The Zika virus is now “spreading explosively,” announced the World Health Organization in a statement released last week[i] and “the level of alarm is extremely high.” The most recent spate of Zika virus infections was diagnosed in April 2015 in northeastern Brazil (the previous large outbreaks were in 2007 and 2013-2014 in the Pacific islands) and a possible result[ii] of the virus presented itself in a most tangible form in October 2015 when cases of microcephaly[iii] —smallness of the head, a congenital condition associated with incomplete brain development—began to appear among newborn infants.
Since its detection in Brazil, the virus has spread to 23 countries and regions in the Americas, and warnings are being issued to consider Zika a public health emergency. The spread of the virus and the responses to curbing it present a perfect storm of climate change, disease, and their intersections with and impact on women’s sexual and reproductive health and rights (SRHR).
A 2009 briefing paper by Oxfam posited “the effects of climate change on health will reach wider and faster across the world than any other fall-out from climate change.”[iv] The paper discussed the increase in water-borne, insect-borne, vector-borne diseases due to increases in temperature and rain, and the inability of health and municipal services to be able to plan and manage these changes. In Asia-Pacific, we see the year-on-year rapid increase in dengue, in particular in the Philippines and Indonesia.[v]
Dengue, Malaria, and now Zika are all examples of how mosquito-borne diseases are interlinked with effects of climate change such as rising temperatures and shifts in precipitation.[vi] Scientists say that long-term climate change will make it increasingly difficult to protect human beings from such diseases and the rapid spread of Zika over a few months is quite telling of this.
Responses to Zika by Latin American governments currently have a major focus on the increase of microcephaly in infants, nearly 4,000 cases detected from October to date.[vii] The effects of microcephaly span a wide spectrum of outcomes, ranging from children who are not affected at all apart from the superficial issue of smaller head size to those who cannot walk or talk and need constant care and special needs therapy[viii]. Therefore an increase in children with microcephaly could place additional stress on families, communities, health services, and later on also on educational services. Given that the virus manifests itself in indiscernible ways on adults, women may not know they have contracted the virus, and if pregnant, until they deliver. There is also evidence emerging that on rare occasions, Zika could be sexually transmitted.[ix].
The responses point to one thing, especially in a region that has limited access to contraceptives, including condoms, and highly restrictive laws on abortion due to socio-religious norms. An undue burden is being placed on women, especially those from marginalised populations, who live in countries that face climate change, have conservative laws and policies (influenced by religion, and not recognising sexual and reproductive rights), and give little or no access to essential sexual and reproductive health services.
For an example, the government of El Salvador has advised women not to get pregnant until 2018, advice that has since been meted out by government officials in Colombia and Ecuador. This advice, challenged by women’s organisations[x] and not endorsed by organisations such as the WHO, fails to recognise the reality of the region where access to contraception is limited, abortion is highly criminalised, and pregnancies often occur as a result of sexual violence. A 2014 study by the Guttmacher Institute[xi] found that 56% of pregnancies in Latin America and the Caribbean are unintended—the highest proportion in the world—showing that women already have little control over their bodies and pregnancies.
While the governments in Latin America are saying that this advice is a secondary strategy to combat the virus, it remains an unprecedented sweeping request. Apart from being impossible to achieve, it is also feared that this approach would lead to women being forced to have unsafe abortions, resulting in death or severe complications, as well as legal consequences. This is particularly concerning in countries like El Salvador, where women may be jailed even for miscarriage of pregnancy.[xii]
A comprehensive approach that is rights-based is essential to combat diseases such as these. Such an approach would include:
Civil society organisations across the world are calling on governments to reform their policies on contraception and abortion, and we stand in solidarity with them.
[ii] A causal relationship between Zika virus infection and birth malformations and neurological syndromes has not yet been established, but is strongly suspected.