Abril 2017
In the second interview – of a series of three – about the contributions of social sciences to the understanding of the disease, we talked to João Nunes, lecturer in International Relations at the University of York.
The researcher has recently presented some of his thoughts about the problem of neglect in global health in the seminar “Zika, social sciences and humanites,” held on March 30th at Ensp/Fiocruz.
João Nunes, lecture in International Relations, Department of Politics, University of York.
According to the researcher, the discipline of International Relations can contribute to the study of Zika not simply because the disease spread internationally, but also because its facilitating conditions – the neglect of primary health care and sanitation infrastructure – are dependent upon dynamics in global health governance.
How the discipline of International Relations can contribute to the studies about zika? Could you give us examples?
The discipline of International Relations (IR) offers a novel, and potentially fruitful, perspective into outbreaks like Zika. Because of its subject matter, IR is uniquely placed to scrutinise the cross-border dynamics that impact upon the spread of diseases, the vulnerability of particular groups and the ability of these groups to respond to disease.
It is not, as is often claimed, that ‘diseases know no borders’. Whilst some diseases do not recognise territorial borders, global health is still characterized by the persistence of multiple ‘borders’, broadly conceived, pertaining to disparities connected with gender, race, class, age or sexual orientation.
These ‘borders’ impact decisively upon individual and group experiences of disease. Therefore, IR can contribute to the study of disease outbreaks like Zika by enabling a more nuanced and encompassing exploration of the reproduction of inequalities at the global level.
This is highly relevant for the case of Zika. IR is important in this case not simply because Zika spread internationally, but also because its facilitating conditions – particularly the neglect of primary health care and sanitation infrastructure and the prevalence of a modality of response focused on short-term crisis management – are dependent upon global-level dynamics pertaining, for example, to long-standing disparities and the subordination of certain groups and regions.
Zika affected regions and groups around the world in a different way – women from poor backgrounds, for example, were particularly vulnerable and unable to respond to the repercussions of this disease. IR is important in this regard because it allows us to understand how vulnerability to the disease, and the ability to respond to it, are distributed unevenly across the globe.
Recognizing this should be an important starting point, not just in the analysis of Zika as a public health issue, but also in the definition of appropriate public health responses.
How zika has been treated in the context of global health?
Zika was represented in different ways in global health, but the most prevalent narratives framed Zika as a crisis and an emergency. This framing has been connected with strong security tropes, in the sense that Zika, its association with microcephaly and other neurological problems, were represented as uncertain events that required measures of control, calculation and prediction.
The result of this framing focused on narratives of crisis and security was the reproduction of a short-termist modality of response based on containment and crisis management – to the detriment of interventions that would tackle the long-term problems enabling the emergence of these crises.
A good example of this in terms of policy was the tendency to see Zika as fundamentally a problem of mosquito control (or lack thereof). The way in which Zika was conceived as a certain kind of problem (that is, as an emergency caused by mosquitoes) impacted upon the range of policy solutions that were deemed desirable and necessary – while at the same time obscuring other deep-seated problems and foreclosing policy alternatives.
In the case of zika, which are the “neglects” it faces in the international level?
The crisis narrative that enveloped the Zika response – by privileging containment and crisis management – is a narrative that neglects long-term structural problems connected with urbanisation, sanitation and other socio-economic conditions that facilitate the emergence of Zika in particular and other arboviruses in general.
The current Zika response, by assuming that ‘we are all in this together’, has also overlooked how various groups have experienced Zika in different ways. Specific vulnerabilities – related for example with gender, class and race – mean that the outbreak meant different things depending on the context in which particular groups are inserted.
The global Zika response has arguably neglected the analysis of the nuanced picture of the different realities of Zika.
Read more in HCSM-Manguinhos:
Brazil confirms links between zika virus and microcephaly in babies
Zika virus and rubella: similarities and differences – Researcher Ilana Löwy, from the Institut National de la Sante et de la Recherche Médicale Paris, traces a parallel between the current zika epidemics in Brazil and past rubella outbreaks.
Human sciences against zika – Researchers of the international consortium ZIKAlliance gathered at Fiocruz to discuss the social aspects of the disease, such as the effects of campaigns and sexual rights.
