Less than a year and a half since the world was panicking about Ebola, the world is dealing with another terrifying epidemic.
Several cases of Zika virus have been detected in the US, following an epidemic in Latin America, which began in Brazil last May. There, hundreds of thousands of people contracted the disease, which is believed to cause increased risk of microcephaly in the newborns of infected mothers. This condition can result in miscarriage or premature death of the newborn, or in serious developmental challenges: while in about 10% of cases microcephaly does not affect the children’s lives, Zika-linked microcephaly cases, like the nearly 4,000 recorded in Brazil, tend to be serious.
The epidemic, which has been declared an international emergency by the World Health Organization (WHO), might reach global proportions. We don’t know very much about this disease, so the first step in containing the epidemic is to develop a test so that people can be more effectively diagnosed. Nikos Vasilakis, a University of Texas professor of pathology, told Quartz the first tests could be available as soon as mid-February.
A vaccine, will likely follow—though it might take years.
But there is a lot the rest of us, and especially rich countries not directly affected by the epidemic, can right now do while the medical community tackles the virus. Applying the lessons we’ve learned from the Ebola epidemic, this is what it will take to strengthen the world against future pandemics—or epidemics that pose a threat for the whole world.
Ebola revealed very quickly that a strong local health system makes an enormous difference. When it hit Nigeria in 2014, the cases were contained relatively quickly, even considering the population density of the country. This was primarily due to the resilience of the Nigerian health system, which while below the levels of industrialized countries, still functions better than others in Western Africa.
Estimates have found that an investment of $4.5 billion (paywall) a year would significantly improve the world’s ability to deal with new pandemics, by improving local health systems where they are deficient as well as aid research and global coordination.
While a large sum, this would by no means be a burden for developed countries; for comparison, it’s just 0.7% of the US military spending in 2015. The cost is about $0.65 per person a year in order to protect the world population from a large pandemic, which according to the World Bank, would result in a global GDP loss of 5%—or $3 trillion.
In a press conference on Feb. 1, the WHO mentioned the elimination of Aedes mosquitoes, responsible for spreading the virus, as a potential way to tackle the epidemic. Far fetched as it might sound, the idea of killing mosquitoes has been explored as a solution for other mosquito-borne diseases. It also points another fundamental need: infrastructure development.
The eradication of malaria in Italy, yellow fever in the American south, and cholera in London were each a victory of infrastructure, as much as medicine. Improving housing and sewage systems help limit the spread of diseases, control contagion, and improve access to medical facilities. Aedes mosquitos are found more commonly (pdf) in slums and rural areas than in developed urban areas with better infrastructure.
We don’t see as many epidemics in rich countries because poverty is a vehicle for disease. Where people have better resources and access to food, they have better immune systems and are less likely to get ill. What’s more, education helps people understand the risk posed by certain diseases, and how to protect themselves.
Indeed, it’s all linked—underdevelopment makes the world more vulnerable to pandemics. We’ve made tremendous progress in the fight against extreme poverty—but health emergencies such as Zika are a reminder that wealthy countries should continue pushing for development, if for no other reason than the fact that it keeps all of us safer.
Imagine you’re a woman in the first trimester of pregnancy—you live in Latin America and are showing Zika symptoms. Understandably, you might consider getting an abortion, since your fetus is at risk of microcephaly and developmental problems. Currently, in most of Latin America, you wouldn’t have that option: abortion is severely restricted in seven countries, where women can even face prosecution for miscarriages, and much limited in all the others, with the exception of Cuba, Guyana, Puerto Rico and Uruguay.
Granting reproductive rights to Latin American women could have greatly helped combat the Zika virus. Some countries have made the recommendation to avoid getting pregnant for up to two years, yet at the same time access to contraception is limited. It is likely that this emergency will generate an increase in unsafe, illegal abortions, which will require some of the medical attention that could otherwise be dedicated to Zika patients.
This would be true also in some of the areas of the US where Zika could spread, for instance the Mississippi delta, where access to abortion is extremely limited.
In most emergencies and epidemics, pregnant women face particular risks, especially when it comes to communicable diseases. It is fundamental for women to have the choice of delaying, avoiding, or interrupting a pregnancy—from a human rights perspective, but also from a public health one.
The outbreak of Zika in Brazil originated in the northeastern state of Bahia, where the population of Aedes mosquitoes is rather large.
A tub full of water stored outdoors is an ideal Aedes nursery, and it so happens that people living in the Bahia area had a lot of those, as they were harvesting water. The area has been suffering from harsh droughts in the past few years: in 2013, the worst drought in 50 years hit Bahia state, and in 2015 another off-season drought has hit the area. Had that not been the case, people wouldn’t have had as much water laying around, ready for Aedes mosquitoes to breed and spread Zika.
There is a direct link that can be drawn from climate change to the Zika epidemic—and it’s only the beginning.