Ethical, legal and societal considerations on Zika virus epidemics complications in scaling-up prevention and control strategies

Abstract

Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus (ZIKV) complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized.

Solidarity, vulnerability and mistrust: how context, information and government affect the lives of women in times of Zika

“…The public health response to Zika should consider how women's organizations interact with the overall society, how they support each other, and whether networks between them do exist. The ability of local communities to mobilize and collaborate for action influences the success of strategies to control infectious disease [21]. Community engagement could be an essential tool to minimize suffering, increase emotional and mental health and support among ZIKV patients and families with affected children.…”

Vector control in Zika-affected communities: Local views on community engagement and public health ethics during outbreaks

“…Community engagement -i.e., the sharing of information, trust, and responsibility between health authorities and affected communities (Schoch-Spana et al, 2007) -was a recurrent theme in the ethics analyses published during the Zika virus outbreak (Nuffield Council on Bioethics, 2016;PAHO, 2016;Tambo et al, 2017). The Pan American Health Organization and Nuffield Council on Bioethics, for instance, advised providing clear, timely, and culturally-aware public information about the health effects including congenital Zika syndrome, local incidence and prevalence, personal protective actions (e.g., repellent use), and public health interventions (e.g., surveillance) (Nuffield Council on Bioethics, 2016;PAHO, 2016).…”

“…Analyses of the public health ethics of Zika virus vector control demonstrated that community engagement is vital (Jamrozik et al, 2018;Nuffield Council on Bioethics, 2016;Tambo et al, 2017;WHO, 2017). Interventions seen as out-of-sync with local values could foster community resistance.…”

“…Accessing private property to identify mosquito habitats, too, could upset residents who cherish their independence, chafe at government interference, and value their property rights. By explaining control alternatives, eliciting community input on acceptable interventions, and sharing the rationale for specific choices, public health professionals have a greater chance of earning the public's confidence and cooperation (Jamrozik et al, 2018;Nuffield Council on Bioethics, 2016;Tambo et al, 2017). Moreover, involving local residents in a coordinated campaign to reduce mosquito habitats at the community level -such as enlisting whole neighborhoods to empty/cover containers with standing water -can raise the likelihood of successful vector control (Jamrozik et al, 2018;WHO, 2017).…”

Solidarity, Vulnerability and Mistrust: How Context, Information and Government Affect the Lives of Women in Times of Zika

“…The public health response to Zika should consider how women's organizations interact with the overall society, how they support each other, and whether networks between them do exist. The ability of local communities to mobilize and collaborate for action influences the success of strategies to control infectious disease [22].…”