Community empowerment, not walls, will prevent Zika

Though news about instances of the Zika virus in the U.S. have quieted down since last fall, transmission of the virus hasn’t stopped. As recently as late July, Texas officials reported a locally-contracted case of Zika inside the state and scientists announced the troubling finding that rising temperatures could make outbreaks of Zika and similar viruses a more common occurrence.

Circumstances are even more difficult in the aftermath of Hurricane Harvey. With over 20 inches of rain leaving massive amounts of debris, coinciding with the peak of arboviral transmission in northern Mexico, the potential for mosquito-borne disease outbreaks in southern Texas is heightened for the coming months. In other words, when it comes to figuring out ways to do a better job of tracking, preventing, and responding to mosquito-borne illnesses, we’re not out of the woods yet.

{mosads}Unfortunately, we now face a new challenge that makes this task even harder than might have been predicted roughly a year ago: strained political relations between the U.S. and Mexico, whose shared border is crucial ground in the fight to stop Zika and other mosquito-borne viruses, like chikungunya and dengue.

A strong U.S.-Mexico relationship is valuable for commerce, education, and personal lives in the border region and beyond, but it’s also important for our greater public health and safety.

Health departments from both countries have long exchanged bi-national case information to improve response to infectious diseases. From investigations into cross-border outbreaks of dengue in Texas/ Nuevo Leon and Arizona/Sonora, to programs developing leaders in border-centered public health, partnerships have been established that improve health in the border region. These collaborations help both sides–after all, insects know no borders, and pathogens spread in both directions.

While many local health departments continue to work well together by pushing politics aside, there are noticeable signs that political strain is nevertheless having an impact on public health efforts.

Despite the added challenges that increased political tensions between the U.S. and Mexico have brought to monitoring and reporting potential Zika outbreaks, community-based technology is surfacing as a promising solution to containing and preventing such occurrences.

For instance, I have started experimenting with the application of this type of strategy. By developing a community-based mobile app that allows users to report symptoms that may be associated with mosquito borne-diseases like Zika, chikungunya and dengue in regions along the U.S.-Mexico border, we may have a greater chance of catching and containing outbreaks before they become widely spread.

Enhancing detection of transmission in the high-risk regions along the U.S.-Mexico border remains as critical as ever.

Potentially infectious mosquitoes are not hampered by our country’s’ political strain and we must not be either. But the reality is that new obstacles have arisen.

Public health officials and researchers in border communities, such as myself, are finding that many Mexican immigrants, especially those living in U.S. border states, are more hesitant to share personal information.

This hesitation limits both the willingness to seek medical care when ill and to share personal health information through a community-based mobile system. Without this information, transmission of viruses such as Zika can go undetected and uncontrolled until a substantial outbreak is underway. While this is certainly an obstacle that needs to be addressed, it is also imperative that we as professionals remain mindful and respectful of communities’ privacy and comfort levels.

It goes without saying that in order for community-based solutions to be successful in aiding public health efforts, that community participation is essential. That is why we must rebuild and repair trust within border communities and work through trusted networks and organizations if we are to succeed in our efforts to empower communities to help stop the spread of Zika.

Once we secure community trust and buy-in, the optimal scenario for community-based technology would look something like this: if a cluster of suspiciously Zika-like symptoms are reported, local health departments would be notified and from there conduct enhanced surveillance of a region to test for a possible outbreak.

In the event of positive results, they would be able to immediately notify the community through a press release and other public health announcements so that community members can take the necessary precautions.

These types of innovations would ideally be taking part as other important steps are being made in parallel. Such as: enhancing policies surrounding the transparency of public data, which would allow communities more notice in responding to an outbreak.

In order to catch outbreaks in the early stages, public health departments must also be empowered and equipped to take proactive measures when it comes to public safety. They should not be forced, by a lack of resources, to take a more reactive approach.

Obtaining the necessary funding requires buy-in at more than just the federal level — it is also critical to get buy-in at the state and local level. By having the necessary resources and infrastructure already in place to handle these types of potential public health outbreaks, we can make a substantial difference in saving lives and money in the long run.

For now, however, the biggest focus should be on rebuilding trust within communities in the U.S. that are most likely to be affected by a Zika outbreak, and potentially most helpful in helping to contain it.

Policies, technological innovations, and public health efforts all have important roles to play — and we need to be doing everything we can to curtail the public health threat that does, indeed, still exist.

Kacey C. Ernst, PhD, MPH, is an Associate Professor and Undergraduate Program Director at the University of Arizona’s Mel & Enid Zuckerman College of Public Health and a 2017 AAAS Leshner Fellow for Public Engagement. Her primary projects examine the environmental determinants of vector-borne disease transmission and control. She and a team recently developed the Kidenga app.

The views expressed by contributors are their own and are not the views of The Hill.