On November 18, the World Health Organization (WHO) declared that the Zika virus is no longer an international medical emergency. The virus—which is spread by mosquitoes and sexually transmitted—does, however, continue to pose a “significant and enduring” threat, according to the WHO. But for those working with and on behalf of the communities most at risk of Zika in Brazil, the emergency is far from over.
Although Zika is typically associated with mild symptoms in adults, its impact on pregnancy can be severe. According to the WHO, in Brazil alone there are over 2,100 confirmed cases of neurological disorders associated with Zika. The most common has been microcephaly, where babies are born with abnormally small heads and restricted brain development.
As the group most affected by Zika, Brazil’s women are left with few options for support and information. The government’s austerity measures and restrictions on reproductive rights have exacerbated the crisis. Despite Zika’s disproportionate impact on pregnant women, Brazil has not changed its policy on abortion; it is still highly restricted and not even permitted in cases of microcephaly. And information about reproductive health or contraception is still hard to access or expensive for poorer women—exactly the population most vulnerable to the virus.
The International Women’s Health Coalition’s grantee partners in Brazil—including Grupo Curumim and ANIS-Institute of Bioethics—are taking action to change the situation for women.
Throughout 2015 and 2016, ANIS’s co-founder and lead researcher, Debora Diniz, visited some of the regions hardest hit by the epidemic. She saw that with its exclusive focus on mosquito eradication, the government was neglecting women and families most at risk for the virus. People in vulnerable regions lacked up-to-date and accurate information about the epidemic, and prevention strategies. Even the free or low-cost mosquito repellent that was promised for pregnant women early on in the outbreak never arrived. In addition, those families already affected by Zika—who had infants with neurological malformations and other developmental issues—often had to travel for hours to reach the nearest therapy center. Debora captured these stories, as well as the stress and uncertainty faced by health care providers, in the documentary Zika.
At the same time the Zika crisis was exploding earlier this year, the country’s political leadership was in turmoil. Shortly after the Zika case was presented, the Senate voted to impeach the president, Dilma Rousseff. The vice-president, Michel Temer, assumed office, and immediately began an attack on social benefits. Temer and his Cabinet claimed that the right to health care can no longer be fulfilled due to the country’s economic situation.
Last week, the Brazilian Senate approved a constitutional amendment to freeze federal spending for the next 20 years. The move would have a devastating impact on some of the most vulnerable people in the country, including those with or at risk of Zika, and the proposal would apply to public spending, such as health and education.
It is an alarming development. “During an epidemic, how can the budget for social protection and health not increase?” said Ms. Diniz. “We’ll need a stronger welfare state, not a weaker one!”
Brazil’s conservative Congress has seemingly done everything it can to make the situation worse. One of its first acts was to attempt to increase the penalty for women who had Zika and wanted an abortion—if the law had passed, women who terminated their pregnancies would have faced jail time.
Congress is also preoccupied with the threat of what it terms “gender ideology.”It has made a point of going after programs and policies related to sexuality education, same-sex civil unions and benefits, and reproductive health services, as opposed to the vast and growing inequality in the country. It is no coincidence that the Brazilians most at risk for the Zika virus—Afro-Brazilian, indigenous, and poor—lack access to health services and proper sanitation.
Prompted by this growing dysfunction and threats to women’s health and rights, at the end of August, ANIS and the Brazilian National Association of Public Defenders filed a petition with the Brazilian Supreme Court calling for more support and services for women and families affected or at risk of Zika. ANIS asserts that the Brazilian government has failed to provide adequate assistance and is demanding a review of the government’s constitutional obligations to ensure access to health information and care and support services. ANIS later filed an amicus curiae request, based on reports by the UN Human Right Council Special Procedures mandate holders, outlining how denial of abortion in the context of Zika amounts to torture and/or cruel, inhuman, or degrading treatment. The Brazilian Supreme court is expected to rule on the preliminary injunction on the Zika case on December 7, but they may deliberate longer.
Ms. Diniz remains determined but realistic: “Between the conservative Congress and now the Temer administration, we cannot hope for much. Our only hope is that the Supreme Court assumes the Constitution’s promise to defend women’s rights.”