In the News 2016

W.H.O. Recommends Contraception in Countries With Zika Virus

The World Health Organization issued a strong call on Thursday for the use of contraception in countries with the Zika virus, and said that women who had unprotected sex and feared infection should have access to emergency contraception, a recommendation that may not sit well with the Roman Catholic Church.

The virus has torn through Latin America and is now in more than 25 countries. It is mostly spread by mosquitoes, and the main fear is that it may cause birth defects if pregnant women contract it. A few cases of sexual transmission have been documented, and the new guidelines were issued to prevent that. But they seemed to go further.

For example, the recommendation that women who have had unprotected sex and fear pregnancy because of Zika should have “ready access to emergency contraception services and counseling” is a reference to the morning-after pill. Health officials later clarified that the recommendation for counseling applied only to emergency contraception, not to broader pregnancy services, which in some countries could include abortion.

Many Latin American countries — including Brazil, ground zero for the virus — are predominantly Roman Catholic. Zika has reignited difficult debates in those countries about abortion and, in some cases, birth control, as some governments advise women to delay pregnancy. The new recommendations are likely to complicate that dynamic, as some of them directly contradict teachings of the Catholic Church.

But in an unexpected development, Pope Francis indicated on Thursday that he was open to some flexibility in dealing with the health crisis. In a midair news conference while flying home to Rome from Mexico, Francis said that contraceptives could be used to prevent the spread of Zika.

Jaime Nadal Roig, the United Nations Population Fund’s Brazil representative, said in a phone call with reporters Thursday that emergency contraception was part of Brazilians’ health insurancepackages and that he did not think the recommendation would be controversial there. He said that reproductive health services were being increased in response to the virus, but that about 6 percent of Brazilian women who wanted contraception still did not have access to it.

The agency explicitly recommended condom use, which Francis appeared to tacitly condone. But he flatly ruled out condoning abortion.

Abortion is highly contentious in much of Latin America, which also has fast-growing numbers of evangelical Christians, but birth control is more accepted. Many people in Brazil, which is the region’s largest nation and has the world’s largest Roman Catholic population, pay little heed to the church’s teachings on birth control, and the authorities there distribute free condoms. Contraception is also available, with some restrictions, in less socially liberal countries in Latin America.

Jon O’Brien, president of Catholics for Choice, a nonprofit in Washington that supports contraception and abortion rights, said that while conservative Catholicism generally disapproved of emergency contraception, there had been efforts to figure out when it could be used — in cases like rape, for instance. In the early 2000s, the Catholic Health Association of the United States, which represents Catholic health care providers, said members could prescribe emergency contraception if implantation had not yet occurred, Mr. O’Brien said.

Marcos Espinal, director of the Communicable Diseases and Health Analysis Department at the Pan American Health Organization, said in a call with reporters that five countries had experienced a rise in Guillain-Barré syndrome, a rare neurological condition that can cause temporary paralysis and has been associated with Zika: Brazil, Colombia, Suriname, El Salvador and Venezuela. The World Bank pledged $150 million on Thursday to help affected countries. It estimated that the epidemic would have a modest cost for the region: $3.5 billion, or 0.06 percent of its total economic output.

This article was first published in the New York Times.

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