Not long after the disastrous outbreak of Ebola in western Africa, the Zika virus has begun to spread quickly across Latin America. A flu-like illness that normally only causes mild symptoms, it has become a cause of increasing concern as more severe symptoms and birth defects such as microcephaly have emerged. Margaret Chan, Director-General of the World Health Organization (WHO), recently declared Zika a public health emergency of international concern.
Although Ebola and Zika are different pathogens, both highlight a global inability to effectively deal with public health crises in a timely manner. A recent UN panel on health crisis response stated, “The high risk of major health crises is widely underestimated, and the world’s preparedness and capacity to respond is woefully insufficient.”
The Zika virus may have even more potential than Ebola to wreak havoc on large populations, as scientists are unsure of exactly how it can be spread and there are no existing vaccines or cures. Certainly a lot of scientific work needs to be done in investigating Zika, but we must also consider underlying factors that enable the spread of such diseases and prevent action from being taken immediately.
Ebola may be mostly contained at this point, but there are important lessons to learn from how communities and governments dealt with the crisis. These lessons should inform how we look at Zika and other future public health issues.
In order to most effectively address the spread of Zika, one of the first priorities must be to frame it as an issue of development, not simply one of public health. It is important to recognize that the communities most vulnerable to such a crisis are those with many residents living in conditions of poverty. The spread of infectious disease is often enabled by political and economic factors such as state incapacity and uneven development.
In the case of Ebola, the communities most affected were poor as well as lacking the resources to cure those infected and slow the spread of the disease to healthy members of the population. This is the case with many public health crises — those who do not have the resources or systems in place to deal with such issues are faced with the greatest burden.
This trend continues with Zika, as mosquitoes that carry the virus cluster around standing water. Poor, rural communities frequently lack sanitation or a clean water source, thus making them particularly vulnerable to the virus.
Proper solutions should not only provide resources to the most susceptible populations first, but also seek to resolve factors that contribute to a lack of development and state inaction. Further, development solutions that address contributors to an inefficient public health system, such as endemic poverty and state incapacity, must be sustainable. It is not enough simply to rush more resources to those in dire need. This may help in the short term, but what will happen when the Zika virus is no longer considered a crisis? Will the resources provided dry up, leaving the people still in poverty? Will there be systems established to ensure that those born with developmental disabilities and their families are able to lead happy, productive lives?
Mechanisms must be put in place to ensure that communities that receive assistance are able to sustain the quality of living that aid affords them.
Ultimately, health crises such as Ebola and Zika, which adversely affect the poor, must be considered first and foremost issues of development. While the spread of Ebola has slowed dramatically, the solutions that led to its containment did not address the factors that allowed Ebola to be so devastating in the first place. It may not be possible to eliminate poverty overnight, but the best solutions to public health crises will acknowledge that the level of development in a community or country is often a key part of the problem.
If we continue to tackle health crises like Ebola and Zika on a case by case basis and do not acknowledge the factors that make poor populations much more vulnerable to such threats, the world will continue to see epidemics that impact human security on a vast scale. Scientific progress is important, but the role of sustainable development in preventing massive disease outbreaks cannot be ignored anymore.
