To fight Zika we must fight poverty and powerlessness and ensure that women enjoy their rights.
by Alicia Ely Yamin
Health ministers throughout Latin America have announced they will unite to stop the alarming spread of the Zika virus. Similarly, the World Health Organization has acted with uncharacteristic haste to curb this virus, of which the world presently knows very little. But there is much we do know about containing Zika’s impact, because it is, yet again, a disease of poverty and disempowerment. Therefore, it will take more than health ministers and agencies to overcome it.
The speed with which the Zika virus appears to be spreading is only surpassed by the speed at which structural political failures in Latin America have been transformed into apparent personal deficiencies. Zika is transmitted by aedes aegypti mosquitoes, the same mosquitoes that transmit dengue fever. These mosquitoes breed in stagnant water and are most endemically found where poor people lack adequate plumbing and sanitation, and collect water in open containers. The lack of piped water and sanitation systems throughout Latin America, even in large cities, leaves millions of people at risk of these diseases.
We also know that transmission from mother to child appears to pose serious risks to the infant, including microcephaly. This has led to the widespread message from ministries of health across Latin America, telling women not to get pregnant. And this in turn has echoes of an equally misguided and ineffective public health campaign of an earlier era — to avoid HIVAIDS by abstinence. Just as with that and other campaigns that reduce systemic issues to individual behavior modification, in the case of Zika, the admonitions to women are not just patently ineffectual but constitute cynical abdications of governmental responsibility.
In many of the countries where Zika is taking hold, poor women, adolescent girls, and women from marginalized communities simply do not have a choice about sexual relations, nor do they have comprehensive sexual education or secure access to contraception, so they cannot control whether they will get pregnant. Let alone those who are impregnated through criminal sexual assault. Moreover, even with contraceptive access, some women and girls will inevitably get pregnant.
Some of the countries in which the virus has broken out have the most restrictive abortion laws in the world, courtesy of governments that are handmaidens to religious ideology rather than protectors of reproductive rights. Take El Salvador, where there are no exceptions for the criminalization of abortion. The trend there is to prosecute women for infanticide (which carries a much stiffer penalty) than for having procured an abortion. Abortion law in Brazil, where Zika has to date had the largest number of cases, is being challenged presently, and no doubt other challenges will follow.
But we might all ask: Why do poor women and girls (and potentially their children) need to be put through this needless suffering, rather than ensure access to abortion where it is legal and also reform laws and policies to eliminate structural discrimination against women who are without access to contraception, abortion and sexuality education that meets internationally accepted standards of human rights?
As Zika demonstrates, precisely because of our reproductive capacities, it is women in particular who experience their poverty and marginalization through their contact with indifferent health systems. It is women who again will pay the greatest consequences of the impacts of the lack of public health measures, inadequate social protection, and discriminatory laws and, to boot, may be blamed for “getting themselves pregnant.”
The efforts of President Juan Manuel Santos of Colombia and other regional leaders to bring health ministers together, and of WHO’s quick response should be applauded. But the response to Zika needs to go beyond immediate containment and vector control, and international health “security” to push for meaningful government commitments necessary to address underlying social conditions and discrimination against women.
Alicia Ely Yamin is lecturer on law and global health, director of the JD MPH program, and policy director of the Harvard FXB Center, all at the Harvard T.H. Chan School of Public Health. Her most recent book, explaining what a human rights approach brings to public health, is Power, Suffering and the Struggle for Dignity (University of Pennsylvania Press, 2015).
Related: Read Professor Yamin’s recent interview in El Pais (Spanish).