Search

During health emergencies, neglect of gender experiences and needs can compromise the outbreak response. Ebola in West Africa and Zika in Latin America had gendered effects that were evident during the crises, yet governments and international organizations failed to prioritize a gender-inclusive response. There is the same risk that gender-inclusive responses and knowledge will continue to be neglected during the COVID-19 pandemic. In this article, we examine the drivers of gender exclusion in health emergency response. We ask: where can we locate institutional responsibility for taking gender seriously to inform and improve sustainable disease control? The article addresses this question by turning to feminist institutional theory to explain why gender inclusion in decision-making processes is vital for effective response and post-crisis recovery. We argue that the institutional responsibility to recognize gender within the global health emergency regime lies with the World Health Organization (WHO). WHO has neglected to mainstream gender in the policies and practices that it promotes for the prevention and detection of, and response to, infectious disease outbreaks. WHO is in a position to support gender-inclusive practices, but this requires the technical agency to recognize the value of having a gender-inclusive framework to inform outbreak response, financial models, and recovery. [ABSTRACT FROM AUTHOR]

Brazil's Zika virus crisis (2015–17), following hot on the heels of the Ebola outbreak (2014–15), dominated newsfeeds and high-level discussions amid governments, the UN system and beyond, with emerging fears relating to Congenital Zika Syndrome (CZS), embodied by microcephaly. However, beyond the ensuing panic in Latin America facing a generation of Zika babies, the outbreak demonstrates key developments in our understanding of the interaction between health and security, based on the Copenhagen School's securitization approach. It suggests that unlike previous diseases that were securitized, it was not the virus that was the cause of the security threat, nor how many people were affected, but a combined concern over where (in Brazil at a time of domestic political crisis), when (immediately post-Ebola), who (foetuses and babies), how (unknown disease characteristics) and what was the existential threat (the vectorized unknown). This article shows these developments for global health security through empirical analysis of the multiple securitization processes that occurred within Brazil for the Zika virus, at the subnational and federal levels. [ABSTRACT FROM AUTHOR]

Medical humanitarianism and global health are two distinct but co-dependent spheres of global health security. Their actors differ in their units of analysis, understanding of neutrality, and organizational capacities. While health underpins the normative principles of humanitarian action, humanitarian ideas, and notably medical humanitarian organizations, are absent from global health security planning. This article develops the work of Lakoff [‘Two regimes of global health’, Humanity, 1(1), 59-79 (2010)], distinguishing between these two governance spheres and how this had stark consequences in the 2014/15 Ebola outbreak in Liberia and Sierra Leone, framed as a problem of global health but which rapidly became a humanitarian crisis. Such a frame excluded medical humanitarian organizations from the initial global strategy and resulted in the creation of a new organization (UMMEER - United Nations Mission for Ebola Emergency Response) and the involvement of militaries to bridge the health-humanitarian divide. Reconciling the distinct but co-dependent relationship between medical humanitarianism and global health is fundamental to effective delivery of global health security. [ABSTRACT FROM AUTHOR]

The Zika outbreak of 2015-7 is a lens to analyse the positioning of abortion within in global health security. The sequelae of the virus almost exclusively affected newborn children, manifested through Congenital Zika Syndrome (CZS), and a focus on women at risk of, planning or being pregnant. At the global level, debate considered whether Zika would provide impetus for regulatory change for reproductive rights in Latin America, a region with some of the most restrictive abortion regulation in the world. However, regulatory change for abortion did not occur. We analyse why the Zika health emergency did not lead to any changes in abortion regulation through multi-method analysis of the intersection between Zika, health emergencies and abortion in Brazil, Colombia and El Salvador. These case study countries were purposefully selected; each had Zika infected women (albeit with differing incidence) yet represent diverse regulatory environments for abortion. Our comparative research is multi-method: framework analysis of key informant interviews (n = 49); content analysis of women's enquiries to a medical abortion telemedicine provider; and, policy analysis of (inter)national-level Zika response and abortion policies. We consider this within literature on global health security, and the prioritisation of a particular approach to epidemic control. Within this securitized landscape, despite increased public debate about abortion regulatory change, no meaningful change occurred, due to a dominant epidemiological approach to the Zika health emergency in all three countries and prominent conservative forces in government and within anti-abortion rights movements. Simultaneously, we demonstrate that regulation did not deter all women from seeking such service clandestinely. • Zika affected reproductive decision making, but did not impact abortion regulation. • Epidemiological framing ignored reproductive dimensions of emergency responses. • Conservative forces instrumentalized disability concerns to oppose abortion rights. • Women sought abortions clandestinely, citing Zika as a justification. • Abortion provision must form part of health emergency planning and response. [ABSTRACT FROM AUTHOR]