Zika Response Funding: In Brief
Susan B. Epstein, Coordinator
Specialist in Foreign Policy
Sarah A. Lister
Specialist in Public Health and Epidemiology
April 28, 2016
Congressional Research Service
7-5700
www.crs.gov
R44460

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Contents
Introduction ..................................................................................................................................... 1
Congressional Actions ..................................................................................................................... 2
The Emergency Supplemental Appropriations Request for Zika Response Efforts ........................ 2
Health and Human Services ...................................................................................................... 3
Centers for Disease Control and Prevention (CDC) ........................................................... 3
Public Health and Social Services Emergency Fund (PHSSEF) ........................................ 3
National Institutes of Health (NIH) .................................................................................... 4
Food and Drug Administration (FDA) ................................................................................ 4
Medicaid Funding for Territories ........................................................................................ 4
Retroactive Reimbursement ................................................................................................ 5
Transfer Authority ............................................................................................................... 5
Expanded Definition of “Security Countermeasure” .......................................................... 5
International Assistance Programs ............................................................................................ 5
Department of State ............................................................................................................ 6
USAID ................................................................................................................................ 6
Use of Ebola Balances for Other Infectious Diseases ......................................................... 7
Transfer Authority ............................................................................................................... 7
Notwithstanding Authority .................................................................................................. 8
Direct Hiring Authority/Personal Services Contractors ...................................................... 8
HHS, State/USAID, and DOD Unobligated Ebola Response Funds .............................................. 8

Tables
Table 1. FY2015 Emergency Funds Appropriated for Ebola Response and Related
Activities, and Unobligated Balances .......................................................................................... 9

Contacts
Author Contact Information ........................................................................................................... 11
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Introduction
In its second session, the 114th Congress is considering whether and how to provide funds to
control the spread of the Zika virus throughout South and Central America. Zika infection,
primarily spread by Aedes mosquitoes, has been linked to severe birth defects and other health
concerns. Local transmission of the Zika virus has occurred in American Samoa, Puerto Rico, and
the U.S. Virgin Islands, and transmission is expected on the U.S. mainland this summer, in areas
where Aedes mosquitoes are present.1
Federal efforts to address the outbreak include research on the infection and its effects, mosquito
control measures, and efforts to develop a vaccine. The public health focus, both domestically and
elsewhere in the Americas, is to protect pregnant women from infection and prevent birth defects.
Administration officials and some in Congress are concerned about the resources needed to
prevent widespread Zika infections as the Northern Hemisphere summer approaches.
On February 8, 2016, the Obama Administration submitted a request for more than $1.89 billion
in supplemental funding to respond to the Zika epidemic, all of which is requested as emergency
FY2016 discretionary appropriations, and therefore effectively exempt from spending limits in
the Budget Control Act of 2011 (BCA, P.L. 112-25).2 The Administration’s request includes
$1.509 billion for the Department of Health and Human Services (HHS), $335 million for the
U.S. Agency for International Development (USAID), and $41 million for the Department of
State. The request also seeks authority to transfer some of those supplemental emergency
appropriations across other federal agencies, such as the Department of Defense, the
Environmental Protection Agency, and the U.S. Department of Agriculture, to allow greater
flexibility as circumstances change. It also would provide HHS, the Department of State, and
USAID with two personnel management authorities for, but not limited to, addressing the Zika
outbreak; broad authority for direct hiring,3 and authority for personal services contracting.4
As of late April 2016, the House and Senate Appropriations Committees have not acted on any
supplemental appropriations measures to address the Zika outbreak. Some in Congress have
considered whether unobligated (uncommitted for expenditure) FY2015 funds that had been
provided to respond to the Ebola virus outbreak should be used to fund part of the Zika response,
either temporarily or permanently.5 On April 6, 2016, the White House Office of Management

1 For more information, see CRS Report R44368, Zika Virus: Basics About the Disease; CRS In Focus IF10353,
Mosquitoes, Zika Virus, and Transmission Ecology; CRS Insight IN10433, Zika Virus: Global Health Considerations;
and CRS Report R44385, Zika Virus: CRS Experts.
2 White House, Office of Management and Budget, Estimate #1 – FY 2016 Emergency Supplemental: Appropriations
Request to Respond to the Zika Virus both Domestically and Internationally, February 22, 2016,
https://www.whitehouse.gov/omb/budget_amendments. For more information on discretionary spending limits and
Ebola funds designated for emergency requirements, see OMB Final Sequestration Report to the President and
Congress for Fiscal Year 2015, January 20, 2015, at https://www.whitehouse.gov/sites/default/files/omb/assets/
legislative_reports/sequestration/sequestration_final_january_2015_president.pdf.
3 For more detail, see https://www.opm.gov/blogs/Director/direct-hire-authority/.
4 As defined in regulation, “The Government is normally required to obtain its employees by direct hire under
competitive appointment or other procedures required by the civil service laws. Obtaining personal services by
contract, rather than by direct hire, circumvents those laws unless Congress has specifically authorized acquisition of
the services by contract.” (48 C.F.R. 37.104(a)) Under this authority, federal agencies can quickly contract with
individual scientists, physicians, and other experts to aid in response efforts.
5 Ryan McCrimmon and Jennifer Shutt, “Zika Funding Squabble Engulfs Senate, House and White House,” CQ News,
April 26, 2016.
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and Budget (OMB) and the Secretary of HHS announced that they had identified $589 million—
$510 million of it from “existing Ebola resources within the Department of Health and Human
Services and Department of State/USAID”—that can quickly be reprogrammed and spent on
immediate efforts to control and respond to the spread of the Zika virus in the Americas.6 Specific
information about the available Ebola funds and their intended uses was not made publicly
available.
On April 8, 2016, USAID notified Congress of its intent to redirect $295 million of the $510
million from FY2015 unobligated Ebola Economic Support Funds (ESF) to be used for the Zika
response efforts. Of that amount, USAID will transfer $158 million to CDC, including $78
million for its Zika response and $80 million for its Ebola response. The remaining $137 million
also from FY2015 ESF will be redirected to fund various USAID activities for its Zika response
efforts.
This report presents the Administration’s request for supplemental appropriations for the Zika
response, and information about unobligated Ebola supplemental funds as of January 1, 2016.
Updates will be forthcoming as details become available.
Congressional Actions
On April 21, 2016, Senator Nelson introduced S. 2843, “A bill to provide emergency
supplemental appropriations to address the Zika crisis.” On April 25, 2016, the Ranking Member
on the House Appropriations Committee introduced H.R. 5044 also for funding the Zika
response. Both bills would appropriate supplemental appropriations amounting to $1.64 billion
for FY2016 to respond to the Zika outbreak, including $1.26 billion for HHS and $376.1 million
for international assistance programs.
Introduced April 26, 2016, the Agricultural appropriations bill (H.R. 5054, as reported in House)
would provide $10 million to the FDA (as per the Zika supplemental request) “to support needs
related to work on Ebola and Zika.” In addition, Section 801 would authorize unobligated Ebola
funds to be available “to prevent, prepare for, and respond to Zika virus, domestically and
internationally,” which explicitly allows redirection of unobligated HHS and State/USAID Ebola
funds.
The Emergency Supplemental Appropriations
Request for Zika Response Efforts
The following describes the Administration’s Zika emergency supplemental request components
by agency. For comparative purposes, numbers in parentheses are funding levels in both S. 2843
and H.R. 5044.
It was reported on April 18 that the Administration submitted a revised Zika supplemental request
to Congress, which would maintain departmental request totals, while redirecting some of the
HHS funds requested for contingency use to vaccine research and development at the National

6 OMB, Shaun Donovan, “Taking Every Step Necessary, As Quickly As Possible, to Protect the American People from
Zika,” OMB blog, April 6, 2016, https://www.whitehouse.gov/omb/blog.
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Institutes of Health (NIH).7 Detailed information about this is not publicly available, and the
following narrative does not reflect this revision.
Health and Human Services
The Administration’s emergency supplemental appropriations request to respond to the Zika
outbreak seeks for HHS a total of $1.509 billion ($1.263 billion). Each HHS agency request
includes the statement that funds would be “to prevent, prepare for, and respond to Zika virus,
other vector-borne diseases, or other infectious diseases and related health outcomes,
domestically and internationally.... ” Most of the requested funds would support research,
surveillance, vaccine and test development, and various domestic preparedness activities. A
portion would support international response activities. The request proposes that all
supplemental appropriations to HHS be designated as emergency spending, and remain available
until expended.
Centers for Disease Control and Prevention (CDC)
A total of $828 million ($743 million) is requested for the CDC-Wide Activities and Program
Support account. Proposed request language would, among other things, authorize the CDC
Director to transfer funds between CDC accounts, and authorize funds to be used for real property
acquisition and improvements to non-federal facilities. Funds would be used as follows:
 Grants and technical assistance to Puerto Rico and U.S. Territories—$225
million to, among other purposes, monitor pregnant women and establish a
registry of women infected while pregnant; expand mosquito control activities;
and enhance laboratory testing capacity.
 Domestic Response—$453 million to provide grants to southern and other U.S.
states with Aedes mosquitoes for surveillance, improved test methods and testing
capacity, public education and outreach, mosquito control measures in areas at
risk, and additional federal and state response activities.
 International Response Activities—$150 million to expand the public health
workforce, and enhance infectious disease surveillance and emergency response
activities, in Zika-affected countries; and to support the laboratory network of the
Pan American Health Organization (PAHO), the regional arm of the World
Health Organization (WHO) for the Americas.
Public Health and Social Services Emergency Fund (PHSSEF)
The PHSSEF is a fund used by appropriators to provide the HHS Secretary with ongoing or one-
time emergency funding, such as for the response to disease epidemics. The emergency
supplemental request seeks $295 million ($233 million) for the PHSSEF for the following:
 several maternal and child health and home visitation programs for low-income
pregnant women at risk of Zika infection, and families that have children born
with birth defects related to Zika infection;
 several health care workforce assistance programs for Puerto Rico and other
territories; and

7 Erik Wasson, “Obama Administration Updates Zika Spending Request,” Bloomberg, April 18, 2016.
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 compensation for persons harmed by the use of tests or vaccines used under
emergency authority.8
The requested PHSSEF funds could, in consultation with OMB, be transferred to other agencies
within HHS or across the federal government. The request stated that this transfer authority is to
provide flexibility in response to changing needs. No congressional notification requirement is
included.
National Institutes of Health (NIH)
The emergency supplemental request seeks $130 million ($277 million) for the NIH National
Institute of Allergy and Infectious Diseases (NIAID) to expand research efforts to characterize the
progression and effects of Zika infection and other vector-borne diseases, and to develop vaccines
against them.9 Proposed request language would authorize the NIH Director to transfer funds
between NIH accounts. No congressional notification requirement is included.
Food and Drug Administration (FDA)
The emergency supplemental request seeks $10 million (same) for FDA’s role in reviewing the
safety and effectiveness of medical countermeasures (such test methods, vaccines, and
treatments), and post-market monitoring of such countermeasures if and when they become
available.
Medicaid Funding for Territories10
The emergency supplemental request would temporarily increase the federal matching rate for
Medicaid in the territories. The territories operate Medicaid programs under different rules from
those that apply to the 50 states and the District of Columbia. Federal Medicaid funding to the
states and the District of Columbia is open-ended, but the territories receive capped annual
allotments (i.e., the maximum amount of federal funds available in a year). In addition, the
Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) provides the
territories with additional federal Medicaid funding to use by September 30, 2019. The territories
have a federal medical assistance percentage (FMAP) rate (i.e., federal matching rate) for
Medicaid of 55%.11
The supplemental request includes a provision that would increase the FMAP rate for the
territories to 65% for one year beginning with the first day of the fiscal quarter following
enactment. This increased FMAP rate would be available for all Medicaid expenditures, not
limited to those provided to treat Zika infection. The federal funding for the increased FMAP rate
would not count against the territories’ annual federal spending caps or additional ACA funding.

8 This compensation program is described in “Covered Countermeasure Process Fund” in CRS Report RS22327,
Pandemic Flu and Medical Biodefense Countermeasure Liability Limitation, and HHS, Health Resources and Services
Administration, Countermeasures Injury Compensation Program (CICP), http://www.hrsa.gov/cicp/index.html.
9 This refers to infectious diseases that are transmitted by a living organism (a “vector,” such as a mosquito), from one
host to another.
10 This section contributed by Alison Mitchell, Specialist in Health Care Financing, Domestic Social Policy Division.
11 For more information about the Medicaid program in the territories, see CRS Report R44275, Puerto Rico and
Health Care Finance: Frequently Asked Questions, coordinated by Annie L. Mach.
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The Administration estimates this FMAP rate increase would cause federal Medicaid
expenditures to grow by $246 million.12
There is some question about how this provision would affect Puerto Rico if it were to exhaust its
additional ACA funding prior to FY2019.13 Depending on the timing of enactment, Puerto Rico
might not have access to its full annual Medicaid allotments or additional ACA funding for a
portion of the time the provision would be in effect.14
Retroactive Reimbursement
The request proposes language that would allow funds provided in the act to be used to reimburse
HHS accounts for Zika response expenses incurred prior to enactment.
Transfer Authority
The request proposes language that would allow funds appropriated to HHS in the act to be
transferred to other federal accounts, including the Department of Defense, the Environmental
Protection Agency, and the Department of Agriculture “to prevent, prepare for, and respond to
Zika virus, other vector-borne diseases, or other infectious diseases and related health outcomes,
domestically and internationally.... ,” following consultation with OMB. No congressional
notification requirement is included.
Expanded Definition of “Security Countermeasure”
The request proposes language that would allow the government to support the advanced
development and procurement of medical countermeasures against Zika virus through Project
BioShield. Currently, Project BioShield supports only countermeasures against specific chemical,
biological, radiological, and nuclear terrorist threats.15 The proposed expansion is not limited to
countermeasures against the Zika virus or vector-borne diseases, but rather is stated broadly as a
“countermeasure to diagnose, mitigate, prevent, or treat harm from any infectious disease that
may pose a threat to the public health.”
International Assistance Programs
The Administration’s emergency supplemental appropriations request to respond to the Zika
outbreak seeks for the Department of State and USAID a total of $376.1 million. This includes
funds for control of the disease, prevention, surveillance, evacuating U.S. employees and
American citizens, vaccine development, and diagnostic research, among other things.
Specifically within the International Assistance section of the request is a request for transfer
authority (without a requirement for congressional notification) with certain limitations,

12 The funding for this provision would be provided through a change in mandatory programs (CHIMP), which is a
provision in an appropriations act that affects a mandatory spending program.
13 According to HHS, Puerto Rico is projected to exhaust its ACA Medicaid funding by the end of FY2017. HHS,
FY2017 Budget in Brief, February, 2017, p. 97, http://www.hhs.gov/sites/default/files/fy2017-budget-in-brief.pdf.
14 If Puerto Rico were to exhaust its ACA Medicaid funding before the end of FY2019, it would have to significantly
increase its own Medicaid funding share in order to maintain the current program. This would worsen its current fiscal
situation. For more information about this situation, see CRS Report R44095, Puerto Rico’s Current Fiscal Challenges,
by D. Andrew Austin.
15 For more information, see HHS, “Project BioShield,” https://www.medicalcountermeasures.gov/barda/cbrn/project-
bioshield-overview/.
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reimbursement authority, and hiring of personal services contractors, as well as authorization to
use unobligated Ebola balances to combat Zika and other infectious diseases. Also worth noting is
that, unlike HHS, funds for international assistance programs have varying periods of availability,
as specified below. (International Assistance Program funding levels proposed in S. 2843 and
H.R. 5044 are identical to those requested by the Administration.)
Department of State
A total of $41.1 million is requested for the Department of State operations, multilateral
assistance within International Organizations and Programs (IO&P), and international security
assistance (nuclear research and techniques) as follows:
 Diplomatic and Consular Programs account (D&CP)—$14.6 million to
remain available until September 30, 2017. Of this amount
 $8.4 million to support the Office of Medical Services for medical support
and possible evacuation under the Chief of Mission authority of at-risk U.S.
employees in Zika-affected countries; and
 $6.2 million to support regional coordination efforts and public diplomacy
outreach, among other activities.
 Emergencies in the Diplomatic and Consular Service—$4 million to remain
available until expended to support response efforts, including potential
evacuation of U.S. citizens.
 Repatriation Loans Program—$1 million to remain available until expended to
finance repatriation loans to U.S. citizens who may seek to leave Zika-affected
areas or who have been exposed to or have contracted Zika.
 Nonproliferation, Anti-Terrorism, Demining and Related Programs
(NADR)—$8 million to remain available until September 30, 2017, for
additional voluntary U.S. contributions to the International Atomic Energy
Agency (IAEA), an autonomous intergovernmental organization related to the
United Nations that promotes the safe, secure and peaceful use of nuclear
technologies. Funds would support Zika research to develop and deploy nuclear
techniques to help accelerate diagnosis, provide related specialized training, and
to implement sterile insect projects to suppress mosquito populations.16
 International Organizations and Programs (IO&P)—$13.5 million to remain
available until September 30, 2017, to support Zika response actions taken by
UNICEF, the Food and Agriculture Organization, the WHO, and PAHO.
USAID
For the U.S. Agency for International Development, the Administration is requesting $335
million to cover USAID’s health programs and implementation expenses:
 USAID Operating Expenses (OE)—$10 million to remain available until
September 30, 2017, to support Zika response efforts.

16 For more information see Aabha Dixit, IAEA Office of Public Information and Communication, “Nuclear Technique
Can Help Control Disease-Transmitting Mosquitoes,” February 3, 2016, https://www.iaea.org/newscenter/news/
nuclear-technique-can-help-control-disease-transmitting-mosquitoes.
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 Global Health Programs (GHP)—$325 million to remain available until
expended to prevent, treat, or respond to the Zika virus and related health
concerns, other vector-borne diseases, or other infectious diseases. Multi-year
funding commitments are requested to provide incentives for the development of
global technologies such as vaccines, diagnostics equipment, and vector control
innovations. Anticipated allocations include
 $100 million to implement vector management and control activities in Zika-
affected countries;
 $100 million to stimulate private sector research and development of
vaccines, diagnostics, and vector control innovations through public-private
partnerships;
 $50 million for maternal and child health support in affected and at-risk
countries, including training of health care workers; ensuring access to
family planning information, services, and methods; providing support for
children with microcephaly; and helping pregnant women and their partners
have access to personal protection, including condoms and repellant to
protect against mosquitoes;
 $25 million for public health communication and behavior change campaigns
for affected communities and countries to take actions to protect themselves
from Zika and other vector-borne diseases; and
 $50 million to issue Global Health Security Grand Challenges that would call
for groundbreaking innovations in diagnostics, vector control, personal
protection, community engagement and surveillance, and other tools to
address Zika and other infectious diseases, as well as to develop public-
private partnerships to accelerate development of innovative tools and
practices.
Use of Ebola Balances for Other Infectious Diseases
Within the Department of State and Other International Programs General Provisions (in addition
to the General Provisions for the entire request), the supplemental request would authorize the use
of unobligated Ebola Funds (Title IX, Div. J, P.L. 113-235), stating: [Unobligated Ebola funds]
“shall also be available to respond to the Zika virus and related health outcomes, other vector-
borne diseases, or other infectious diseases.”
As of January 1, 2016, the Department of State/USAID’s unobligated Ebola funds totaled nearly
$1.3 billion. Of that total, about $600 million is available until September 30, 2016 (just a few
months away), and about $694 million is available until expended.17 (See the subsequent section,
“HHS, State/USAID, and DOD Unobligated Ebola Response Funds.”
Transfer Authority
The Department of State and Other International Programs General Provisions in the
supplemental request would allow transfer of State Department-related funds in the request only
among State Department-related accounts within the request and transfer of USAID-related funds

17 Based on departmental spend plans and/or quarterly reports for HHS, State/USAID, and Defense, as required by P.L.
113-235, and obtained by CRS; and additional departmental communications.
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in the request only among USAID-related accounts. No congressional notification requirement is
included.
Notwithstanding Authority
The supplemental’s notwithstanding authority request could allow funds from this or prior acts
supporting the U.S. Zika virus response to be expended despite any previously enacted
restrictions and conditions on U.S. foreign aid. For example, if enacted, this authority could allow
foreign aid to be provided to states that are otherwise restricted by law: those designated as
sponsors of terrorism, those with debt arrearage, human rights violators, or states that practice
coercive family planning. The Department of State has indicated in the Global Health Program
(GHP) section, however, that funds will provide support for “ensuring access to voluntary family
planning information, services, and methods.”
Direct Hiring Authority/Personal Services Contractors
The General Provisions Title for the act, and also the General Provisions Title for the Department
of State and Other International Programs, allows for expedited hiring authority to directly hire
staff during critical public health threats, such as Zika, and to enter into contracts with individuals
who are experts in Zika-related fields. This measure does not limit direct hiring or personal
services contractors only for Zika-related purposes. This authority for direct hiring and personal
services contractors could be used in a broader set of public health circumstances than the Zika
virus.
HHS, State/USAID, and DOD Unobligated Ebola
Response Funds
In December 2014, the Consolidated and Further Continuing Appropriations Act, 2015 (P.L. 113-
235), provided $5.4 billion in emergency supplemental appropriations to HHS, the Departments
of State and Defense, and USAID to address the Ebola outbreak that began in West Africa in
January 2014.18 Because these funds were designated as emergency appropriations, they are
effectively exempt from spending limits in the Budget Control Act of 2011 (BCA, P.L. 112-25).19
On April 6, 2016, the Obama Administration announced its plan to reprogram $510 million of
unobligated FY2015 Ebola funding to respond to the Zika virus.20 HHS Ebola funds may be
reprogrammable without additional congressional action (subject to existing restrictions on
reprogramming, including notification). This is because the relevant appropriations measures
stated the funds are available for Ebola and other infectious diseases. It is currently unclear,
however, if congressional action is necessary to provide the Department of State and USAID with
the authority to reprogram the unobligated Ebola funds, as much of the funding was appropriated

18 This section addresses funds provided in P.L. 113-235 only; it does not track the $88 million appropriated to HHS for
Ebola-related activities in the first FY2015 continuing resolution (P.L. 113-164).
19 For more information on discretionary spending limits and Ebola funds designated for emergency requirements, see
OMB Final Sequestration Report to the President and Congress for Fiscal Year 2015, January 20, 2015, at
https://www.whitehouse.gov/sites/default/files/omb/assets/legislative_reports/sequestration/
sequestration_final_january_2015_president.pdf.
20 OMB, Shaun Donovan, “Taking Every Step Necessary, As Quickly As Possible, to Protect the American People
from Zika,” OMB blog, April 6, 2016, https://www.whitehouse.gov/omb/blog.
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with specific language to be used to “prevent, prepare for, or respond to the Ebola disease
outbreak.”
Table 1 provides, by account, the original appropriated Ebola funds, remaining (unobligated)
amounts, the period of funding availability, and purpose of the funds, based on quarterly reports
to Congress as required by the law. As of January 1, 2016, unobligated Ebola funds totaled $2.77
billion: $1.46 billion for HHS, $1.29 billion for State/USAID, and $17.3 million for Defense. A
portion of the total, $652.9 million—most of which is USAID funding—expires September 30,
2016. Nearly all of the remaining unobligated funds expire September 30, 2019, or are available
until expended.
Table 1. FY2015 Emergency Funds Appropriated for
Ebola Response and Related Activities, and Unobligated Balances
Amounts are U.S. dollars in millions. Unobligated amounts are as of January 1, 2016.
Agency and
Account or
P.L. 113-
Unobligated
Period of
Activity
235a
Funds
Availability
Purpose(s)
DEPARTMENT OF HEALTH AND HUMAN SERVICES
CDC:
603.0
369.4
Until Sept. 30,
Disease control assistance to affected
International activities
2019
and neighboring countries.
CDC:
597.0
525.2
Until Sept. 30,
Implementation of Global Health
Global Health Security
2019
Security Agenda (GHSA) activities.b
CDC:
165.0
11.3
Until Sept. 30,
Domestic preparedness and response
Public health emergency
2019
activities, including control in health care
preparedness
settings, and procurement for stockpile.
CDC:
255.0
56.0
Until Sept. 30,
Grants to state health departments for
State and local
2019
surveil ance, testing, case management.
CDC:
0.0
—
—
$10 mil ion for this activity was
Worker training
transferred to NIH. See below.
CDC:
119.3
57.4
Until Sept. 30,
Screening and management of entrants
Migration/quarantine
2019
from affected countries/regions.
CDC:
37.0
11.9
Until Sept. 30,
Vaccine trials and other applied public
Other domestic
2019
health research.
activities
CDC Subtotal
1,776.3
1,031.2
—
—
ASPR (PHSSEF):
208.5
21.2
Until Sept. 30,
Domestic training, PPE, and establishing
Hospital Preparedness
2019
regional Ebola Treatment Centers
Program
(ETCs).
ASPR (PHSSEF):
352.2
347.4
Until Sept. 30,
Not specified. Could include domestic
Other prep. and
2019
treatment costs for affected individuals.
response
ASPR (PHSSEF):
157.0
3.7
Until Sept. 30,
Research, development, and
BARDA
2019
procurement of vaccines and treatments.
ASPR/PHSSEF
717.7
372.3
—
—
Subtotal
NIH, NIAID
238.0
35.2
Until Sept. 30,
Research and clinical trials on
2016
investigational vaccines and treatments.
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Agency and
Account or
P.L. 113-
Unobligated
Period of
Activity
235a
Funds
Availability
Purpose(s)
NIH, NIAID
10.0
9.0
Until Sept. 30,
Ebola responder safety training, funds
2019
transferred from CDC.
FDA
25.0
13.7
Until expended Development, review, and regulation of
vaccines and treatments.
HHS Total
2,767.0
1,461.4
—
—
STATE DEPARTMENT/USAID
USAID, Operating
19.0
15.2
Until Sept. 30,
Operating costs to address Ebola
Expenses
2016
outbreak in West Africa, including
temporary staffing and technical support.
USAID, Inspector
5.6
3.4
Until expended Oversight of Ebola response in West
General
Africa.
USAID, International
1,436.3
542.4
Until expended Disaster assistance to address
Disaster Assistance
humanitarian needs for West Africa,
(IDA)
such as rapid response, maintaining
surveil ance, screening, and contact
tracing.
USAID, Global Health
312.0
148.0
Until expended Expanded USAID global health security
Programs
activities to control infectious diseases
and limit spread of Ebola, including
surveil ance and building lab capacity.
State/USAID, Economic
711.7
583.0
Until Sept. 30,
Training and program assistance to
Support Fund
2016
prevent economic and government
instability during Ebola crisis, including
reimbursement for earlier response.
Activities include rehabilitation of the
water infrastructure, strengthening
health information systems, and
developing technology to prevent the
spread of Ebola.
State, Diplomatic,
36.4
2.2
Until Sept. 30,
Medical support and evacuation capacity,
Consular Programs
2016
repatriation assistance, and other needs.
(D&CP)
State, Repatriation
ns
ns
ns
Repatriation loans to U.S. citizens as
Loans Program
necessary related to Ebola outbreak.
Funding not specified in P.L. 113-235.
Explicit transfer authority is provided for
up to $1 mil ion from D&CP into this
account.c
State, International
ns
ns
ns
Estimated U.S. contributions to
Organizations and
UNMEER. Funding not specified in P.L.
Programs (IO&P)
113-235. Explicit transfer authority is
provided for up to $35.3 mil ion from
IDA for this account.c
State, Contributions to
ns
ns
ns
Funding not specified in P.L. 113-235.
International
Explicit transfer authority is provided for
Organizations (CIO)
up to $35.3 mil ion from IDA and $50
mil ion from Global Health Programs for
this account.c
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link to page 13 link to page 13 Zika Response Funding: In Brief

Agency and
Account or
P.L. 113-
Unobligated
Period of
Activity
235a
Funds
Availability
Purpose(s)
State, Nonproliferation,
5.3
0.0
Until Sept. 30,
Biosafety and hazardous materials
Anti-terrorism,
2016
training in affected countries, efforts to
Demining, and Related
mitigate il icit acquisition of Ebola virus
Programs
and to promote biosecurity practices
associated with outbreak response
efforts.
State/USAID Total
2,526.3
1,294.2
—
—
DEPARTMENT OF DEFENSE
Defense/DARPA:
95.0
17.2
Until Sept. 30,
Developing medical countermeasures
Defense-wide research,

2016
technologies (e.g., using antibodies from
development, testing,
survivors) and shortening vaccine
and evaluation (RDT&E)
development time.
Defense/DARPA:
17.0
0.1
Until Sept. 30,
Procurement of detection and diagnostic
Defense-wide
2017
systems, mortuary supplies, and isolation
procurement
transport units.d
Defense Total
112.0
17.3
—
—
TOTAL
5,405.3
2,772.9
—
—
Sources: Departmental spend plans and/or quarterly reports for HHS, State/USAID, and Defense, as required
by P.L. 113-235, and obtained by CRS; and additional departmental communications.
Note: Amounts may not add due to rounding; “ns” means not specified.
Glossary: ASPR is HHS Assistant Secretary for Preparedness and Response; BARDA is HHS Biomedical
Advanced Research and Development Authority; CDC is HHS Centers for Disease Control and Prevention;
DARPA is Defense Advanced Research Projects Agency; FDA is HHS Food and Drug Administration; NIAID is
NIH National Institute of Allergy and Infectious Diseases; NIH is HHS National Institutes of Health; PHSSEF is
HHS Public Health and Social Services Emergency Fund, administered by the HHS Secretary; PPE is personal
protective equipment; UNMEER is United Nations Mission for Ebola Emergency Response, and WHO is World
Health Organization.
a. HHS amounts reflect transfers between the funded agencies, as permitted by the law. P.L. 113-235, 128
Stat. 2522, Sec. 604, December 16, 2014.
b. For more information, see CDC, Global Health Security Agenda, http://www.cdc.gov/globalhealth/security/
index.htm.
c. P.L. 113-235, 128 Stat. 2694, Sec. 9001.
d. Explanatory statement accompanying H.R. 83, Congressional Record, vol. 160 (December 11, 2015), p. H9635.



Author Contact Information

Susan B. Epstein, Coordinator
Sarah A. Lister
Specialist in Foreign Policy
Specialist in Public Health and Epidemiology
sepstein@crs.loc.gov, 7-6678
slister@crs.loc.gov, 7-7320

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Zika Response Funding: In Brief

Acknowledgments
The authors acknowledge the assistance of Frank Gottron, Specialist in Science and Technology Policy; L.
Elaine Halchin, Specialist in American National Government; Don Jansen, Specialist in Defense Health
Care Policy; Kate Manuel, Legislative Attorney; Alison Mitchell, Specialist in Health Care Financing; and
Barbara Schwemle, Analyst in American National Government in the preparation of this report.
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