Key Messages on the Zika Virus Response

In countries affected by the Zika virus where there are refugees, asylum-seekers and returnees governments should aim to ensure that such persons have equal access to essential health care on the same basis as nationals.
Where national strategies/plans are being developed in countries affected by displacement, governments should ensure that IDPs are included and have equal access to essential health services as other citizens.
With governments in affected countries advising women to avoid pregnancy access to sexual and reproductive health services is critical. Women need access to contraception and sex education.
Women, in particular poor women, do not necessarily have control over their reproductive health choices. This takes into account that roughly 50% of pregnancies in the region are unplanned.
In Brazil, and many of the other South and Central American countries where the virus is spreading, women have no or limited access to terminate a pregnancy. That means when pushed because of fear or a positive diagnosis, they may resort to back-alley procedures, which jeopardize women’s health.
Placing the responsibility on women to not get pregnant disproportionately burdens women, in particular poor women, who don’t have that control. There should be equal responsibility on men – say, for condom use.
There are high rates of sexual violence in several affected countries, this makes it even more critical to ensure proper treatment and prophylaxis is available for survivors of sexual violence.
We might anticipate that a general sense of panic, disruption of normal activities and increased separation of family members could lead to a rise in violence: such a phenomenon was observed in the heightened risk of sexual violence in Sierra Leone during the Ebola crisis.
While the response plan is necessarily focussed, there is also a need to focus on prevention, through communication for development (C4D) and partnership with local stakeholders to promote the engagement of the communities in both individual protection from the vector and reduction of vector burden in homes, community sites, schools, workplaces etc. This approach will not only contribute to preventing the spread of Zika, but also to reducing other diseases such as dengue and Chikungunya that are transmitted by the same vector.
Agencies responding to the Zika virus should advocate for the safeguarding of human rights in national policies for and responses to the epidemic, as well as for a multi-sectoral approach in the response, with engagement from all sectors, including Health, Nutrition, Water and Sanitation, Protection, Education, ECD, and Disability among others.
Efforts should be directed to the most disadvantaged population and geographical areas, to ensure that Zika and its consequences will not aggravate the already high inequities existing in the region. This will require further analysis of epidemiology of the virus, as well as of mapping the mosquito distribution patterns in the region.
Child protection is impacted by all types of crisis, including epidemics. While medical services are concentrated on the epidemic, other concurrent illnesses should not be neglected (malaria, chronic diarrhea, infectious child diseases etc.). The importance of hygiene promotion and sanitation measures for children at risk of contamination should be underlined.
The psycho-social aspects of being at risk of contamination, including for women bearing children, and the effect of the Zika virus need to be addressed as part of the response. It will be important to address disinformation and beliefs and myths surrounding the epidemic.

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