Since the virus first emerged in Latin America at the end of 2015, Zika has been the topic of discussion among individuals working on sexual and reproductive rights. There was no history of the virus in the region, it was spreading rapidly, and there was great uncertainty about the extent of its effects.
What health authorities in Brazil did know was that the virus was primarily affecting women and newborns.
Governments panicked. Several countries issued statements asking women to postpone pregnancy for months, and in the case of El Salvador, for two years. Initial responses from the Pan American Health Organization and other global health authorities focused almost exclusively on mosquito control. These responses, which placed the burden of the virus square on the shoulders of women, are unjust, unreasonable and ironic in a region where women often lack the legal rights or power to make decisions about their bodies.
The Zika virus has brought the realities of women and adolescent girls in Latin America and the Caribbean to the forefront of global discourse with an intensity I have not witnessed before. In doing so, the epidemic has highlighted two key failures of governments in the region: a lack of investment in sexuality education and quality sexual and reproductive health services like care during pregnancy, and a deep denial of the human rights of women and adolescents.
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Despite the progress that many countries in the region have made economically, multilayered inequalities persist in every sphere of life, especially when it comes to sexual and reproductive rights and health. Until women have bodily autonomy, we cannot eradicate social inequalities, gender inequalities or level the playing field when it comes to health care access.
As a result of our failure to uphold the rights of women and girls, 23 million women in Latin America and the Caribbean want — but lack access to — modern contraceptive methods, and up to one-half of unmarried sexually active girls between 15 and 19 have an unmet need for contraception.
This tremendous unmet need is even more acute for poor and indigenous women in areas with little public health service coverage. In Guatemala, for example, 49 percent of indigenous women had a met demand for contraception compared to 72 percent of Spanish-speaking women. These women not only have little access to services, they are often more likely to live in areas with standing water that serve as mosquito breeding grounds.
Yet even where public health services exist, women and girls face barriers to accessing quality care. Many clients are met with judgment from health providers or asked to “consult” with their husbands and return. Cost is also a factor. In Venezuela, a three-pack of condoms costs as much as $169 — the rough equivalent of five days' salary for the average worker.
Conservative attitudes around sexuality, high rates of violence and sexual assault, and restrictive laws compound these challenges, making it difficult for women to negotiate sex with their partners and use contraception. That’s why access to unbiased, medically accurate information, emergency contraception and safe abortion services must be part of the package of sexual and reproductive health services.
But Latin America has some of the most restrictive abortion laws in the world, and a staggering 95 percent of all abortions are performed in unsafe conditions. Access to emergency contraception in the region is also not a given. Honduras has an outright ban on emergency contraception and in Costa Rica and Haiti, there are no emergency contraceptive products registered. In countries where it is not outright banned, barriers to access like age restrictions often exist.
Women and girls are confronted with difficult decisions and should be empowered with information and tools to effectively make and carry out their own decisions — not only during the Zika crisis, but 365 days a year. This epidemic may be the turning point in closing the gap in access to sexuality education and comprehensive reproductive health care. Recent evidence suggesting that Zika might be transmitted sexually also offers the opportunity to more involve men and boys in sexual and reproductive health issues and opens a window for deeper discussions around gender equality.
The women’s right movement has a rich history throughout the region, and while our path is just, it has never been easy. Zika provides us the opportunity to have these difficult conversations, to open a dialogue around the issue of abortion and women’s rights in general, as well as social support and access to health services for children born with disabilities. Most importantly, it paves the way for the political will needed to create a world of inclusion, choice and opportunity for all.
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