Can the International Community Prevent the Coming Zika Crisis?

Earlier today, World Health Organization executive director Margaret Chan announced that the WHO would hold an emergency meeting on Monday on the Zika virus.

Zika, said Chan, is now present in 23 countries and is “spreading explosively” in the Americas. Mathematical models offered by the WHO suggest there could be 3 to 4 million infections in the next 12 months.  “The level of alarm is extremely high,” Chan told a meeting of the WHO in Geneva today.

Zika is rarely deadly, but it can cause some severe birth defects should a pregnant woman contract the disease, which is carried by mosquitos. Some regions of Brazil are already experiencing a large number of these birth defects, known as microcephaly — or infants born with unusually small heads.

On Monday, the WHO emergency committee of experts will convene and possibly decide whether the Zika outbreak constitutes a “public health emergency of international concern.” This is a technical, bureaucratic designation that kick starts a number of emergency procedures within the WHO and member states. Once one of these emergencies is declared, the bureaucracy of the WHO and its member states institutes an emergency response system to help countries more effectively cooperate with each other to implement measures to stop this disease.

The emergency committee that meets next week could also offer some preliminary advice to the WHO and member states on measures to prevent or disrupt this disease. An equally important function of this committee, says Dr. Bruce Aylward, WHO’s assistant director general, is to advise governments on measures to avoid. This could include a whole-scale travel ban on endemic countries in the Caribbean, which could devastate the tourism based economies of many countries. In a press conference today, Aylward also predicted that the WHO would never advise that women avoid pregnancy, something that some governments in Central America and the Caribbean have suggested.

The Poverty-Zika Nexus

Zika is what’s known as a “neglected tropical diseases.” These disease are neglected largely because they have historically only affected the poorest people on the planet. But now that one of these diseases is fast spreading in middle income and wealthy countries, this is poised to become the next big global health crisis requiring a global response. And, in all likelihood, Zika will gain a foothold in the Southern United States in the near future.

This new infectious disease outbreak comes just as the ebola outbreak is winding down. To that end, one of the key questions facing the WHO and broader global health community is the extent to which some of the lessons drawn from the ebola experience will be applied to this new outbreak?

Yesterday afternoon, I spoke with Dr. Peter Hotez, one of the world’s leading experts on neglected tropical diseases, about this new Zika outbreak and its larger political and public health implications. He predicts that Zika will be endemic in every Caribbean island by the end of February and warns that without a robust response Zika could devastate weak health systems in countries like Haiti. He also describes how poverty in the United States, particularly in communities along the gulf of Mexico, may exacerbate this crisis and lead to its spread in the USA.

If you have 20 minutes, want to understand the Zika outbreak and its broader public health implications, have a listen.

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