From Ebola to Zika: How Religious Actors Can Support Prevention Efforts in Public Health Emergencies
October 11, 2016
Religious leaders and faith-based organizations (FBOs) have a long history of responding to crises around the world, including public health emergencies. The successful nature of their efforts to shape opinions and behaviors during the 2014 Ebola outbreak underscores the important role that these individuals and groups can play in the response to the current Zika outbreak, particularly in the area of prevention.
During the Ebola outbreak, community resistance—stemming from deeply rooted mistrust of government and wariness of outside intervention by the international community—was a critical obstacle to effective prevention and treatment measures in West Africa. This distrust was a legacy of long years of violence, harsh military and police interventions, and widespread corruption. In Liberia, for example, decades of corruption left many suspicious of their government and willing to believe that Ebola was merely a scam its officials crafted to garner funds from international donors. Tragically, the high levels of distrust toward governments in the affected countries undermined health workers’ ability to carry out communications campaigns aimed at curbing the spread of the virus. Concealment of cases, unsafe burial practices, refusal to report contacts, and, in some cases, violence against health providers, as a result, contributed to the continued spread and persistence of the virus.
Religious leaders in the affected countries, conversely, were well positioned to shift attitudes and promote behavior change in the context of the outbreak. Unfortunately, public health officials and international development partners initially paid little attention to the affected countries’ dense religious networks at the community level or simply took them for granted. If anything, they viewed religious beliefs about disease as more an obstacle than an asset. Ultimately, however, religious leaders and other community leaders played a key role in effectively identifying cases of Ebola, tracing contacts, and disseminating public health messages that managed misinformation, combated stigma, and resulted in a reduction in high-risk behaviors.
In the context of the current Zika outbreak, similarly, mistrust and fear have the potential to undermine Latin American governments’ ability to effectively carry out prevention measures. For example, mistrust of government has allowed various conspiracy theories about Zika to gain traction in Brazil and hampered efforts by health officials to stop the spread of the virus in Puerto Rico. In other countries in the region, mistrust has led to resistance to government-led mosquito control campaigns. Given the reach and density of their local networks, trusted religious actors in Latin America are well positioned to address this type of community resistance to Zika prevention efforts.
Fortunately, the international community has been quicker to acknowledge the key role that religious actors could play in the context of the current Zika outbreak. The World Health Organization’s (WHO) Zika Strategic Response Framework lists religious groups as a key stakeholder in areas with ongoing Zika transmission. The multifaceted approach proposed by WHO includes coordinating, collaborating, and partnering with faith-based associations and churches, among other civil society groups. In practice, the Pan American Health Organization has already begun to engage FBOs in the Caribbean in Zika prevention efforts. At a meeting in April, representatives from FBOs in Barbados agreed that they had an important role to play not only reducing mosquito breeding sites, but also providing their congregations with the tools to minimize the risk of Zika virus infection.
According to WHO, however, the multifaceted approach to Zika prevention “should not only be concerned with vector control, but also with protecting individuals, especially pregnant women and women of reproductive age, from infection and preventing unwanted pregnancies.” Religious actors’ involvement in Zika prevention efforts, similarly, can and should go beyond vector control, particularly in light of Pope Francis’ suggestion that the use of contraceptives to avoid pregnancy is permissible in countries affected by Zika. Religious actors’ risk-communication and community-engagement efforts should include the provision of comprehensive information about safe, effective, affordable, and acceptable methods of contraception, as it is a critical tool for preventing the further spread of Zika and the adverse health outcomes associated with the virus.
Fear, distrust, and misinformation during a public health emergency, as well as the resulting stigma and discrimination against those affected by it, serve as major barriers to effectively carrying out prevention efforts in this context. Religious leaders and groups can play a key role in challenging these dangerous beliefs and practices and promoting ones that instead advance public health, social justice, and human rights.