The social implications of Zika

U.S. responses to the Zika crisis are fundamentally flawed. Headlines like “The War on Zika in Miami Turns to the Air” and “Genetically modified mosquitoes newest weapon in war on Zika” may be intended to signal the seriousness of the response, but the world is more complicated than that.

Even if military and medical might could eliminate every single trace of Zika, the social, environmental and political conditions that made Brazil, Florida, and Puerto Rico vulnerable to the rapid spread of a new infectious disease remain in place.

These conditions include, global warming, movements of populations into overcrowded urban areas, and attitudes and policies that restrict women’s sexual and reproductive rights.

{mosads}Patterns of spread of the Zika virus highlight the reality that the world’s poorest families disproportionately bear the burdens of global warming.

In Brazil, residents of shantytowns are exposed to Zika virus due to crowded living conditions, substandard sewage systems, and reliance on public water pumps that often are surrounded by pools of standing water (and mosquitoes).

Here in the United States, Zika virus-bearing mosquitoes have shown up in Florida and other southern states that have inadequate public health resources and in which many low-income people are unable to access basic healthcare because their state governments have refused to expand Medicaid under the Affordable Care Act.

Wars on disease too easily turn into wars on those who embody the disease (as has been the case in our disastrous “war on drugs.”) In the case of Zika, the military language is more than metaphorical. While the virus is the presumptive enemy, it’s an enemy that takes cover in human populations that become “military” targets. Naled, the pesticide used to spray communities in Florida, has been deemed to pose unacceptable health risks to humans by the European Union. Respected scientists point out that “the family of chemicals naled belongs to can harm a growing fetus — which means [spraying] could be harming the very same pregnant residents it’s trying to protect.”

Declaring war on disease sends the message that the sufferer is somehow at fault, placing far too much responsibility in the hands of sufferers who have little power regarding their circumstances. The CDC has urged pregnant women not to travel to areas in which the Zika virus has been reported. Most recently, this included the Wynwood neighborhood of Miami, a majority Hispanic neighborhood with a median income of $11,000 per year. Local woman are unlikely to be able to afford to live elsewhere to avoid both the mosquitoes and the sprayed pesticides.

One woman I interviewed in Mississippi (one of the states in danger from Zika) explained that she doesn’t know what to do about sex. She is hearing “everywhere” that women should not get pregnant because of the danger of bearing babies with microcephaly, but in Mississippi it’s nearly impossible to get an abortion. She even has trouble getting hold of reliable contraception. Indeed, few women in the states most likely to be affected are currently using the most reliable forms of birth control.

While media and public health sources encourage women in Zika-affected areas not to fall pregnant, the prevalence of both stranger rape and intimate partner violence force many women into pregnancies that, in the wake of Zika, are not only unwanted but also likely to carry the extra stigma of failure to obey “sensible” public health directives. Recent reports that Zika can be carried in male sperm for at least six months after a man was infected add new layers of terror to a sexual landscape that is already stacked against women.

The problematic history of public responses to viruses such as HIV-AIDS that may be spread through sexual contact, especially when the virus initially impacts disenfranchised or stigmatized groups, is further cause for concern. For women in Brazil and other countries that prohibit abortion, women are forced to choose between illegal, backstreet abortions and the fear of carrying a pregnancy to term in a setting in which pictures of tiny-headed babies grace the front pages of newspapers nearly every day.

I hope that the Zika crisis will drive progress on addressing global warming and environmental conditions, particularly in low-income communities. At the very least, shocked and saddened by the pictures we are seeing in the press of babies born with microcephaly, the Zika crisis should serve as a wake-up call for making contraception and abortion universally available and extending healthcare access to all people.