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Zika Virus and Health Systems in Brazil: From Unknown to a Menace

Health Systems & Reform presents the article “Zika Virus and Health Systems in Brazil: From Unknown to a Menace,” a commentary by Professor Marcia C. Castro, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, on the Zika Virus epidemic in Brazil and the Americas. On February 1, 2016, a World Health Organization (WHO) emergency committee declared clusters of birth defects suspected of being linked to an epidemic of Zika virus in the Americas as a Public Health Emergency of International Concern (PHEIC).

An association between Zika infections during pregnancy and the birth of babies with microcephaly (a birth defect in which an infant’s brain does not develop properly resulting in a smaller than normal head) was first suggested by Brazilian physicians in August 2015, and in November microcephaly cases potentially associated with Zika started to be recorded; three months later WHO made its announcement. In Brazil, the country hit hardest by the epidemic so far, there have been 6,906 suspected cases of microcephaly as of April 2, 2016. The exact number of Zika infections in Brazil is not known, but autochthonous transmission of the virus has been confirmed in all 27 states in Brazil. In addition, as of April 7 autochthonous transmission of Zika virus has been confirmed in 34 countries/territories of the Americas.

According to the commentary, “the unfolding story of Zika virus in the Americas is much more than a mosquito-borne disease that may affect fetal development. It is the story of a disease that exposed problems and raised challenges that the affected health systems and governments cannot ignore.” Based largely on lessons provided by Brazil’s Zika epidemic, Castro discusses five critical problems and challenges and reflects on opportunities to remedy them.

The article concludes that “the challenges currently faced by the Brazilian health system from the Zika virus epidemic, as well as the solutions being implemented to overcome some of these challenges, highlight actions that other countries in Latin America and the Caribbean, with active transmission of Zika virus, should be considering. With a universal health care system, and a successful primary health care strategy, Brazil is in a better position than its neighboring countries to handle the chaotic situation that has emerged with the Zika virus epidemic. The struggle in Brazil shows that the fight against the Zika virus, and against other diseases transmitted by Ae. aegypti (dengue and chikungunya), cannot be won if the only fighter is the health sector, if the weapons are limited and/or inappropriate, and if the battle plan does not address the basic needs and rights of the population. Otherwise, besides losing this fight against Zika, it is just a matter of time until the next menace arrives.”

Zika Virus and Health Systems in Brazil: From Unknown to a Menace. Marcia C. Castro.Health Systems & Reform. DOI:10.1080/23288604.2016.1179085. Published online April 25, 2016.