In a recent press release, Dr. Anne Schuchat, a senior Obama administration official with the Centers for Disease Control and Prevention (CDC), stated that “Everything we look at with this [Zika] virus seems to be a bit scarier than we initially thought.” As of April 2016, there have been 700 confirmed cases related to the Zika Virus in the United States.
There have also been 358 cases in US-controlled territories, including 32 pregnant women and seven cases in which the disease was sexually transmitted. In February 2016, The World Health Organization declared a global health emergency due to epidemic levels of microcephaly and other neurological disorders caused by the Zika virus.
Earlier this year, the Obama administration requested an emergency appropriation of $1.8 billion to address the danger posed by Zika in the US, but this was rejected by Congress, on the basis that the “administration should first use money set aside to combat Ebola.” As a result, the CDC has stated that public health officials will have to divert money from flu vaccine, malaria, and other state-led prevention programs.
Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases has stated that precautionary measures must be taken quickly, as “the more we learn about the neurological aspects, the more we look around and say this is very serious.” He also noted that officials have been forced to “take money from other areas of non-Zika research to start. We couldn't just stop and wait for the money.”
As with everything under capitalism, the public health system is suffering from capitalist crisis and austerity, and millions of people’s lives are directly affected and in danger.
What is the Zika Virus?
Originally isolated in Uganda in 1947, Zika virus is a flavivirus related to yellow fever, dengue, the West Nile and Japanese encephalitis viruses. Zika is spread primarily through mosquito bites, and often also through sexual transmission. Other possible ways in which the virus spreads is through pregnancy (mother-to-child infection) and blood transfusions.
Symptoms of the Zika virus include mild fever, rashes, headaches, and pink eye. While studies have shown that only one in every five persons exposed to the Zika virus is actually infected, the recent Zika epidemic is related to pregnancy problems and birth defects. At the moment, there is no vaccine or preventive drug for Zika infections.
Zika virus in South America
It was not until 2015 that the Zika virus received widespread attention from medical professionals and others. Thousands of infected Brazilian women gave birth to babies with with undersized skulls and brains. As of March 2016, there have been a total of 6,158 microcephaly related cases just in the country of Brazil.
At the moment, doctors in Brazil are having a difficult time understanding the relationship between Zika and brain damage in unborn children. The Guardian recently reported on the alarming rise in microcephaly cases in mostly working class neighborhoods, such as Recife: “Oddly, the babies in Recife were of normal weight and most had good Apgar scores, measuring heart rate, breathing, muscle tone, reflexes and skin colour at birth. They were able to breastfeed. But their chances of normal development with the sort of calcifications of the brain that were seen on CT scans were zero. Some had spasticity. Many were irritable… From the beginning, the children would scream and scream and scream. It is very hard for families coping with that.”
Many doctors began to discover further similar cases of brain damage in unborn fetuses, describing the situation as a “feeling of being in a horror movie and having no cure for it.” While at the moment, there is no clear correlation between microcephaly and the Zika virus, many doctors in Brazil are concluding that Zika infects the pregnant mother, where the viral infection damages the brain and cortex of the unborn baby before eventually “dying out.”
Among adult cases, Zika has also been the source of the Guillain-Barre syndrome, a muscle-weakening disease that is related to paralysis. Throughout South America the Zika Virus is resonating with Guillain-Barré syndrome. In countries like Colombia, for instance, there have been more than 227 cases of the syndrome whilst there have also been a total of 64,839 Colombians infected with the Zika virus. In other neighboring countries, there has been a rise in the number of Guillain-Barré syndrome and microcephaly cases. In Venezuela it is disputed whether the number of Zika virus cases is as low as 3,700 or actually as high as 400,000. This large discrepancy between the government and doctors with regard to how many people have actually been infected with Zika is a mere reflection of how ill-planned the nation’s leaders and administrations are in dealing with this situation.
Zika Virus: Medical Assault on the Working Class
It should come as no surprise that most of the microcephaly and other related cases are occurring in the most underdeveloped neighborhoods in Brazil, Colombia, Venezuela, and other Latin American countries. In Recife, and other favelas (slums), the residents have previously been exposed to other deadly diseases through the Zika virus-carrying mosquito (Aedes aegypti), such as dengue and chikungunya. While the number of cases in these outbreaks were fewer than the number of Zika cases, there has been no proper treatment to prevent the Aedes aegypti mosquito from spreading further. In fact water storage in areas like Recife is not properly maintained, as “water pools in the bottom of open plastic bowls and buckets where mosquitoes can breed.” In most favelas water is only supplied on one in every four days, which forces residents to preserve and ration the water as efficiently as possible. This creates ideal conditions for mosquito-breeding.
While many residents have been advised by national health officials to use mosquito repellent, such products are financially inaccessible. As one resident states, “They tell us to turn bottles upside down and cover the water tank and use repellent. We can’t afford to buy repellent. They say to use it but they don’t give it to us.”
In these areas, where many residents live on less than $220 per month, access to screened windows and mosquito repellent is considered a luxury. Furthermore, there is no proper provision of public services in many of these favelas. Jardim Jandaia and other neighborhoods, for instance, are “plagued by informal garbage dumps, and in some places, raw sewage trickles along sidewalks.”
The disparity in income inequality is extremely visible in Brazil, with these favelas being situated side by side with luxury shopping centers, “high-rises with shining glass windows and air conditioning.” Furthermore, the hospitals surrounding these favelas serve patients with private insurance or who can afford the fees (who don’t usually have or carry the virus).
At other public health clinics that surround the vicinity, such as Quintino Facci II, the situation is different. These clinics are filled with untrained doctors or medical students with inadequate quantities of materials and medicines. Dozens of patients, particularly pregnant women, wait for “four to seven hours” to be examined by a doctor, in which they are treated with saline solution to prevent the dehydration caused by dengue rather than Zika.
At private hospitals, on the other hand, patients are called in for regular check ups that usually last for little more than an hour, and they are able to leave with prevention kits and other materials.
According to the Guardian, the options that face favela residents are in complete contrast with the options available in upper middle class areas:
“Regardless of the cause, those on lower incomes have fewer choices when deciding how to deal with the risks. Some wealthy pregnant women are quitting their jobs and taking refuge overseas until their babies are born. Others are having illegal pre-emptive abortions at private clinics rather than take the risk of their foetus being diagnosed with microcephaly closer to term.
“Poorer women cannot afford to run anywhere that would make a difference and are less likely to be able to pay for a termination.”
This is not the first time that poor sanitation, polluted water supplies, inadequate healthcare and inadequate social services have had a massive impact during a viral epidemic in Brazil or elsewhere. Prior to Zika, mosquito-born viruses such as dengue and Chikungunya were (and still are) a major issue in low-income, working class neighborhoods, yet no preemptive action was taken by state officials to resolve these problems.
Similarly, in southern Mexico the Zika virus is becoming a rampant issue, as poor neighborhoods like Tixtla, and areas in Guerrero, Chiapas and Oaxaca lack adequate water supplies. For many families, water comes once every week or even as little as once every two weeks. As with the favelas in Brazil, these small quantities of water, contained as they are in storage tanks, become ideal breeding grounds for mosquitos.
US Imperialism and the Zika Virus
From the creation of the Monroe Doctrine, to the construction of the Panama Canal, through to the modern day, U.S. imperialism has continued to encroach across Latin America in all spheres, including medicine and public health. The establishment of multinational pharmaceutical companies with investments in countries like Brazil and Colombia could not have taken place without the assistance of “philanthropic” organizations such as the Rockefeller Foundation. Through the creation of public health initiatives and services, such as free health clinics in favelas, such groups laid the basis for the participation of multinational pharmaceutical and private insurance companies. The stranglehold of such companies over the prices of vaccines, to which they hold the patents and intellectual rights, is guaranteed by their complete domination of the medical industries in these countries. Those who desperately need access to care, such as favela residents, are now unable to afford the materials and medical assistance, the supply of which is controlled by these foreign companies. The absence of well-equipped hospitals and clinics trained in dealing with pandemics is what ultimately results in ill-planned emergency actions such as those we are now seeing in the Zika case.
Another recent example of this was given by the handling of the Ebola epidemic, where international drug companies had again left countries in Africa without a strong infrastructure of primary care clinics and hospitals. For these companies to have taken an interest in tackling Ebola, it would have to have first been a profit making opportunity, which it was not. We previously wrote (20 October 2014) the following at the time of the outbreak:
“(...) questions have to asked about the preparedness and even the willingness of the big international drugs companies in terms of their research and development. Diseases that affect the low income countries have always been the ones with the lowest priority for the drug corporations because there is no profit in them. They have therefore had the least amount of research and development.
“(...) Lassa fever and Ebola have relatively few resources committed to them so the development of vaccinations is slow at best. But now that there is a serious possibility of this disease spreading outside of Africa and given its very high mortality, we can now expect western government to direct big Pharma to commit far more significant resources to vaccination development.”
Zika in the United States
As of April 2016, there have been 358 cases related to the Zika virus in the United States, mostly concentrated in Puerto Rico. In Puerto Rico, where government austerity measures combine with its water shortages, poor neighborhoods are being hit hard.
According to the Centers for Disease Control and Prevention, “A quarter of the island’s 3.5 million people will probably get the Zika virus within a year, and eventually 80 percent or more may be infected.”
Through the attacks on the working class by the current right-wing government, led by the Popular Democratic Party, there has been a series of privatizations affecting chemical companies that would otherwise have provided the insecticides used to exterminate mosquitoes. According to the New York Times, “thousands of civic workers needed to fight mosquitoes have been laid off.” Instead, the government has been using drug abuse convicts to dispose and clean “cemeteries, abandoned houses, auto junkyards, unsealed septic tanks and piles of old tires.” In addition, the mosquitos carrying the virus have grown resistant to the previous pesticides, a devastating blow to the attempts of the chemical companies and the CDC to contain the situation.
In Puerto Rico too, many of the expenses associated with hospital visits, as well as prevention kits and abortions (which are legal in Puerto Rico), are beyond the means of many.
Doctors and scientists are predicting that the Zika virus will become a serious issue across the United States as a whole, especially in areas like Flint, Los Angeles, West Baltimore, and other barren neighborhoods where unsanitary water systems could create a breeding ground for mosquitoes.
While areas like Baltimore do not have the particular climate in which the aedes aegypti mosquito is able to breed, in “low income communities, with less access in general to health care, symptoms may also be more likely to go unnoticed” as “mosquito species have adopted survival and reproductive strategies that depend upon the artificial urban environments created by humans.” Meanwhile in areas that have climates that are hospitable for the mosquito, like Miami and New Orleans, “there’s potentially a greater danger because of the more hospitable climate for Aedes aegypti and, again, relatively high poverty rates.”
The recent halt imposed by the White House on budgeting for the Zika virus, and the inability of the the Brazilian, Colombian, Venezuelan, Mexican, Puerto Rican and other Latin American governments in zones affected by the Zika outbreak to properly deal with the situation is a reflection of the crisis of the system itself. Whilst these respective governments have all agreed that the Zika virus is a global health emergency, no one is acting proactively to resolve the issue.
Whilst many research companies, such as Intrexon, Cerus and Inovio, are in the process of developing possible vaccines for the Zika virus, many investors remain unconvinced that the virus is worth investing in. According to an article in Forbes magazine, the CEO of Inovio, Joseph Kim, claimed that it would take some time for such a vaccine to become a marketable asset due to the lack of urgency being shown in the United States. Such an attitude reflects the ruling class’s general disinterest in solving the Zika epidemic.
In the past years, we have seen deadly viruses and diseases metamorphosing into global health emergencies, as we have seen with Ebola and dengue. Yet outcries soon die out once insufficient demand is found to satisfy the profit motive of the giant pharmaceutical companies. Furthermore, as in the case of Ebola, Zika treatments and prevention kits are not accessible for the majority of those who have been affected, as this is a virus that results from sanitary issues—a situation that is prominent in slums and poor working class neighborhoods across South America and the United States.
The failure to allocate resources and materials with which to eliminate the Zika virus is a reflection of the artificial scarcity that capitalism creates. The Zika virus is completely preventable — were repellents, nets, clean water, and sanitary incentives to be provided and implemented in Zika-infected areas. It is not a question of whether the capitalist class can afford to solve the problem but rather one of whether they can profit from it. It is the dislocation and mismanagement caused by cutting spending on public services, sanitary programs, and changes to water systems (in the case of Flint and Brazil) that encouraged the proliferation of the virus. Yet, it is the working class who are facing the burden of the virus. Whether a cure for Zika is found or not, its distribution among residents of the favelas and among the low-income residents of underdeveloped neighborhoods is extremely doubtful as it would be the same healthcare officials and distribution networks that previously refused to distribute repellants and preventions kits that would be charged with the distribution of a cure.
In Brazil, where abortion is illegal, backstreet abortions are not affordable for the majority of pregnant, Zika-infected women. Of the backstreet abortions that are conducted, many are not carried out properly due to a lack of medical equipment. Such abortions can cost anywhere from $800 to $4,000 USD.
In the recent period, Brazilian authorities have seized abortion pills from women who fear that they might be infected with Zika. Even in such a situation, “providing pregnancy-ending alternatives to women in a country where abortion is in most cases illegal is proving to be nearly impossible.”
Were Zika to find its way to the United States, it would stir yet another controversy as abortions remain inaccessible for many working class women. Just last year, a woman was sentenced to twenty years in prison for “feticide.” Whether it is Brazil or the United States, the same bourgeois morality exists, which uses intimidation to dissuade women from seeking abortions. As we have stated elsewhere:
“Even though abortion has been legalized, it is not so simple for working class women to get one if they choose to have one. 58% of women seeking abortion are in their 20s and don't have a regular or high enough income, or a partner to help cover the costs. Most health care plans won't cover the cost of an abortion, which averages $500, but can approach $1,500 in the first trimester. 42% of women seeking abortions have an income level below the poverty line—a percentage that has surely increased dramatically since 2008.”
Capitalism: Humanity’s illness
The Zika virus is a direct byproduct of a system that is fueled by market anarchy and profit. In a world where scientists and engineers have developed extraordinary methods in purifying water, from dirty river water to seawater, providing access to clean water in these neighborhoods should not pose any problems. It is capitalism itself which is no longer able to properly handle such crises when they occur, as we can see with the garbage and water situation in areas like Recife and Tixtla.
The solution to the Zika virus lies in first nationalizing the multinational pharmaceutical companies under workers’ control, which would then be able to provide the large quantities of medical supplies necessary to assist current Zika-infected patients, offer access to abortions for pregnant women, and distribute trained medical and sanitary staff able to protect and clean neighborhoods and install water systems capable of providing residents with more than enough water for their requirements, without the need for rationing. This is not on the ruling class’s agenda, however, as this would mean cutting their profits and attacking their own interests. Capitalism itself is unable to resolve this task—it is in a crisis from which it cannot extricate itself. The only solution is a socialist solution, which will unleash the tremendous latent human potential and creativity that exists within society. Not only will we then be able to eliminate this deadly virus but we will ensure the elimination of poverty, hunger, war and disease in general, which are at the heart of these problems.