In 2015, Brazil attracted worldwide news due to the rising number of babies born with microcephaly. A cluster in the northeast of the country raised the epidemiological alarm for Zika outbreak in Brazil, triggering what would then become a national and international public health emergency, largely due to Zika’s unprecedented and unknown consequences on the fetus.
The Zika Congenital Syndrome still faced considerable uncertainties, both scientific and political, when Fiocruz created the Zika Social Sciences Network to address some questions about Zika’s effects. Yet today, many of these questions remain unanswered.
Over the course of the epidemic, Brazil demonstrated its epidemiologic capacity to identify the virus, a strong clinical evidence base, as well as a national study control conducted with local maternity´s hospitals to show a correlation between the virus and the rise of microcephaly cases.
What became apparent, however, was a lack of coordination between epidemiologic surveillance and primary health care databases, as well as the uneven social and geographical distribution of complex hospital facilities. Scientific cooperation between developed and unequal countries such as Brazil also revealed issues about data-sharing, intellectual property, authorship, and equitable partnerships.
The civil society response, mainly through poor (mostly black) mothers who found themselves abandoned by their male companions and in serious need of public policies, was to form NGOs to increase political pressure. From 2015 to 2018, 3.332 cases of microcephaly by Zika were confirmed, but just 33% have access to adequate early stimulation and specialized care. Children are now three and four years old and new challenges arise, such as inclusive education.
We have to qualify what we- locally, understand by preparedness and how that gets entangled in the long term and historical infrastructure shortcomings, such as vector control challenge, sanitary and water storage issues and the social, racial and gender-biased impact of the lack of access to health care rights.
As social scientists we do engaged research, drawing from local issues and responses, we try to develop research that can translate to health care policies. Ultimately, our goal is to achieve what is written in the Brazilian constitution (1989): public healthcare is a universal right and a State duty. It is not just a Brazilian issue but a Global one.
Gustavo Matta is a public health researcher at Fiocruz and the coordinator of Zika Social Sciences Network.
Carolina Nogueira is an anthropologist. Member of Zika Social Sciences Network.