* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
The challenge in containing dengue demonstrates the inadequate investment in preparedness and longer-term development
In a matter of weeks, Zika has gone from a relatively obscure tropical disease to a household name, and an international public health emergency. As Latin American governments, aid groups and communities grapple with this unfamiliar threat, the public health responses to Dengue and Ebola hold some valuable lessons.
In 1960, few people outside of a handful of countries in Asia and the Pacific would have known what Dengue was. At that time, the mosquito-borne disease affected about 15,000 people annually. Today, it is now present and endemic in more than 100 countries and, every year, 390 million people are affected.
What happened since the 60s? How did it spread so quickly? Why weren’t we able to prevent it?
The challenge in containing dengue demonstrates the inadequate investment in preparedness and longer-term development. Over recent decades, health workers have fumigated countless houses. But ultimately, these measures have only had short-lived and localized effects on the spread of the disease. Dengue has spread in the shadow of weak health systems, poor or non-existent sanitation, and poverty. The same goes for Zika – indeed the same mosquito that spreads Dengue also carries Zika. These mosquitoes thrive where sanitation is absent, finding refuge in the poor drainage and solid waste that so often results from low investment in preventative public health and environmental improvement measures. This is the first lesson for Zika: reactive response cannot be enough. The best protection lies in holistic and sustainable development.
A similar lesson was vividly demonstrated by the deadly spread of Ebola through West Africa. This outbreak taught us many other things as well, including some we honestly already knew. One of these was the worrying and growing distance between weak health systems and communities that are isolated and marginalized due to poverty, distrust and other factors.
Unless these gaps are overcome, then diseases will flourish.
In countries with weak health systems, public health structures need to be expanded to incorporate community actors and leaders. Such an approach will add many, many thousands of qualified and caring individuals to the national health workforce, extending health care in ways that are responsive, culturally sensitive, and cost efficient.
Health systems alone could not effectively respond to Ebola, and they will not be able to cope with the Zika outbreak. Governments in affected countries will need to adopt a “whole of society approach”. Health system strengthening must go hand-in-hand with community system strengthening.
The Red Cross and Red Crescent is uniquely placed to play this role. Our volunteers are drawn from the very communities they serve. They speak the same languages and hold the same fears as their neighbours, but are ready to care and support. Armed with knowledge and training, they can be an effective front line response. In West Africa Red Cross volunteers were able to earn the trust of frightened and vulnerable communities, and in the process, help break the transmission of Ebola.
Volunteers can be the bridge between the home and the hospital, and the link between the formal and informal health care system. This is the second lesson: support communities to engage and be part of the solution.
These two lessons are complementary to each other. They are necessary elements of strengthening resilience, of laying a firm and stable foundation upon which development can take place. Last month, the International Federation of Red Cross and Red Crescent Societies joined with UNICEF, the World Food Programme, Zurich Insurance and the Rockefeller Foundation to announce a One Billion Coalition for Resilience. The goal of the coalition is, by 2025, to support a billion people around the world to reduce their vulnerability to natural hazards and other threats.
Health is the foundation of resilience. No individual or community will be able to cope with a disaster, or benefit from new economic opportunities, unless we invest in healthy communities and effective health systems. This is the best protection we can offer against Zika, and against the next health threat to come.
Elhadj As Sy Secretary General of the International Federation of Red Cross and Red Crescent Societies.
