THE Zika virus has been the predominant item across news agencies this past couple of weeks. Until the outbreak in Brazil in May last year (2015), most of us can probably safely assume had never heard of it or forgotten the Pacific region outbreak within the last decade (2007, 2013-2014).
The spread of the Zika disease and its association with microcephaly (a congenital malformation that manifests as abnormally small heads which may lead to delayed brain development) prompted the World Health Organisation (WHO) to declare the Zika virus an international public health emergency on Monday (February 1, 2016).
Some perspective before going any further. Brazil has reported about 3700 suspected cases of microcephaly. WHO estimates as many as four million people in the Americas are at risk of contracting the Zika virus disease having spread across 24 countries and territories. The Zika virus disease does not have a cure and Tonga declared a Zika epidemic on February 4 with two confirmed and 265 suspected cases.
The decision to make the declaration, WHO director-general Dr Margaret Chan said, was “first and foremost, the big concern about microcephaly”. The announcement makes official the urgency of action and the sourcing of relevant funding needs. The declaration will also expedite work on vaccines and better diagnostics for the disease.
The rapidity with which Zika has spread across the Americas has been attributed to the prevalence of Aedes aegypti (same mosquito family which spreads dengue fever) and a lack of immunity among the population.
“As the agency that is concerned with reproductive health, UNFPA, the United Nations Population Fund, is closely monitoring the outbreak of the Zika virus and warning about its potentially adverse effects on the health of women and babies,” United Nations Population Fund, UNFPA, Pacific director and representative Dr Laurent Zessler said.
“Women and girls should be able to make informed decisions about their reproductive health and family planning methods, and to protect themselves and their babies if they decide to be pregnant. We urge health systems to ensure reproductive health services are accessible to pregnant women and mothers, and those who are in their child-bearing years.”
A UNFPA statement issued on January 29, 2016 advised that “pregnant women in general, and particularly those who develop symptoms of the Zika virus infection, should be closely monitored by health providers” and that “in all cases, women, including those who are pregnant, should be able to access the full range of sexual and reproductive health services in accordance to national laws and policies”.
While the Zika virus disease is being largely transmitted to humans by infected mosquitoes, the first case of it being sexually-transmitted was reported in the US last Wednesday (February 3), underlining the importance of ensuring the availability and accessibility of reproductive health services.
The UNFPA will continue to lead efforts to promote widespread information about the virus and about voluntary family planning.
“The role of UNFPA as the world’s leading agency on reproductive and maternal health, and the biggest public sector supplier of family planning commodities, including condoms, is ever more pertinent,” Dr Zessler said.
“UNFPA will continue to work with countries around the world to scale up access to information and to a wide range of voluntary family planning commodities so that women can make informed decisions and protect themselves.”
Another aspect of Zika very much relevant to the Pacific Islands is the role the various impacts of climate change can or will play as far as vector-borne diseases like dengue and Zika are concerned. WHO acknowledges that “rising global temperature” “altered precipitation” and “humidity” are throwing up reactions that are different from existing data and historical narratives around such health situations.
El Nino, the warming of sea surface temperatures in the tropical Pacific, which in turn impacts weather systems across the world, can cause both reduced rainfall and drought and/or heavy rain and flooding is also considered for its potential to enhance mosquito breeding conditions.
UNFPA strongly encourages vigilance over exposure to mosquitoes particularly for pregnant women including those of child-bearing age. Women who are pregnant or planning to become pregnant must do so in close consultation with their doctors.
Just as sexual and reproductive health (SRH) is arguably an imperative for any development plan, it should also be core to considerations around national responses to emerging issues like climate change-sensitive diseases. If we do not ensure voluntary family planning services for example, an unplanned pregnancy in the absence of recourse for termination would amplify existing socio-economic challenges.
The Pacific which has largely voted on various world stages as a bloc has a few health-related regional agreements like Kaila! — Pacific Voice for Action on Agenda 2030, which Pacific health ministers endorsed in October last year (2015).
Kaila! — Pacific Voice for Action on Agenda 2030 recognises, among other things, that the “specific roles, needs and rights associated with reproductive, maternal, newborn, child and adolescent health, are often invisible in adaptation planning and response processes”.
The Zika virus disease outbreak has brought to the fore potential threats to our people and health systems if we do not make a concerted effort to minimise new infections. The outbreak has also reminded us of the impact of changing climatic elements, an emerging reality that leaders and policy developers must now acknowledge as an essential progress determinant.
The Zika virus disease outbreak has also driven home the importance of ensuring lived sexual and reproductive health and reproductive rights. The ability to decide whether they want to be pregnant or not, and being able to access the tools (contraceptives including condoms) to help them can, among other things, prevent women from being unfairly burdened, as they have been for the Zika outbreak.
Lived sexual and reproductive health and reproductive rights are imperative for both prevention (adaptation, mitigation) and response: it is key to bridging inclusive development and humanitarian action (response).
* Ariela Zibiah is the communication analyst at the UNFPA Pacific subregional Office. The views expressed are not of this newspaper.
