Virus itself. Lack of knowledge and misinformation has stoked apprehension and fear among many. According to the World Health Organization some of the reasons why we dont know more about this disease include a relatively small proportion of about one in four, some say one in five of people develop symptoms, a virus only detectable for a few days and infected peoples blood. The failure of current tests to definitively distinguish zika from similar viruses such as dengue. Especially pregnant women wear protective clothing and stay indoors if possible with Windows Doors or screened. Or diligently protect against mosquito bites if travel is unavoidable. Currently no therapeutics exist to treat zika virus nor is there a vaccine. But that gap need not be forever. One of our distinguished Witnesses Today, doctor Anthony Fauci will explain the scope of nih research on the zika virus as well as Vector Control. Surely Lessons Learned from years of malaria Vector Control have ek witability to zika virus. Dr. Thomas frieden who has been here so many times during the ebola problem, and Ariel Menendez, who in like manner has been here and has done a wonderful job on all of these issues. The u. S. Government has for quite some time promoted such tactics as insecticide laced mosquito nets, window endorsed screen small pool and container drainage and use of strong but safe pesticides to eradicate mosquitos. However our programs are largely tailored for developing countries with the reemergence of dengue in the Southern United States and hawaii, we have to step up our domestic efforts to control mosquitos before warmer weather leads to an explosion of mosquito population during an epidemic in the homeland. According to dr. Luiz alberto machado, ambassador of brazil to the United States, the brazilian government has deployed 220,000 troops and 300,000 Health Agents to fight the vector of the infection by visiting communities to educate the population and help eliminate all mosquito breeding grounds. Experts cite possible links with the zia infection of pregnant mothers and the dangers of their unborn children. No definitive proof of such a linkage according to brazils ambassador and i quote him in part, microcephaly in newborn babies can also be caused by a number of other diseases. Health experts are dealing with something new. The link is unprecedented, he says, in scientific literature and requires in depth studies and analyses. As a matter of fact an a. P. Story just out, the president of colombia said in all the cases theres not one of microcephaly. A supplemental some of 1. 8 billion in order to combat zika virus there, quote, may be a link. Dr. Marcos, director of the communicable said theres a Broad Spectrum of impacts from mild to severe. A fact sheet on microcephaly in Boston Children hospitals notes some children with microcephaly have normal intelligence and experience no particular difficulty with school work. However, many children with the disease especially those with severe cases face mild to significant learning disabilities, impaired motor functions, difficulty with movement and balance and speech delays. In the meantime we must work harder to prevent maternal infections and devise compassionate ways to any child born from this or any other infection is welcomed, love and gets the care that he or she needs. Usaids Ariel Menendez will say we need to support best practices. Children with disabilitiessuppo well. And a brazilian journalist born with microcephaly told the bbc in a february 5th interview that the conditions, and i quote her in part, is a box of surprises. You may suffer from Serious Problems or you may not. On the day i was born, she says, the doctor said i had no chance of survival. She will not walk, she will not talk. But he like many others the doctor that is, was wrong. I grew up, went to school, went to university. Today im a journalist and i write a blog. People need to put their prejudices aside and learn about this syndrome, closed quote. This hearing will look at the implications of the current and longterm threat from the zika virus. And we have assembled expert Infectious Health leaders from the centers for Disease Control and prevention, the National Institutes of health and u. S. Agency for International Development to help us to understand where we are and where do we go from here. I would just note paraphernalia thetically that for more than four years ive been urging passage of my bill and dr. Menendez or Pablo Menendez has been very supportive and has testified at several hearings on this issue of neglected tropical diseases. The full Foreign AffairsCommittee Approved the bill last month. Since 2011 our committee has discussed efforts on more study and identify tropical diseases and find diagnostics, vaccines and treatments of such illnesses. At that time 2011 west nile virus was quickly making its way across the globe including in the United States from origins in east africa. Ebola first discovered in remote area of africa in 1976 caused a Global Health crisis only two years ago. And finally, and i say this with some concern, for the second Consecutive Year the administration has slashed funding for Global Health accounts in the Budget Proposal released this week including a 19 cut for Global Programs on tuberculosis, the worlds leading Infectious Disease killer. I know that the three distinguished Witnesses Today that is not your prerogative, but that is what was sent up to the capitol hill. Additionally the administration is being short sided in regards with tropical diseases cutting that program by nearly 15 . In the face of the wave of Infectious Diseases in recent years including multidrug resistant tuberculosis, west nile virus, ebola and now zika the administrations disregard for this danger iss in eexplica. Zika created global alarm, before the next explosive Health Crisis appears we must provide sufficient resources to the study of tropical diseases. I would note hr1797 authorizes the creation of centers of excellence to study every aspect of these diseases. And i would note in the year 2000 and even most recently just a few years ago legislation i authored on autism created such centers of excellence at nih and cdc and i think that has had a huge impact in combatting that developmental disability. So hopefully well get some traction on that legislation. Id like to now yield to the distinguished chairman my good friend mr. Duncan. Well, i thank the chairman, chairman smith, for the joint hearing here. And appreciate us being involved. The western hemisphere subcommittee is wanting to get engaged in this issue because were seeing this virus here. And theres a lot of concern with the allies and neighbors in the region before 30 days ago a lot of folks in my district never heard the word zika virus. So the zika virus virtually unknown until the first reported case was on Easter Island in february 2014. Its now exploded in the region with cases of 26 countries, territories and the World Health Organization projecting zika will likely spread almost to every single country in the americas. While symptoms for the majority of people who contract zika are quite mild, the disturbing potential links of zika causing microcephaly in unborn babies and gbs syndrome has created panic around the region. Last month brazil having reported over 4,000 suspected cases of microcephaly potentially linked to zika as of october 2015. Although further investigation is confirmed microcephaly in just 400 of the suspected 4,000 cases and only 17 in which tested positive for sdzika, concerns remain very real for those living in the conditions. Also reported an increase in gbs cases potentially connected to zika. Just last week colombia confirmed the first three deaths of patients infected with zika. In may of 2015 pan american Health Organization issued an alert regarding the first confirmed zika case in brazil. Last month u. S. Centers for Disease Control issued a level two alert warning to follow enhanced precautions for pregnant women and women of childbearing age and any travel to zika infected places. Subsequently last week the w. H. O. Declared the spread of zika an International Public health emergency. President obama has since responded. The request this week for congress to provide an additional 1. 8 billion to address the zika crisis. Im deeply concerned about the impact zika virus can have where most of the population has little or no immunity where mosquitos are simply a part of everyday life especially in poor communities. Many Governments Health care systems are not equipped to handle a mass influx of microcephaly or gbs cases. In particular venezuela is reporting of having over 4700 zika cases with a lack of even basic Health Care Options available due to horrible economic mismanagement, venezuelas ability to address rising numbers of zika cases and provide the needed care for women in particular is severely in doubt and deeply worrisome. With some predicting that venezuela could see the regions worst zika cases. In contrast, brazil, the host of this years summer olympics in august, has made huge efforts to curb the spread of zika but fighting with genetically modified mosquitos, deploying hundreds of thousands of troops to help educate the population about and to help research the virus and develop treatments. Given the rapid spread of the zika virus and americas, several countries have tried to buy time to address the problems by urging women to postpone pregnancy. Colombia, jamaica, ecuador and el salvador all issued these re recommendations. However they may try to delay, many women unfortunately do not have the luxury of simply choosing to wait. Crime and violence plague much of the region, corruption and impunity are endemic and women are often caught in the cross hairs consequently facing unexpected pregnancies. As a result the zika virus has created a growing push for latin american countries to liberalize their laws to allow greater access to contraception and abortion. On february 5th the u. N. High commissioner for human rights called on latin american countries affected by the zika virus to increase this access. Today, latin american countries have some of the strongest laws on the books protecting life of the unborn. Chi chile, Dominican Republic and el salvador ban abortion completely, uruguay and cuba legalized abortion, other countries only allow abortion in the case of rape, incest or the threat of the life of the mother. This pushed for more Abortion Access due to the potential birth defects from microcephaly is heartbreaking especially since there are different degrees and some children born with the special needs may go onto live very normal lives. I think you gave a prime example flt regardless i believe every person including the unborn child is made an image of god and therefore has inherent worth. Thus we must do everything we can to support the very real needs of women in latin america and the caribbean who are facing incredibly difficult situations while also seeking to protect the lives of the unborn children. So in conclusion its my hope Witnesses Today will provide testimony of how the u. S. And countries around the world, especially here in the western hemisphere can fight protect against the spread of zika while simultaneously working together to provide health care that addresses the needs of women, promotes life of the unborn and promotes therapy options for those born with microcephaly and gbs. I yield back. Thank you very much. I would like to yield to dr. Burr. Thank you, gentlemen. Thank you for the timely hearing here. Obviously this is an esteemed panel. As a physician who has Public Health work in nicaragua, in areas that were finding endemic of certainly dengue fever when i was down there but now with zika virus, this is going to be a challenge. Certainly the mosquito were dealing with is not an easy one to eradicate, not an easy one to prevent. But the purpose of this hearing is to make sure we get information out and also dispel misinformation. And in epidemics like this that is incredibly important. Because lack of knowledge because the spread of misinformation certainly can create panic. And what we want to do is reassure the public that we are taking this outbreak and this epidemic very seriously. But were doing things in a responsible way. I look forward to the testimony of our witnesses on, you know, how were approaching this, the steps that we need to take. I applaud the president for his request of 1. 8 billion, how we best can utilize those funds. But theres a lot that we dont know. I mean, weve got to come up with more rapid diagnostic tests. Weve certainly got to, you know, understand the extent of folks that are infected but also the fact that the vast majority of folks that do get infected probably are asymptommatic. We also know theres heightened risk in women of childbearing age and certainly women who are currently pregnant. You know, certainly want to hear the testimony of the witnesses with regards to what we can be doing. But as a physician myself certainly one thing we can do in endemic areas is liberalizing access to contraception, making sure that more women of childbearing age in endemic regions have access to full contraception. This isnt about abortion or not abortion, this is about, you know, making sure that those women who are not planning on getting pregnant have the ability to prevent that pregnancy until we get a better understanding of what were dealing with. And i would make a strong push in endemic countries to dedicate some of those resources to access to those Family Planning services, to access to contraception, to access to birth control. Again, incredibly important. For u. S. Citizens that are planning on travel, you know, obviously if youre of childbearing age, you know, we would urge you to take the caution. If youre pregnant, again, i would hear what those travel restrictions are, but my sense is we would urge those women who are currently pregnant not to travel to endemic areas. In addition id be curious, you know, it is my sense that, you know, given the interconnectedness of the globe, weve started to see some zika virus cases pop up in the United States. My sense is these are generally folks that have traveled to endemic area who is are now returning. Id also be curious about the p epidemiology in terms of where were seeing the virus. We may be potentially seeing it in see men and saliva and other bodily fluids. What we can do in terms of recommendations there. Again, you know, i applaud the panel here. You know, again, looking at this as a health care professional, i would urge that we dont panic. I would urge that we collect the data, the information. You know, if folks are traveling to endemic areas, obviously take the usual precautions to prevent mosquito bites. If youre of childbearing age, you know, certainly take those precautions. I would urge that we do use some of the resources that the president has requested to make access to full contraception more available for women of childbearing age in these endemic regions. That is one simple thing we can do to prevent, you know, congenital abnormalities and so forth. Again, i dont think anyone argues that that isnt good medicine or and good prevention. I look forward to the testimony of the witnesses and again, thank you. I would like to now yield to the Ranking Member of the western hemisphere committee, my good friend and colleague from new jersey. Thank you, chairman. And thank you for holding these hearings. I know how much you care about world health and people, and this certainly is a theme a situation that we have to deal with right now. You know, the lack of clarity on the virus and its effects and its treatment make it all more important that we respond to this more aggressively than we have in some of the other diseases. Very concerned now that we have the olympics, a lot of people going into brazil. And i think the brazilian people should be the brazilian government should be very concerned that a crisis doesnt spur because i dont think anybody would go to the olympics if you have the situation where it gets to be panicky. So i want to hear what the panel has to say. And i want to thank the chairman, again, and Ranking Member for holding this hearing. Thank you. I would like to acknowledge professor of entimology. Shes an expert on the mosquitos that carry zika and provided us some testimony without objection will be made part of the record. Introducing our very distinguished panel beginning first with dr. Tom frieden whos been director of the centers of Disease Control and prevention since june of 2009 and has dedicated his career to fighting infectious and chronic diseases both here and the United States abroad. He led new york citys program that controlled tuberculosis and reduced multidrug cases by more than 80 and worked in india for five years helping build a Tuberculosis Control Program<