Zika has faded from the media spotlight in recent months, but public health officials are gearing up for the virus to resurface as the summer brings warmer weather and mosquitos, through which it is primarily transmitted. The virus is linked to serious birth defects in babies of mothers who were infected while pregnant.
In February 2016, the World Health Organization declared the spread of Zika an international public health emergency. First detected in the Americas in early 2015, Zika has now spread to 33 countries in the region. Several U.S. states, including Florida and Texas, were considered high-risk regions for the virus last year.
But global health experts warn that the infectious disease and others like it will be much more difficult to contain in the future as Trump moves ahead with the reenactment and expansion of the Mexico City Policy, a ruling that blocks U.S. federal funding for NGOs and agencies that provide abortion counseling or referrals in any way. Future funding will reduce the possibility of properly combating the virus in Latin America, where it surfaced over the last two years. That’s because Trump’s version of the Mexico City policy, which the administration recently dubbed the “Protecting Life in Global Health Assistance,” will cut $8.8 billion in funds, a dramatic increase from past implementations of the rule. And it will eliminate funding for USAID, the U.S. Agency for International Development, a government agency responsible for administering foreign aid. Prior policies cut around $600 million per year in global reproductive health funding, but the number has increased significantly, because, unlike prior policies under Republican administrations, Trump’s plan includes cuts to all global health assistance, not just reproductive health.
Health care providers working overseas to combat diseases like Ebola, tuberculosis, HIV/AIDS, malaria and Zika, among other diseases, will all likely see their work and research diminish as a result of the funding cuts.
And experts say the results could be devastating.
“These viruses don’t respect country borders, and the U.S. experienced alarm when both Ebola and Zika reached its shores,” said Dr. Mellissa Withers, assistant professor at the Institute for Global Health at the University of Southern California Keck School of Medicine. “But with proper interventions and health care abroad, citizens [were able] to stay healthy.”
More than 5,000 cases of the Zika virus — which can be transmitted through mosquitoes, sexual intercourse, or from mother to unborn child — were recorded in the U.S. between Jan. 1, 2015, and March 1, 2017, according to a report released in April by the Pan American Health Organization. According to that data, about 4,700 of those cases occurred after Americans traveled back home from Zika hot spots.
There is currently no vaccine or treatment for the illness, which, if contracted by a pregnant woman, can cause severe brain malformations known as microcephaly in newborns.
“We live in an increasingly globalized society, where negative health outcomes in one part of the world can impact health and economics tens of thousands of miles away,” said Dr. Kelly Culwell, a former medical officer with the World Health Organization and current chief medical officer for WCG Cares. “If these organizations do not have sufficient funds to carry out their missions, we could see increased threats from these global diseases here in the U.S.
“The impact this sweeping rule could have on the fights against these and other yet-to-emerge public health emergencies could be devastating domestically, just as these policies will likely have devastating consequences for women seeking family planning services globally,” continued Culwell.
President Ronald Reagan enacted the Mexico City policy, named after the host city of the U.N. International Conference on Population where the U.S. announced it in 1984. It has gone in and out of effect since, depending on which party holds the Oval Office. Bill Clinton immediately rescinded the policy in his first week as president. George W. Bush reinstated it, and Barack Obama nixed it again. Trump’s move to reenact the policy falls in line with his campaign promise to restrict abortion rights, both domestic and abroad.
The U.S. does not and has never funded abortion services overseas, even in countries that legally offer abortion in cases of incest, rape or life-threatening complications for the mother.
“The money used for any abortion service is very, very separate from USAID funds,” a spokesperson for Marie Stopes International (MSI), a family planning NGO that serves more than 150 countries, told Yahoo News in January. But under the Mexico City rule, American aid will be denied to organizations like MSI if it also provides abortions through separate funding sources.
Trump held an antiabortion stance during his presidential campaign. “You have to ban it,” he said in March 2016.
When the policy was last enacted during the George W. Bush administration, health care clinics in many countries were forced to close, and outreach services for the most vulnerable populations were eliminated. Millions of people around the globe were left without critical health services, including maternal and child health care, HIV testing and counseling, and contraceptives, including condoms. Bush’s policy did not include cuts to funding for non-family-planning issues like malaria, tuberculosis, and vaccinations.
Trump’s proposed budget also includes $1 billion in cuts to PEPFAR, or the President’s Emergency Plan for AIDS Relief, which was instituted by George W. Bush. It funds HIV/AIDS treatment, testing and counseling around the world, and many consider the program to be the 43rd president’s greatest legacy.
Even fellow Republicans criticized Trump’s proposed cuts to foreign aid programs like PEPFAR.
The government also announced in April that it will cut all funding for the U.N. Population Fund (UNFPA), which provides maternal and child health services in more than 150 countries worldwide. The U.S. has long been a top donor to the U.N. agency — in 2016, the funds totaled $69 million. The agency credits those funds for helping to save 2,340 women from dying of pregnancy and childbirth, preventing 947,000 unintended pregnancies, preventing 295,000 unsafe abortions and ensuring 1,251 fistula surgeries.
Around 225 million women across the world are currently estimated to have an unmet need for modern family planning. In countries such as Zambia, Madagascar and Niger, up to 21 percent of married women have an unmet need for contraception, with fertility rates as high as 7.6 births per woman, said Culwell. The Population Fund works directly with local outreach workers, doctors and midwives to deliver reproductive health care to women throughout the world.
A spokesperson for UNFPA told Yahoo News that, with previous U.S. contributions, the agency was combatting gender-based violence and reducing the scourge of maternal deaths and injuries in the world’s most fragile settings, in areas of conflict and natural disasters, including Iraq, Nepal, Sudan, Syria, the Philippines, Ukraine and Yemen.
“This will significantly affect the health and well-being of millions of girls and women in developing countries who depend on the life-saving health services affected by this decision,” said Arthur Erken, direct of communications and strategic partnerships at Population Fund.
A recent report from the Guttmacher Institute found that each decrease of $10 million in U.S. funding for international reproductive health programs is estimated to result in 433,000 fewer women and couples receiving contraceptive services, 128,000 more unintended pregnancies and 55,000 more abortions. Numerous studies have shown that a lack of access to legal and safe abortion actually increases abortions.
Along with the millions of lives — mostly those of women and children — that are at stake because of the policy, research also shows that lack of contraception increases poverty and conflict, and in turn, decreases stability, not only in a region but also around the globe.
“The world only has a finite amount of resources,” said Withers. “Those resources are becoming more scarce, so we should really be considering the health and sustainability of our planet when thinking about taking away access to contraception in already impoverished countries.”
Furthermore, “it has been reported that the U.S. directly benefits when societies across the world are healthy, thriving and growing more prosperous,” said UNFPA’S Erken.
He broke it down in this way: When women are able to time and space out the births of their children, families thrive. When families have the number of children they’re able to responsibly support, they are better able to feed, clothe and educate them. When families thrive, communities and economies thrive, resulting in a more prosperous and secure world. When developing countries become wealthier, they are better trading partners for the American people. Trade with them keeps American jobs.
“An action like this deprioritizes women and girls and threatens women’s rights across the globe,” said Culwell. “It will cost lives and money, while contributing to a more unequal and unstable world.”
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