Zika Virus: The No More Epidemics Campaign Recommendations
[UPDATED February 1, 2016]
Just as the world is recovering from the Ebola crisis, Zika breaks out across most of the Americas, reminding us of the ongoing challenges we face in addressing infectious diseases. Whether it is SARS, MERS, avian flu, swine flu, Ebola or Zika, contemporary living exposes us all to new pathogens, many of which originate in animals. This situation is likely to continue due to population expansion, especially into previously uninhabited areas, global travel, conflict migration, and urbanization increase our exposure to different pathogens and amplify the possibility for transmission.
Today, February 1, 2016, the World Health Organization (WHO) declared Zika as a Public Health Emergency of International Concern, assessing that the Zika virus constitutes a public health risk to other states and requires an immediate and coordinated international response. This swift response by the WHO is commendable and will go a long way to re-establish confidence, eroded following the Ebola response. Immediate action will be needed to mitigate the impact of the virus through, among others, vector control measures to protect the public. It will also require planning for the longer term impact of the virus.
I. Government Action Aligned with Community Needs
During the current Zika outbreak, the most pressing need is to mitigate the spread and impact of the virus until we have more research. The best way to do this is to provide people with up to date information to enable them to take measures to reduce their exposure. It is critical that during this period, governments across the Americas work with the Pan American Health Organization, the WHO and the Centers for Disease Control and Prevention to develop sound, measured advice and communications messages. Public information of the sort seen in some countries advising women not to get pregnant for up to two years is not only unrealistic, it may also increase levels of stigma and anxiety among women who do get pregnant. Governments need to ensure the guidance being given to women in particular is consistent with other government policies on family planning.
Zika is a vector-borne disease, spread by mosquitos; therefore the response will need to be broad based and multi-sectoral, including in particular the education, environment and agriculture sectors. These need to work with communities on mitigation measures to reduce exposure of individuals and to reduce the ability of the mosquito to reproduce. The Pan American Health Organization and the WHO will need to ensure the guidance and advice provided to governments includes these sectors. Chambers of commerce will also have key a role to play to ensure that the business community is able to take measures to inform their staff and their customer bases – and for multinational businesses to be able to develop a realistic assessment of the business risk posed by this outbreak. This will be critical to ensure minimum impact on trade and businesses.
II. The Way Forward – More Investment in Strong Public Health Systems
The current Zika outbreak and the recent Ebola epidemic in West Africa highlight the need for a more comprehensive approach to infectious diseases. The alert and response approach that we have taken to date is very effective when health systems are strong and coverage extensive or universal. However when an outbreak occurs in a country or a region with a weak health system, it frequently goes undetected. This allows the outbreak to take hold and to spread. Once an outbreak becomes an epidemic, it requires a far greater effort to control it, and the costs dwarf those required for prevention and containment.#fn:1">
Governments around the world are aware of the threat posed by infectious diseases. That is why in 2007 they approved the International Health Regulations (IHR), a legal framework that requires governments to implement measures to improve their capacity to detect, assess and report public health events. If effectively implemented, the IHR would help ensure we are all better protected. However, effective implementation requires political leadership, effective management, resources at the national level, and adequate oversight. They also require stronger public health systems. Unless the IHR are implemented by every country using the same standards and core competencies, they will not achieve what they set out to do. The 2015 Review Committee on the Role of the International Health Regulations (2005) in the Ebola Outbreak and Response made a set of recommendations that need to be implemented. The next World Health Assembly needs to take action to ensure the WHO is given the mandate and the resources to implement these recommendations. Governments and donors also need to ensure these recommendations are implemented in the context of greater investment and political support for public health systems that have a strong community care component.
No More Epidemics is a 5 year global campaign that brings together partners from the business community, academia, and civil society to work with governments and multilateral institutions to ensure we are better protected from epidemics. For more information visit www.nomoreepidemics.org or contact Dr. Frank Smith, Campaign Director.