Zika and Inequality

Disasters, however “natural,” are a wonderful (well, horrible really) entry point into exposing to the public to deep fissures on inequality in a society. That’s true whether they are earthquakes, hurricanes, floods, fires, or disease epidemics. This includes Zika, even as our knowledge of what is really going on remains very much a work in progress. But what is clear is how it exposes the severe inequality problems of Brazil:

What kind of country can be denounced by a mosquito? For a start, it is a country where Arthur Chioro, a doctor trained in the field of public health, was removed from the ministry of health at the moment when the ministry most needed to be led by a public health physician. At that time, last September, the dengue epidemic, also caused by the Aedes aegypti, was reaching tragic proportions: in 2015 there were over 1.6 million likely cases and the number of related deaths increased by more than 80%.

Against that backdrop, the president handed over control of the department of health – the ministry with the largest budget – to a politician from the Brazilian Democratic Movement party, which Rousseff needed to appease in order to pass government bills in congress and stave off the threat of impeachment. Political horse-trading thus resulted in a public health specialist being replaced by the psychiatrist and career politician Marcelo Castro.

Faced with the link between Zika and microcephaly, the new health secretary has come out with a collection of bizarre statements. Castro declared that “sex is for amateurs, pregnancy for professionals”. He said that women protect themselves less than men from mosquitoes “because they expose their legs”. He stated that he “hoped women would catch Zika” before they reached a fertile age, since “that way they would be immunised” and would not need a vaccine. But perhaps the most damning of all his statements was the following warning: that the epidemic may give rise to “a handicapped generation in Brazil”.

The Aedes mosquito has proliferated in Brazil due to the negligence of the state: an inadequate sewage system, poor management of waste, precarious urban development and the difficulties a section of the population faces in accessing drinking water, making it necessary to store it. The distribution of the number of suspected cases of microcephaly linked to the Zika virus, according to the Brazilian Association of Public Health, shows that those affected are the poorest members of society, who live in dramatic socio-environmental circumstances.

Official discourse, however, holds the individual citizen responsible for containing an epidemic that has only taken on such proportions because the authorities have proved to be incapable of moving beyond palliative measures. On Saturday, the government promoted a “national day of action to combat the Aedes aegypti”, a high-profile operation involving more than 200,000 soldiers inspecting homes. Rousseff led a rally wearing a T-shirt bearing the slogan: “A mosquito is not stronger than an entire country.”

Now, the problems of inequality and poverty in Brazil run far deeper than the corruption problems of the Dilma government. For most of Brazil’s history, it has been governed by elites who did not care about the poor one bit, with a military ready to overthrow democratically-elected regimes with U.S. support if that changed too much. The Lula and Dilma governments have at least attempted to change the course of the country on this path. So blaming her exclusively for these problems is like blaming Castro for relying too much on sugar in the early decades of the Cuban Revolution. That road was blazed a long time ago. Yet that doesn’t mean that her government and the tremendous corruption problems Brazil faces isn’t a major problem in addressing Zika and other public health problems. Certainly replacing experts with political appointees is rarely a good idea. For those of us who are not Brazilian, at least this becomes an opportunity to have a serious discussion of the interaction between disaster and inequality there and throughout the world, a reminder that events like Hurricane Katrina expose the same problems in American society.