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HEALTH

WHO slams ‘policy failures’ for Zika crisis

The spiralling crisis surrounding the Zika virus is due to decades of policy failures on mosquito control and poor access to family planning services, the Geneva-based World Health Organization said on Monday.

WHO slams 'policy failures' for Zika crisis
File photo: AFP

“The spread of Zika… (is) the price being paid for a massive policy failure that dropped the ball on mosquito control in the 1970s,” WHO chief Margaret Chan told the opening of the UN health agency's annual assembly.
   
Those failures have allowed the mosquito-borne virus to spread rapidly and create “a significant threat to global health,” Chan told some 3,000 delegates gathered from WHO's 194 member countries.
   
Experts agree that Zika is behind a surge in Latin America in cases of the birth defect microcephaly — babies born with abnormally small heads and brains — after their mothers were infected with the virus.
   
The virus, which also causes the rare but serious neurological disorder Guillain-Barre Syndrome, in which the immune system attacks the nervous system, is mainly spread by the Aedes aegypti mosquito but has also been shown to transmit through sexual contact.
   
Programmes in the 1950s and 60s targeted the aegypti in a bid to prevent the spread of dengue and yellow fever, which it also spreads, and all but eradicated the mosquito species from Central and South America.
   
But when the programmes were discontinued in the 1970s, the mosquito returned.
   
Chan also decried policy failures in the realm of reproductive rights.
   
Many of the hardest-hit countries in the ongoing Zika outbreak are conservative Catholic, and she warned their “failure to provide universal access to sexual and family planning services” had exacerbated the crisis.
   
With the virus now present in 60 countries, countless women who may want to delay pregnancy have no access to contraception, and even fewer to abortion.
   
Chan pointed out that Latin America and the Caribbean “have the highest proportion of unintended pregnancies anywhere in the world.”
   
“With no vaccines and no reliable and widely available diagnostic tests to protect women of childbearing age, all we can offer is advice,” she told the assembly.
   
“Avoid mosquito bites, delay pregnancy, do not travel to areas with ongoing transmission.”
   
In Brazil, the hardest-hit country, more than 1.5 million people have been infected with Zika, and nearly 1,400 cases of microcephaly have been registered since the outbreak began last year.
   
Researchers estimate that a woman infected with Zika during pregnancy has a one percent chance of giving birth to a baby with the birth defect.

'Not prepared to cope'

Zika is not new. The African strain of the virus was discovered in Uganda's tropical Zika forest in 1947, and an Asian strain has long circulated on that continent, without sparking concern.
   
On its own Zika is fairly benign, like a bad cold or a mild flu.
   
But when the Asian strain jumped to Latin America last year, it suddenly wreaked havoc in a population never before exposed to the virus.
   
Alarmingly, the WHO last week said the Asian strain was now for the first time spreading locally in an African country — Cape Verde — raising concern over what impact the strain might have on the population on that continent.
   
“The rapidly evolving outbreak of Zika virus warns us that an old disease that slumbered for six decades in Africa and Asia can suddenly wake up … on a new continent to cause a global health emergency,” Chan said.
   
Zika is not the only virus that has taken us by surprise.
   
Chan pointed especially to the recent Ebola disaster that killed more than 11,000 people in West Africa, which revealed “the absence of even the most basic infrastructure” to deal with the outbreak.
   
Chan offered Monday's assembly “a stern warning”.
   
“What we are seeing now looks more and more like a dramatic resurgence of the threat from emerging and re-emerging infectious diseases,” cautioning: “The world is not prepared to cope.”

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HEALTH INSURANCE

What isn’t covered by Switzerland’s compulsory health insurance?

Switzerland’s basic health insurance is among the most expensive in the world, but there are certain services it doesn’t pay for. Here are some of the benefits the scheme won’t cover in full.

What isn't covered by Switzerland’s compulsory health insurance?

Basic insurance — KVG in German and LaMal in French and Italian —  is compulsory in Switzerland. It doesn’t come cheap, but it is quite comprehensive and includes coverage for illness, medications, tests, maternity, physical therapy, preventive care, and many other treatments.

It also covers accidents for those who do not have accident insurance through their workplace.

Basically, whatever the doctor orders is covered by KVG / LaMal, at least partially.

READ MORE: Everything you need to know about health insurance in Switzerland

However, there are some treatments the basic insurance won’t pay for.

Experimental treatments

Any experimental treatments or drugs — that is, those not approved by the Swissmedic regulatory agency or the Federal Office of Public Health (FOPH) will not be covered.

This exclusion is not specifically Swiss; insurance schemes is most countries won’t cover unauthorised medical treatment either.

Dental care

In most cases, services such as teeth cleaning, dental fillings, root canals, tooth extractions, and orthodontic braces, are not included under basic insurance.

The only exceptions, according to the Federal Office of Public Health (FOPH), are dental interventions “necessitated by a serious disorder of the masticatory system, or if such treatment is required to support and ensure the success of medical treatment for a severe general disorder (e.g. leukaemia, heart-valve replacement)”.

Most dental treatments are not covered. Photo by Pixabay

Eyeglasses and contact lenses

Compulsory health insurance will contribute up to 180 francs per year towards glasses and contact lenses prescribed by an ophthalmologist for children up to the age of 18.

No such benefit exist for adults. However, “in the case of serious visual impairment or certain illnesses (e.g. disease-related refraction abnormalities, postoperative alterations or corneal disease), compulsory health insurance will, regardless of age, make higher contributions towards medically prescribed spectacle and contact lenses”, FOPH says.

READ MORE: Reader question: Can Swiss health insurance exclude me if I have pre-existing conditions?

Ambulance

Emergency vehicles that transport you to a hospital can be quite expensive — depending on the canton, the costs can range from 900 to 2,000 francs per trip. 

Basic health insurance will contribute a certain amount  to the cost of emergency transportation, but only if it is a medical necessity — a serious accident, an illness, or a life-threatening situation. But if the patient could have travelled by private car or public transport, basic health insurance policies will pay nothing.

Insurance will cover some of the cost of ambulance transport only in emergency. Photo by Fabrice COFFRINI / AFP

Private hospital room

While the cost of your hospitalisation will be fully covered, the basic insurance does not pay for a private room.

You will be accommodated in a room with other patients.

Depending on a medical facility — whether it’s a small hospital or a large, university medical centre, you could end up with just one other person or possibly four or five, the latter being common in teaching hospitals.

If you insist on a private accommodation, you will have to pay for it out of your own pocket.

Reader question: Can Swiss health insurance exclude me if I have pre-existing conditions?

Vaccines

Immunisations outlined by FOPH  will be paid for by insurance, as will the Covid vaccine.

Not covered, however, are travel-related vaccinations or preventive measures, such as against yellow fever or malaria.

Treatment abroad

Outside Switzerland, only emergency care is covered  — double the amount that the same treatment would cost in Switzerland.

Usually, basic health insurance will not cover transportation costs back to Switzerland, except in case of emergency, when it will cover 50 percent of the total cost of transportation to the nearest hospital abroad — but no more than 500 francs per year. 

If you only have a basic insurance policy and travel abroad often, especially to the United States, you should take out a travel insurance that will cover you for illness and accidents in foreign countries above and beyond what your Swiss carrier will pay.

And if you want to upgrade your treatment options, consider taking out a supplemental insurance or, if you can afford it, private one.

READ MORE: Should you buy supplemental health insurance in Switzerland?

You can find out more about what KVG / LaMal will and will not cover here.

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