A Call to Prioritize Health

Zika Map

All countries and territories with active Zika virus transmission (noted in orange). Source: Centers for Disease Control and Prevention (www.cdc.gov/zika/geo/active-countries.html)

Published September 14, 2016, last updated on October 12, 2017 under Voices of DGHI

By Matt Boyce, 2nd Year Master of Science in Global Health Candidate

Traveling through east Africa this past summer I was met with many questions ranging from “How are you?” To, “How do you find our climate?” To, “Would you like more ugali and chai?” 

But much to my surprise, one of the most frequently asked questions I was asked was, “What do you think about Hillary?” Or, “How do you like Donald Trump?”

The more I thought about it, though, the less surprised I was that people all around the world might hold an interest in American politics. Irrelevant to the argument of what America does or does not do well, it is the undeniable truth that it is one of the world’s most powerful countries, as well as one that plays a large role in setting various global agendas. 

So when I was being asked about the upcoming elections, what I was really being asked was the often unsaid but implied question of, “How will this election impact my life?”

Now, this is not a piece about foreign aid, nor is it directly about the presidency. Instead, it is one much more about what the next president and his or her government’s need to prioritize. That is, investing money into health research and fighting disease here in the United States and around the world. 

The United States has been a leader when it comes to setting health standards and global health agendas. It remains one of the leading donors in the world when it comes to foreign aid (just look at the $9.3 billion it plans to invest in health 2017), and has assisted immensely in global efforts to combat HIV, various flu outbreaks, Ebola and other emerging diseases. Still, this is not enough. 

In a press conference last Friday, Tom Frieden, the director of the Centers for Disease Control and Prevention and the head of the government’s fight against the Zika virus said, “… we are now essentially out of money [to fight Zika].” This statement—and our current situation—have several upsetting and unsettling aspects to it. 

First, this disease has persisted for as long as it has without any real action. We have known about Zika since 1947. The first large outbreak in humans occurred in 2007, and others followed in 2013 and 2014. Frieden’s recent announcement comes well over one year after Zika was first reported in Brazil; months after the virus spread throughout most of South America, Latin America, and the Caribbean; and weeks after the first confirmed transmission in Miami. 

While it is naïve to think that the spread of disease could have been completely halted, it is not naïve to think that the collective we could have handled this situation better. We should currently be better equipped to prevent Zika, diagnose it and mitigate its morbidity. Still, we are not. Scientists have known for a very long time that the spread of this disease was trending towards imminence and that this was ignored by politicians and policy makers is rather alarming.

Second, is that this scenario is not new. In fact, it is a story that is all too familiar to anybody that consumes the news on a regular basis. Many people may write up Zika simply as the next disease to fall into the media’s cyclic process of overstressing a disease before it fades back into obscurity. But this assumption would be wrong. 

Largely owing to its type of transmission (primarily through the bite of infected Aedes mosquitoes) Zika transmission is much more difficult to control than other infectious diseases. In fact, theoretically, Zika has the potential to establish itself in local transmission cycles wherever Aedes mosquitoes are found—a range that includes much of the country, as well as cities including Atlanta, Boston, Chicago, Houston, Los Angeles, New York and Washington, DC. 

Additionally, the health effects of Zika are much longer lasting than some other infectious diseases. Though the infection itself tends to be mild, often going undiagnosed, it can severely impact pregnancy outcomes. Current research suggests that the virus can result in pregnancy complications, serious birth defects, and may be associated with Guillain-Barré Syndrome in children born to infected mothers. 

Put more simply, Zika has serious health implications, is hard to control, and is likely here to stay for a while because health was not a priority when it should have been.

So, to whomever wins the Presidency, House, and Senate elections this November, this is what I ask: Make health a priority. As Zika has so clearly demonstrated, disease knows no boundaries, and our world, including its health issues, are all connected. You have the ability to leave a legacy and greatly impact the health of your country, as well as that of the entire world. But only if you choose to do so.