When There's No Olympic Opt-Out: Reproductive Rights In The Time Of Zika

As the Rio Olympics kick off this week, we're acutely aware of the absence created by athletes who chose to stay home because of the Zika virus outbreak. The reason they opted out is simple -- concern for the children they plan to have in the near future -- because Zika during pregnancy can cause microcephaly, a severe brain defect.

In less than a year, the virus has caused more than 1,600 cases of microcephaly and almost 400 stillbirths in Brazil alone. And while Olympic athletes and fans can decide to stay home to avoid the pregnancy-related risks of Zika, that's not an option for the millions of women and families that live in affected areas.

Therein lies one of the most important barriers to overcome in our response to the Zika epidemic: while those with the most resources can protect themselves against the virus, those with the fewest are also the most vulnerable.

In the absence of a vaccine, there are two main ways to protect people in Zika-affected areas: mosquito control and contraceptives to help couples delay or prevent pregnancy. Predictably, current attention and effort have focused primarily on mosquitoes, when we should also be rapidly expanding our efforts to provide access to family planning supplies and services. Empowering women to control their reproductive outcomes is a critical, highly effective strategy for preventing the most damaging effects of Zika, and it's something we can do right now.

Reproductive health empowerment depends on three factors: an informed population, an enabling policy environment, and "on-the-shelf" availability of effective contraceptive devices. To date, we are failing on all three. Education on the dangers of Zika during pregnancy and the role of contraception in prevention has been limited. The Catholic Church continues to oppose contraception, and abortion care is criminalized in most countries in this region. Many governments have not taken meaningful steps to increase the availability or affordability of contraception. In fact, several countries report that birth control is regularly out of stock at health centers. As a result, millions of women at risk for Zika in Latin America today have an unmet need for contraception and are at risk for an unplanned pregnancy.

We must do better.

Education, especially during an epidemic, is a critical function of governments, NGOs and civil society. All three need to do more to link the Zika response to reproductive health and rights. From the highest levels of government all the way to community health workers, the message must be clear -- effective use of contraception is a very good way to protect families from microcephaly.

One example is the work of the Reproductive Health Supplies Coalition (RHSC), a global partnership of public, private, and nongovernmental organizations, which works to ensure that all people in low- and middle-income countries have the contraceptive information and tools they need to take charge of their reproductive health. Today, in Latin America, El Foro Latinoamericano y del Caribe (ForoLAC), a working group of the RHSC, is gathering, translating, and disseminating information on the Zika epidemic, how to detect microcephaly, the effects of Zika on pregnancy, the role of contraception and more.

An enabling policy environment is also critical to establishing clear guidance and action points for governments and partners. Many Latin American countries signed onto the Consenso de Montevideo Sobre Población y Desarrollo, which included a commitment to implement comprehensive sexual and reproductive health programs, particularly for adolescents. As with any commitment, however, adopting a policy is only as powerful as the determination to implement it.

But education and an enabling policy environment are not sufficient unless reproductive health services and supplies are actually available to those who need them. Purchasing power is low in many Latin American countries and most people have to buy their own contraceptives, which can push modern family planning out of reach. The capacity of governments to take on the full burden of delivering reproductive health supplies and services is also limited. What countries need is to strike the right balance between public health system support and private sector engagement.

Of course, the benefits of expanding access to voluntary, rights-based family planning extend beyond Zika. When women and girls can take charge of their reproductive health, it yields exponential gains -- improving their lives as well as the health, productivity, and prosperity of their families and communities.

Epidemics always expose inequity, with the poor and marginalized paying the highest price. As we gather this week to watch the finest athletes in the world perform at their best, it's incumbent upon all of us to make sure men and women in Zika-affected areas have the same power to protect their families that Olympic athletes do.

Co-Authored by Milka Dinev & David Fleming:

Milka Dinev is the regional advisor for the Latin American and Caribbean forum, Reproductive Health Supplies Coalition. Ms. Dinev has 32 years of experience in the development and management of projects in international development, mainly in reproductive health and has demonstrated technical expertise in program design, strategic planning and program implementation. She has almost 20 years of experience working directly on global US Government funded programs and has led the design of successful proposals for USAID. An Engineer by profession, Milka has a MBA and Diplomas in Gender and Project Management. Currently working for PATH, under the Reproductive Health Supplies Coalition/LAC FORUM.