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The first section catalogs key ethical issues related to surveillance activities and describes three examples of public health interventions. This chapter discusses ethical issues related to the implementation of interventions for mosquito-borne illnesses. These facts, not simply conflicts of values, underscore the need for meaningful community engagement, through mechanisms that are attentive to procedural justice. As if the ethical challenge was not daunting enough, the emerging nature of many mosquito-borne diseases, such as Zika, encourage the adoption of new technologies and novel interventions, such as genetic modification of the host organism, which introduces a larger degree of uncertainty to activities with already high stakes. These two features, when taken together, make evident that vector-control interventions have the potential for affecting many people, internationally as well as intergenerationally.
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Other, more specific ethical issues result from the particular characteristics of the vector-control approach to mosquito-borne illnesses: from taking an integrated approach, which means mobilizing action across various sectors of society, to targeting interventions across the entire mosquito life cycle, which results in unavoidable environmental impacts. Moreover, there is no easy solution to ensure that the costs of public health activities are fairly distributed, especially when the disease disproportionately affects the poor. For example, surveillance activities necessary for monitoring and addressing communicable diseases raise concerns about privacy. Yet achieving all three of these recommendations, and doing so ethically, raises many challenges.Ĭhallenges to implementing successful mosquito control programs include issues that arise in public health interventions for other communicable diseases. The WHO Vector Control Advisory Group recommends that mosquito control programs have an integrated approach, target the entire mosquito life cycle, and achieve meaningful community engagement (WHO, 2016). With increasing public health threats from emerging and reemerging mosquito-borne infections, including malaria, Zika, dengue, chikungunya, and yellow fever, the World Health Organization (WHO) has recommended strengthening measures for mosquito control. Globally, since vector-borne diseases tend to thrive where housing conditions are poor and water is unsafe or inadequately sanitized, these illnesses disproportionately affect people living in poverty (WHO, 2014). Mosquito-borne illnesses kill approximately 725,000 people each year, making mosquitoes the deadliest species on earth (Zielinski, 2016). Keywords: mosquito-borne illnesses, public health intervention, surveillance, reproductive rights, pesticides, genetically modified mosquitoes, Zika virus disease, insect repellent, insecticide-treated nets, community engagement, health systems, public health ethics The chapter emphasizes the need for community engagement at all levels of mosquito control interventions, and it highlights the disproportionate impact of mosquito-borne disease on the poor, calling to action the need to strengthen health systems in low- and middle-income countries. A case study of Zika virus disease highlights specific ethical challenges surrounding the safety of insect repellent use in pregnancy and the complex issue of women’s reproductive rights arising in a fast-moving epidemic. Ethical issues surrounding surveillance activities and key public health interventions for mosquito control are discussed, including provision of insecticide-treated nets (ITNs), the spraying of aerial pesticides, and the introduction of genetically modified mosquitoes. Emerging and reemerging mosquito-borne infections remain a public health threat worldwide, prompting public health agencies to strengthen individual and population-wide measures for mosquito control. This chapter delves into the ethical issues surrounding the implementation of public health interventions for control of mosquito-borne illnesses.