Pregnant woman versus mosquito: A feminist epidemiology of Zika virus
| Date | 01 June 2017 |
| DOI | 10.1177/1755088217702671 |
| Published date | 01 June 2017 |
| Author | Candace Johnson |
https://doi.org/10.1177/1755088217702671
Journal of International Political Theory
2017, Vol. 13(2) 233 –250
© The Author(s) 2017
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DOI: 10.1177/1755088217702671
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Pregnant woman versus
mosquito: A feminist
epidemiology of Zika virus
Candace Johnson
University of Guelph, Canada
Abstract
This article investigates the contradictions between public health protocols and infection
containment efforts concerning Zika virus and reproductive rights. In El Salvador, for example,
women are being advised to avoid pregnancy until 2018, at which time local authorities hope
that the virus will be under control. This is not so easy, however, as there is limited access
to contraception, abortion is illegal in all instances, and women tend to have little household
authority. In this article, I examine the policy, legal, and political contradictions related to
the global proliferation of Zika virus in the context of ongoing debates about stratified
reproduction. This term conceptualizes the phenomenon that accords different values to
reproductive tasks undertaken by women in different socioeconomic, cultural, and national
contexts. Whereas reproduction and reproductive autonomy tend to be highly respected
and protected for relatively privileged women in the Global North, they tend to be much
less so for women of the Global South. Furthermore, the adherence to public and private
divisions in both national and transnational contexts segregates reproductive rights from the
mainstream of political negotiation and public health intervention, and in doing so frustrates
progress toward the realization of global reproductive rights.
Keywords
Feminist theory, reproductive rights, stratified reproduction, Zika virus
Introduction
In 2016, as the world prepared for the Olympic Games in Rio de Janiero, Brazil, Zika
virus emerged as a major and unique health concern. It was major because of the rapid
manner in which it spread across Brazil, and then across Latin America, and unique
Corresponding author:
Candace Johnson, Department of Political Science, University of Guelph, 50 Stone Rd. E., Guelph,
ON N1G 2W1, Canada.
Email: cajohnso@uoguelph.ca
702671IPT0010.1177/1755088217702671Journal of International Political TheoryJohnson
research-article2017
Article
234 Journal of International Political Theory 13(2)
because it was mainly a threat to the health of pregnant women and their fetuses. The vec-
tor of the disease, the Aedes aegypti mosquito, is borderless, whose range expands as a
response to both climate change and inequality. Affected women in Latin America, how-
ever, experience many borders: distinctions between private and public realms, national
and North–South borders, and tensions between reproductive autonomy and public health.
Some of these are deeply rooted in colonial legacies (Greene et al., 2013) and maintained
by political commitments to global economic structures and patriarchal practices justified
as a matter of religious fidelity. Yet, despite the complexities of the political and epidemio-
logical dimensions of the virus, there has emerged a fairly straightforward contradiction
between global public health protocols (concerning Zika control) and reproductive rights
(which are limited to non-existent in many countries in Latin America).
El Salvador and Brazil are two countries in Latin America that have had globally reso-
nating public health responses to Zika. In El Salvador, women are being advised to avoid
pregnancy until 2018, at which time the virus will (hopefully) be under control. This is
not so easy, however, as there is limited access to contraception, abortion is illegal in all
instances, and women tend to have little household authority, which means that they are
largely unable to make decisions about sexual behavior and family planning. In apparent
contradiction to the recent Brazilian High Court decision that determined abortion in the
first 3 months of pregnancy to not constitute a crime (plus55, 2016), abstinence is also
the primary policy recommendation of the Secretary of Health in Brazil.
On 18 November 2016, the World Health Organization (WHO) lifted Zika’s emer-
gency status (McNeil, 2016; WHO, 2016a). This declaration is misleading, however,
as the virus and the mosquitoes that transmit the virus continue to spread. Aedes
aegypti mosquitoes carrying Zika virus have been found in Florida and Texas in the
United States (CDC and US Centers for Disease Control, 2017a), and cases of babies
born with microcephaly, the most serious Zika-related birth defect, have been docu-
mented in 29 countries (WHO, 2017: 2). While Zika has been framed, in global terms,
as a public health issue, in reality it is a matter relevant to reproductive rights, mater-
nal health, and inequality. Paul Farmer explains that most suffering related to infec-
tious disease is related to socioeconomic inequality, which can be attributed to the
structuring effects of history (Farmer, 1999, 2003; Farmer et al., 2013). Furthermore,
Hanna and Kleinman (2013) explain that “when structural violence is overlooked,
agency is often overestimated, constraint underestimated” (2013: 31). In the case of
Zika virus, legacies of colonialism and structural violence provide robust but only
partial accounts of the patterns of disease progression. The epidemiology of Zika,
however, requires a more acute focus on gender and reproductive rights. As such, the
argument presented in this article relies on the concept of “stratified reproduction” as
a way to understand and explain both the global and particular inequities that are
revealed by Zika virus. I will examine the policy, legal, and political contradictions
mentioned above in the context of ongoing debates about stratified reproduction
(Colen, 1995; Ginsburg and Rapp, 1991; Rapp, 2000).
This article is multidisciplinary in content and method as it integrates contributions
from epidemiology, public health, medical anthropology, and history. The result, a femi-
nist epidemiology of Zika virus, is, however, intended primarily as a contribution to the
domain of feminist political theory, as the multidisciplinary approach marshals theoreti-
cal and empirical evidence of the devastating effects of the public/private distinction in
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