Learnings from Zika Virus and reproductive rights in Africa

JOHANNESBURG - May 12, 2016 - PRLog -- The late termination of pregnancies displaying severe foetal anomalies is both an ethically and morally challenging dilemma. The outbreak of the mosquito born Zika virus in South America last year is a good example of this dilemma faced by under-resourced countries. What started out as a question about containment and the causal relationship between the Zika virus and microcephaly, quickly escalated into an issue about access to reproductive health and women's right to abortion.

Declared an international public health emergency by the World Health Organisation, the United States Centre for Disease Control and Prevention (CDC) have concluded that the Zika virus is indeed directly responsible for the exponential birth of babies born in South America with severe neurological defects.

According to Sylvester Chima, Professor of Medical Ethics at the University of KwaZulu-Natal and speaker at the 6^th annual Health Exhibition & Congress 2016, doctors have a legal and ethical obligation to provide an accurate antenatal diagnosis to enable informed decision making. "With a duty to protect women's autonomy and preservation of scarce healthcare resources on one hand, but the foetuses right to personhood and the doctor's moral obligation to society on the other, counselling women to make an informed decision is a real challenge."

Chima explains that, based on MRI scans, the brain stem and the cerebellum of babies born with microcephaly are severely deformed, as has been the case with the Zika virus. "These parts of the brain oversee bodily functions that don't require active thought. Affected children will need constant care for the remainder of their lives. Health professionals are unable to confirm the life expectancy of a baby with microcephaly who is severely intellectually impaired, and the prognosis is not a good one."

Abortion is illegal under any circumstances in seven South American countries, including El Salvador which has been the hardest hit by Zika after Brazil. In addition, abortion is not permitted for any reason in eleven African countries. With regards to South Africa, the Choice on Termination of Pregnancy Act 1996 allows women in South Africa to terminate pregnancies with severe congenital anomalies such as those caused by the Zika virus i.e., microcephaly, if diagnosed before delivery up to 40 weeks of pregnancy (late termination).

"In countries with restrictive laws, women carrying an abnormal foetus will be forced to deliver the baby," says Chima. "In these cases, developmentally challenged babies and children generally require extensive and lifelong support, which can add greater resource allocation issues to already under-resourced healthcare systems."


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