The recent and rapid spread of Zika virus, a mosquito-transmitted infection, into the Americas is the latest in a series of emerging infectious diseases that pose new threats to human health. Active Zika transmission is now reported in over 20 countries in Latin America and the Caribbean, as well as several other territories, and the World Health Organization (WHO) predicts it could affect 4 million people across the Americas this year alone. On February 1 following an emergency meeting of experts, WHO declared that clusters of birth defects associated with Zika infection during pregnancy constitute a “public health emergency of international concern” requiring a stepped up, coordinated global response. In April the Centers for Disease Control and Prevention (CDC) confirmed this link.
Even before the association between Zika infection and births defects was confirmed, the Pan American Health Organization (PAHO), the CDC and other health authorities had issued guidance to pregnant women and those seeking to become pregnant to consider delaying travel to Zika-affected areas, and for those living in countries with widespread Zika transmission to avoid exposure to mosquito bites. In some countries public health authorities have gone even further, recommending that women postpone becoming pregnant for a period of time; most notably, the Minister of Health of El Salvador, a country which is experiencing a rise in suspected Zika cases, has recommended delaying pregnancy until 2018.
Such calls to postpone pregnancy raise serious issues, because many women across the region have limited access to contraceptives and other reproductive health services, experience high rates of sexual violence, and face other reproductive health decision-making barriers that can result in unintended pregnancies. In fact, some of the Zika-affected countries have among the strictest abortion laws in the world, potentially presenting women who have an unintended pregnancy with a dangerous catch-22. The United States government may have an important role to play in addressing health access and rights for women in Zika-affected countries, both through its direct health and development assets as well as its diplomatic engagement and public health expertise. To understand more about where these issues are likely to be more acute, we examine available country-level data on access to contraception, abortion policies, and the US government’s foreign assistance and global health presence in Zika-affected countries.