The Extremes To Which Non-Resilient National Medical Systems Must Go When Facing a Potential Epidemic
Monday, January 25, 2016 at 1:30PM
Thomas P.M. Barnett in Citation Post, healthcare, new rules, resilience
LATIN AMERICAN COUNTRIES, EXPERIENCING OUTBREAKS OF A PREVIOUSLY MUNDANE VIRUS (ZIKA) THAT HAS APPARENTLY MUTATED TO THE POINT OF TRIGGERING DEVASTATING BIRTH DEFECTS, ARE TAKING THE UNPRECEDENTED STEP OF ASKING WOMEN TO DELAY PREGNANCIES - IN ONE CASE UNTIL 2018. Mosquito-borne, Zika seems to be expanding its reach with climate change and the heightened international travel dynamics associated with globalization. In other words, this growing medical challenge feels like a glimpse of the world's near-term collective future, one which places unusual and profound pressures on the resilience of national medical systems. (The map above comes from the CDC).

The gist from a great WAPO piece over the weekend:

The rapid spread of the Zika virus has prompted Latin American governments to urge women not to get pregnant for up to two years, an extraordinary precaution aimed at avoiding birth defects believed to be linked to the mosquito-borne illness.

What until recently was a seemingly routine public health problem for countries that are home to a certain type of mosquito has morphed into a potentially culture-shaping phenomenon in which the populations of several nations have been asked to delay procreation. The World Health Organization says at least 20 countries or territories in the region, including Barbados and Bolivia, Guadeloupe and Guatemala, Puerto Rico and Panama, have registered transmission of the virus.

Although the Zika virus has been documented since the 1940s, it began its assault on Latin America in the past several months. The hardest-hit country has been Brazil, where more than 1 million people have contracted the virus. In the past four months, authorities have received reports of nearly 4,000 cases in which Zika may have caused microcephaly in newborns. The condition results in an abnormally small head and is associated with incomplete brain development. Colombia, which shares an Amazonian border with Brazil, reacted to its own Zika outbreak, numbering more than 13,000 cases, by urging women not to get pregnant in the next several months. Other countries, including Jamaica and Honduras, also have urged women to delay having babies.

After more than 5,000 suspected Zika cases were reported last year and in the first weeks of 2016, El Salvador on Thursday took the most extreme stance so far: Deputy Health Minister Eduardo Espinoza urged women to refrain from getting pregnant before 2018.

Culture-shaping is the operative term here. We've long associated globalization with culture/society-shaping dynamics - particularly in the violent responses it can spawn in terms of insurgencies and terrorist movements designed to "safeguard" locals from its perceived pernicious effects (often surrounding the social standing of women who are disproportionally empowered by gender-neutral networks that invade traditional societies in globalization's wake). But climate change will clearly fall into the same category of impact: social behavior will be transformed. Here, we're talking overwhelmingly Catholic societies being asked to embrace birth control by states fearful of medical costs associated with an unfolding epidemic.

But as we've learned with "the pill," AIDS epidemic and abortion rights, it gets really hard to alter that most intimate of social behaviors.

Outside the National Maternity Hospital in San Salvador, Selina Velasquez Cortez, a 30-year-old employee of a sardine factory who has been trying to get pregnant for two years, said there is no way she will stop trying now.

Clearly the US is already taking note and following a similar path of prevention - for now:

The Centers for Disease Control and Prevention on Friday added eight to a list of 14 countries and territories it has urged pregnant U.S. women to avoid because of the risk associated with Zika outbreaks. So far there is no vaccine for the virus.

Having the right vaccine is the ultimate resilience reservoir, as we've learned across the 20th century, when the biggest killer (at 300 million) by far was chicken pox - not warfare. Humanity basically doubled its life-expectancy at birth from 1900 to 2000 (from low-30s to mid-60s globally), and early childhood vaccines were the primary engine of that amazing achievement. Prior to vaccines, that life expectancy at birth measure hadn't move much at all over the previous 10,000 years of human existence.

But now humanity enters into a new age (Anthropocene, as some in the scientific community call it) where our cumulative and growing impact on the planet doubles back upon us with sped-up evolutionary challenges that not only trigger one of Earth's biggest extinction spasms (loads of species disappearing in a massive die-off) but likewise force nations to rethink what it means to have truly resilient national medical systems.



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