2.7. IN A HIGHLY CONNECTED AND CHANGING WORLD: CROSS-CUTTING ISSUES
Box 2.7.2: The Zika virus - a convergence of unsustainable development, gender politics and ecological disruption
Global attention to the emergence of the Zika virus (ZIKV) as a public health threat in the Americas in 2015, and the initial policy responses to it in the first half of 2016, bring into sharp focus the importance of gender-informed environmental policies – as well as the ineffectiveness of developing environmental policies
in a “gender vacuum”. Initial policy responses framed the problem primarily through a biological lens without incorporating a gender perspective, exemplifying the pervasive gap between social and environmental policy. The ecology: ZIKV is a Flavivirus transmitted to humans by bites from arthropods, particularly the Aedes mosquito. Other Flaviviruses include dengue fever and yellow fever. The precise combination of factors that brought ZIKV to the Americas is not yet known. Like many insect-borne emerging diseases, it is the consequence of complex interactions between ecological disruption, climate change and human behaviour (CDC 2016). Confusing gender analysis with sex analysis: In humans ZIKV can cause several neurological impairments, including Guillain-Barré syndrome. ZIKV appears to be able to cross the placental barrier, which means a foetus may be susceptible to the virus if infected mosquitos bite a pregnant woman. ZIKV infection can cause microcephaly and related neurological deficits in newborns. As the arrival of ZIKV in the Americas became evident, and given concerns about the threats to foetuses, public health attention by Latin American health authorities turned quickly to women. One of the first responses by government authorities in several countries in the region, including Colombia, Ecuador, El Salvador, Honduras and Jamaica, was simply to advise women to “not to get pregnant” for various periods between six months and two years (until the health threats of ZIKV to developing foetuses was further understood). Such policy approaches confuse sex analysis with gender analysis, positioning women primarily as biological vessels. As policy nostrums, these suggestions represent a striking disregard for the realities under which women become pregnant, the extent to which they may not control their own reproductive lives, or the extent to which they have sexual autonomy. Globally about 42% of all pregnancies are unintended; in Latin America and the Caribbean this figure is 56% (Sedgh et al. 2014). It is evident that women are not fully or solely responsible for determining whether or not they ‘get pregnant.’ A policy focus that makes men’s role in creating pregnancies invisible is guaranteed to fail. Further, health authorities’ advice to “avoid pregnancy” cruelly disregard the reality that many of the same governments restrict abortion rights and distribution of contraceptives, further denying women the power to manage their own reproductive lives (Lancet Global Health 2016).
In terms of vulnerability to ZIKV, social inequality intersects with gender dynamics: people living in the poorest urban communities, lacking municipal services and with uncontrolled waste and standing water, are at particularly high risk of mosquito exposure (Diniz 2016). Women who live in substandard housing are more likely to become ZIKV infected in the first place, and then to be the least likely to be able to protect themselves (or a foetus they are carrying) from the health effects. For poor women who have the most limited access to basic reproductive services and less capacity to evade restrictive abortion laws that strip them of a choice when faced with the dire consequences of the virus on their health and that of their children, the health guidelines merely represent heightened state scrutiny and judgement, with no real assistance (Lancet Global Health 2016). This is a familiar pattern -- shifting responsibility for managing environmental crises onto women, and blaming women’s fertility for social and ecological crisis (Hartmann 1995). Precaution and pesticides: As early as 1962, Rachel Carson in Silent Spring described the high environmental costs of indiscriminate use of pesticides. Yet decades later, health authorities across Latin America responded to the ZIKV threat by immediately resorting to aggressive campaigns of saturation spraying of pesticides in interior spaces, along roadways, around waterways and throughout urban neighbourhoods. While there is vigorous debate in the public health field on the benefits and drawbacks of insecticide use (and evidence of strong disease-control benefits from targeted uses of specific pesticides), ecological harm and problems with insecticide resistance are inevitable by-products of wide-scale pesticide campaigns. Ironically, widespread pesticide use represents a considerable and specific threat to children (Watts 2013). Environmental precautionary principles suggest that in the face of uncertainty, actions – particularly those taken in haste – need to be weighed against possible (irrevocable) harm. However, in this case the initial policy responses showed little of the restraint and considered judgment that the past 50 years of gender and environmental analysis have demonstrated to be essential.
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