evidence reports inconsistent positive associations between colorectal cancer and the intake of certain animal protein products, mainly red and processed meat. Limited evidence shows that animal protein products are associated with prostate cancer incidence.”
Another recommendation that didn’t make the cut was the advice for Americans to consume more plant-based foods and less meat to help promote environmentally sustainable eating habits. That suggestion elicited intense lobbying and criticism from the food and meat industries, leading to a congressional hearing on the topic last year. In December of 2015, Congress passed a spending bill that contained a directive for the Obama administration to ignore environmental factors and focus solely on nutrients in the next revision of the guidelines. However, food production, and livestock in particular, has a significant negative impact on the environment. Livestock producers, which include meat and dairy farming, account for about 15% of greenhouse gas emissions around the world. That’s more than all the world’s cars, buses, boats, and trains combined. If you think regulating this would fall under the Environmental Protection Agency’s jurisidiction, think again. In December of 2015, Congress renewed a provision that prevents the EPA from requiring emission reports from livestock producers, making the meat industry the only major source of greenhouse gases in the country excluded from filing annual reports. Despite the evidence and the recommendations from the committee, the pressure from industry and farm state lawmakers has led USDA Secretary Tom Vilsack and HHS Secretary Sylvia Mathews Burwell to promise furious lawmakers that they would steer clear of recommendations concerning the environmental impact of the consumption of meat.
Nutritional issues were also a bargaining chip in the spending bill that was passed in December. In recent years, reforms to the school lunch and breakfast programs have allowed the USDA to improve critical nutritional standards. A study published in JAMA Pediatrics earlier this month concluded that the nutritional quality of school meals has increased by about 30 percent, and an analysis by the Centers for Disease Control and Prevention (CDC) documents improvements, too. Yet the School Nutrition Association (SNA), which represents cafeteria directors and receives financial support from food companies, has lobbied Congress to relax some standards, complaining that the sodium standards would be “extremely difficult to achieve” and that stricter nutritional standards have led to cafeterias losing money. Their demands were met in the congressional directives that were attached to the bill, which prohibits the federal government from requiring less salt in school lunches until more research is done and allows schools to obtain exemptions from whole-grain requirements. This despite the fact that the CDC found in 2014 that 90% of school-aged kids eat too much sodium, and that the USDA reports that 97% of all schools are already meeting the 100% whole grain rich rules. As of January 20th, 2016, the Senate Agriculture Committee has voted in support of a compromise plan in the re-authorization of the Healthy, Hunger-free Kids Act, which incorporates the SNA’s demands to table the sodium recommendations and allow exemptions to the whole-grain requirement. The SNA had also asked to relax the fruit and vegetable requirement, but lawmakers didn’t budge on this key tenet of the standards.
Nutritional research is constantly evolving, and our guidelines should evolve with new evidence as it comes out. Debates over the scientific evidence for certain guidelines, such as the link between saturated fat and heart disease, are reasonable. That’s the point of having a Dietary Guidelines Advisory Committee made up of scientists and medical professionals review the evidence before submitting their recommendations. As a prime example, the committee reversed the recommended cholesterol limit of 300mg/day in the new guidelines “because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol.” However, scientific evidence isn’t the only factor influencing our guidelines. Agricultural and corporate interest groups, due to their size and financial incentives, have the power to shape the nutritional guidelines based on economic interests rather than scientific evidence. This power, and the desire of certain politicians to cater to these groups, is troubling, especially in a time when childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years and when type 2 diabetes accounts for 20% to 50% of new-onset diabetes case patients in youth.