Social and health inequalities augment the incidence of Zika virus disease and its after effects

Even though Zika virus was discovered more than 6 decades back, it attracted attention from the global stakeholders very recently.^[1]

As a matter of fact, till 2007, only 14 cases were reported worldwide; while during the current outbreak, which has been detected in 62 nations, Brazil alone has recorded more than 1.5 million cases.^[1],[2] The cases have been reported in different nations and territories of South America, Europe, and even in China.^[2],[3] Further, despite the fact that almost four-fifth of the cases are asymptomatic, the real cause of concern is the neurological complications associated with the infection.^[1],[2],[3]

Moreover, two major modes, namely mosquito bites and sexual transmission, have been identified for the disease transmission, both of which are related with poverty and health inequality.^[3] The disease has been quite predominant in regions to favorable breeding conditions for mosquitoes like poor drinking water supply and substandard sanitation facilities.^[3] Also, women who have poor access to the reproductive health care (viz., health education about sexuality, knowledge about family planning, access to contraceptives, antenatal care, etc.), a higher incidence of the disease has been observed.^[2] In addition, women are also finding it very difficult to access prolonged, specialized care, and supportive services for their infected child, predominantly if they are from poor socioeconomic status.^[2],[4]

Among all the nations in which the infection has been reported, Brazil is the worst affected, with more than 1,700 cases of microcephaly and other nervous system disorders have been notified till mid-July 2016.^[2] In fact, in some of the regions of the nation, poor people have been affected mostly and amidst the fear which the disease has created or due to the shortcomings in the health sector, the human rights of the affected women and child are neglected on a daily basis.^{[1],[2],[3],[4]} Weaknesses in the health infrastructure are just one side of the story, on the other side, a poor woman with a malformed child has been exposed to stigma, humiliation, comments from the local residents, and even abuse from the partners or the other family members.^[2],[4],[5]

In short, the disease is not only a public health emergency but is often the outcome of the prevailing health and social inequalities, with a serious gap in the reach of sexual and reproductive health care services.^[2] There is no doubt that since the outbreak has emerged, the demand for sexual and reproductive health care has increased, but the question which the policy makers have to answer is that whether they have also increased their commitment (viz., health personnel, diagnostic tools, counseling services, supply of contraceptives, referral services, supportive services for the infected newborn, better mosquito control measures, etc.) at a proportional rate.^[2],[3],[4]

In order to deal with the issue of prevailing inequalities, the United Nations Population Fund has started an initiative in collaboration with the local stakeholders to end gender-based violence and promote women’s health and rights, by improving their access to reproductive health (like information, services, contraceptives, etc.) and strengthening of the referral services for availing specialized care for infected pregnant women, with special focus on vulnerable poor women.^[2] Further, a support group has also been created where mothers of children with microcephaly can interact with each other and share their experiences.^[2]

To conclude, the infection has resulted in devastating impact on the affected population, the health care system and economic progress of the nation. However, most of the untoward consequences can be minimized by eliminating the social and health inequality prevailing in the affected nations.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.213168