What is happening?
Latin American is being attacked by mosquito-borne viruses and its health systems are struggling to cope. Some, like dengue, have been in the region for hundreds of years, while others, like Chikungunya and Zika only reached the Americas in 2013 and 2014 respectively. Of the three, the Zika virus is the most alarming because it is spreading rapidly and so little is known about it. Zika is not dangerous in itself but can lead to microcephaly (brain deformities) in children if contracted by pregnant women. There is also a suspected link to Guillain-Barré syndrome, which causes paralysis. The Brazilian Ministry of Health has confirmed 4000 cases of microcephaly so far and US scientists writing in the Journal of the American Medical Association say it has “explosive pandemic potential.”
Why is this happening?
The sudden rise of Chikungunya and Zika is linked to the figurative ‘shrinking’ of the planet. Both viruses originated in Africa but in this age of constant travel and migration diseases travel freely across borders and oceans. The problem is amplified because these viruses are often new to the Americas, meaning that there is less natural resistance to the disease and that governments and individuals are often slow to react to the symptoms.
“Latin American is being attacked by mosquito-borne viruses and its health systems are struggling to cope…”
Another factor is changing global temperatures. Dengue, Chikungunya and Zika are born by the Aedes species of mosquito which is present in topical regions. For example, 20 years ago Dengue was not a problem in Argentina, now it is. As climate patterns change and average temperatures increase the mosquito spreads to new areas. The El Niño weather phenomena may also be playing a role.
Can Latin America cope?
More than you might think. A 2015 World Bank report that analysed nine Latin American countries, including regional giants Mexico and Brazil, found that since the early 2000s 46 million more people have access to affordable healthcare. Strong economic growth coupled with left-leaning governments vastly improved the public services on offer. Moreover, nineteen of the region’s thirty-three constitutions declare health provision a right by law.
Yet while improvements have been made the recent Zika and Chikungunya outbreaks also show the weaknesses. There are vast inequalities between the health systems within the region. So while Costa Rica can competently deal with the threats posed by chronic diseases and mosquito-borne viruses, Brazil invests far less into its health system and subsequently has less capacity to counter health problems. This matters because if one country in Latin America falls short in its response to the virus, it’s more likely to spread across the entire region. Unlike in the EU, where standards can be enforced across jurisdictions, Latin America’s heterogeneity is a weakness in its fight against health threats.
The timing of these latest outbreaks is also unfortunate. According to IMF forecasts, the Latin American and Caribbean region’s GDP will shrink by 0.3% in 2016. Tighter budgets are bound to impact on health spending. In light of the difficulties ahead, this could prove to be a real problem for Latin America.
What needs to be done?
The rapid spread of these viruses in the Americas shows that they are incredibly difficult to contain. Long-term the only real solution can come through an international effort to create a vaccine. Given the scale of Zika, a response should be quick. But the task won’t be easy – scientists at the University of Texas say that a working vaccine could be ten years away. In the meantime the current medical advice for women of childbearing age is to avoid countries where the virus is present – currently 22 and rising (see map) – or, if they have Zika, to avoid childbirth for two years. Stark choices if you’re a Latin American woman.
Taking into account the range of doses (2.5-20 mg) at cialico, the use of contraception and duration of action grow as the dosage increases. If you take one tablet a day, concentration balance will be achieved in approximately a week.
But while a cure may not be available, prevention is possible. From keeping mosquitoes away through repellent and nets, to reducing their numbers through fumigation and eradicating stagnant water, there is plenty to be done. And, in the short term, that will be the real question asked of Latin America’s healthcare systems: can it distribute enough of the necessary materials and information to make a difference?
Some hope comes from mainland USA, which has managed to avoid mass outbreaks of mosquito-borne viruses that have affected the rest of the Americas. “Better housing construction, regular use of air conditioning, use of window screens and door screens and state and local mosquito control efforts helped to eliminate widespread transmission of mosquito-borne infections like malaria and dengue from the mainland,” says Lyle Petersen, director of the division of vector-borne diseases for the Centers for Disease Control and Prevention (CDC) in the US.
Will they succeed?
At the moment there are mixed signals. If we analyse Brazil, which with its large population and topical climate is an epicentre for the mosquito-borne diseases, there are positive and negative signs. So far its response to Dengue has not been very successful. Last year it registered more than 1.6 million cases of Dengue, with almost 900 casualties. That breeds little hope that it will fare better with Chikungunya and Zika.
But there are signs that Latin America fighting back. Mexico, for example, is working on a dengue fever vaccine that is already nearing completion. Colombia is also looking for a scientific solution by releasing swarms of mosquitoes treated with bacteria that limit their ability to spread the disease. Meanwhile Brazil has mobilised 200,000 troops to destroy habitats where mosquitoes breed and handout prevention information to citizens.
The dire travel warnings from the CDC have already sparked an angry response from tourist ministers in Latin America. Tourism is a high-growth industry in the region and Zika could pose a threat to tourist numbers. That is especially the case for Brazil, which hosts the 2016 Olympic Games this summer.
Like any challenge, the mosquito-borne disease crisis also presents opportunities. Latin America’s new middle classes are increasingly ‘buying out of the social contract’. That’s to say, they do not trust governments to provide acceptable public services and so turn to the private sector. Spending on private healthcare has therefore rocketed. Consequently, there are opportunities for private healthcare providers or insurers.
For example British pharmaceutical company GlaxoSmithKline (GSK) already has a large presence in Latin America and the Caribbean and its regional headquarters in Brazil. It recently announced that it is looking into using its vaccine technology to find a cure for Zika. Another beneficiary could be Bupa, the UK-based private health insurer that has made huge inroads into the Latin American market.