of Defense).134 At the time of writing, clinical trials are underway.135
Congress added Zika to the list of voucher-eligible diseases in April
2016.136 As with Ebola, there was no window of time for the voucher program
to possibly have any bearing on the R& D landscape that generated the current
vaccine candidates. Yet the program will reward sponsors of Zika vaccines
for gaining FDA approval. Even so, Congress rushed to approve the inclusion
of Zika on the tropical disease list—the same Congress that shortly thereafter
could not agree on funding for the domestic response to Zika, stalling the
reallocation of Ebola response funds, at a time when the Centers for Disease
Control (CDC) were running out of money to combat the spread of Zika.137
The expansion of the list of tropical diseases to include Ebola and Zika is
aligned with the architecture of the voucher program: it opens an additional
stream of incentives to two traditionally neglected diseases that are endemic
to markets of limited purchasing power. However, the condensed period of
time in which funders and innovators came together to enhance R& D on
Ebola and Zika sheds light on the fact that all resulting biopharmaceutical
innovation was completely detached from this type of incentives program.
Instead, that innovation was both hampered by pre-existing market failures
(like the pre-2015 concentration of Zika cases in neglected markets) and
driven by pre-existing incentives (like the role of bioterrorism in Ebola R& D
or the fear factor introduced by the high number of fatalities during the West
Africa Ebola outbreak and the congenital defects linked with Zika).
The issue therefore becomes one of assessing whether adding Ebola and
Zika to the voucher program is likely to encourage future R& D on these
pathogens. Whereas Ebola will likely maintain the status of high priority
threat,138 Zika ceased to be considered a public health emergency in
November 2016.139 Typically, post-emergency funding for outbreak diseases
decreases quickly.140 While the magnitude of the Zika outbreak will probably
134. See Gary Sheftick, Army Researchers Testing Zika Vaccine, U.S. ARMY (Jul. 6,
135. Barrett, supra note 129.
136. See Clarke, supra note 107.
137. See Kelsey Snell, Another Failed Zika Vote Could be the Start of a Resolution,
WASH. POST (Sept. 6, 2016),
138. PHEMCE, supra note 113; see also Orlando Cenciarelli et al., Viral Bioterrorism:
Learning the Lesson of Ebola Virus in West Africa 2013-2015, 210 VIRUS RES., 318, 319
(2015) (noting that, even though the West Africa outbreak is over, Ebola remains one the
major pathogens associated with potential bioterrorism threats).
139. See Lena H. Sun, WHO No Longer Considers Zika a Global Health Emergency,
WASH. POST (Nov. 18, 2016), https://www.washingtonpost.com/news/to-your-