James McGuire, professor and chair of government, professor of Latin American studies, is the author of a new op-ed titled, “Is Brazil Better Prepared than the U.S. to Fight Zika?”
Brazil is ground zero for the recent wave of Zika infections. McGuire argues that the country “is better prepared to fight Zika than many people think—and is, in some ways, better prepared to fight Zika than the United States.”
The Zika virus is difficult to fight, and Brazil faces some major obstacles, including a deep economic crisis, political turmoil, and an ongoing battle against other infectious diseases. Still, he writes, “Brazil has advantages in the struggle: a history of public disease control in the northeast dating back to World War II; a large and talented public health community; and years of experience with evidence-based public health interventions.
“It is no accident that the government knew where to send the 220,000 soldiers, because health data on the country’s 5,600 counties have become more complete, transparent and available during the last couple of decades. Most important, the Brazilian government in the mid-1990s expanded the Family Health Program (now Family Health Strategy), which by 2014 involved 39,000 health teams, each providing primary health care to about 1,000 specified households, including through home visits.”
In contrast, the United States “lacks a public health structure of the size and efficacy of Brazil’s for destroying mosquito breeding sites, educating high-risk populations, monitoring the spread of the disease and counseling expectant mothers.”
In the United States, mosquito monitoring and eradication is handled by 700 disconnected and underfunded public agencies, mostly administered at the municipal level but funded in part by the federal government. Federal funding for mosquito control fell from $24 million in 2004 to $10 million in 2012.
In February 2016 Congress denied President Obama’s request for $1.9 billion in emergency funding to fight Zika, demanding instead that he shift money earmarked for the fight against Ebola. On April 7 the Obama administration, citing a public health emergency, shifted about $500 million from Ebola to Zika.
The United States is a rich country with a temperate climate, but lacks an integrated public health service provision and disease control program like Brazil’s Family Health Strategy. Not surprisingly, then, both Mississippi and the vastly poorer Brazilian state of Espirito Santo have identical infant mortality rates: 9.6 per 1000.