The most terrible chapters of the Zika virus in the Caribbean are considered behind us. Yet this is a region of the world that knows in its heart and soul how a calm may just be the eye of the storm. With the worst of Zika over, many governments around the region have now switched gears and returned to the day to day, bread and butter issues as their key focus.
What lessons need to be learned from the outbreak of Zika? And what do many people, even today, fail to understand about the unique terror of a pandemic in the 21st century?
The Toll of Zika
The passage of the Zika through the Caribbean in 2015 and 2016 was one of indiscriminate carnage. An estimate 800,000 people were infected. So severe was the outbreak that in February 2016 the World Health Organization declared it a Public Health Emergency of International Concern, a rare event that placed Zika in the same league as Swine Flu and Ebola as illnesses that represent a borderless threat.
Especially harrowing in this outbreak was the revelation that around 4,000 newborns sustained serious brain damage as a result of it. This drove home the reality that thousands of people in the Caribbean family would not have the prospect to ever fully recover, but would instead face lifelong challenges. It’s also a long road to recovery, even for those who have that option available.
Around 20% of those who contract Zika are still unable to walk some six months after the first diagnosis. Unsurprisingly, such an enduring and powerful illness that delivers symptoms such as this, at the scale of a public health emergency, can place an immense strain on a nation’s healthcare sector. For countries with small populations and embattled healthcare sectors, effectively combatting Zika is a cause where there’s zero room for failure, especially considering the threats posed beyond the hospital doors to a nation’s sustainability.
Stopping the Spread
The outbreak of Zika beyond its traditional confines is testament to the need for strong national approaches to combatting it. Zika was originally found in the African and Asian region but its emergence in Yap Island, Micronesia in 2007 was the first time it had been detected elsewhere. Recent local history might have been very different if that nation of 113,000 had been able to quarantine and contain Zika in its territory. The failure to do so ultimately saw the disease spread to over 65 countries with some two million people contracting the illness.
There are complicating factors of modern life that encourage the spread of disease. The trend towards urbanisation has seen more people move to cities, and the resulting higher urban density means more of us now live in close quarters. For the Caribbean, there is a particular vulnerability; not only is the shift to cities growing, but international travel too, especially as tourism is often the lifeblood of the economy. Anyone anxious about the emergence of another outbreak will view the otherwise positive news of tourism growth with some apprehension because Zika and diseases like it can now spread more easily than ever before.
Lessons Learned and implemented?
As identified in the USAID and Knowledge for Health summit ‘Learning from Zika: Lessons for future public health emergencies’ in Washington in June, harmonising collaboration across relevant sectors and refining knowledge management processes are key battlegrounds in combatting any future pandemic that arises. In turn, the difference between a pandemic successfully contained, or enabled to spread, often comes down to the capability of authorities to respond rapidly. The capacity of a nation to combat a future pandemic depends on its complete preparation today.
Just as businesses are forever spouting the benefits of a lean and agile business model, public authorities will succeed or fail in combatting outbreaks based upon their preparations beforehand, and the ability for their plan to be successfully rolled out speedily. Like any other emergency service, this requires subjecting response plans to constant stress tests now, to ensure that when the need arises, a battle-proven plan can be implemented.
This approach is not a new one. In fact, it’s one that was identified as crucial prior to Zika’s outbreak in the region. As Mensua, Mounier-Jack and Coker cited in 2009’s ‘Pandemic influenza preparedness in Latin America: analysis of national strategic plans’: “A number of plans remain developmental in nature and, as elsewhere, more emphasis should be placed on strengthening the operability of plans, and in testing them.”
Governments caught by surprise by Zika were woeful; any government caught in future by surprise would be unacceptable, especially because, nationally and regionally, there remain areas of defence with glaring issues but straightforward solutions. Chief among these is the variance in reporting standards across the region. As the World Health Organization noted in July, some nations in Latin America only report lab-confirmed Zika outbreaks whereas others declare probable and suspected cases, making it difficult to obtain a clear picture of each nation’s battle with the virus.
A Caribbean Community
The first duty of governments is to protect their people. Governments and public authorities must fire on all cylinders to effectively combat the risk of another pandemic. The failure to do so is something voters will have far less patience for than the day-to-day bluster and stonewalling of progress in other areas of policy. It’s here that governments in the region share a national and collective self-interest, especially as it’s relatively easy to make strong inroads in bolstering defences against pandemics.
Action starts with harmonising data sharing; it continues with optimising co-ordinated responses. It must be pursued overall with a recognition that future pandemics will test and strain societies in ways like never before. That’s why the Caribbean family is not unreasonable in expecting stronger and more effective partnerships between public institutions.
