Research and research capacity strengthening in the context of an emerging epidemic: Zika virus in Latin America

1UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland 2UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland 3Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization (PAHO), Washington, DC, USA 4Center for Perinatology, Women’s Health, and Reproduction (CLAP/PAHO), Montevideo, Uruguay

The Zika virus epidemic was declared an international public health emergency in 2016 following reports of a suspected association between pregnant women infected with Zika virus and microcephaly as well as other fetal malformations. 1 The World Health Organization in the countries most affected by the epidemic were encouraged to apply for funding that prioritized implementation research projects to support an evidence-based, comprehensive public health response. 3 In many of the Zika-affected countries in Latin America, socioeconomic inequities and legislation limit access to sexual and reproductive health services such as modern contraceptives and safe abortion. 4 The Zika epidemic exposed this vulnerability further, given its dire consequences for pregnant women. Viral characteristics, such as sexual transmission of the virus caused by it persisting in semen several months after infection 5 and the highly contextualized varying incidence rates of microcephaly following Zika infection during pregnancy, highlighted how inequities in and unmet access to sexual and reproductive health services determine the epidemic's impact.
The combined effort between the WHO-hosted special research programs and the WHO regional office-focusing on infectious diseases of poverty and sexual and reproductive health and rights-enabled WHO to address the need for cross-cutting efforts between research areas and disciplines, in response to a complex emergency like the Zika epidemic. Ranging from studies on the spatial distribution of the virus and its relative risk, to articles on understanding how the virus impacts women's reproductive choices in communities without access to safe abortion, the papers in this Supplement illustrate the broad variety of perspectives necessary to ensure an understanding of the Zika virus context and to tailor the necessary response.
The articles included in this Supplement come from Brazil, Colombia, and Peru. Colleagues implementing a study in Colombia (Forero et al. 6 ) This is an open access article distributed under the terms of the Creative Commons Attribution IGO License which permits unrestricted use, distribution and reproduction in any medium, provided that the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or the article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's URL. The evidence obtained through these projects offers helpful guidance to the national health system responses, as well as useful insights to research capacity strengthening initiatives. Outbreaks and health emergencies create the need to act fast; they are also a reminder that high-quality evidence springing from these situations is critical for shaping the real-time public health response. By building research capacity that can be available both nationally and regionally, we further contribute to a sustained focus on research related to the interplay between emerging infectious diseases of poverty, like Zika virus, and sexual and reproductive health and rights, ultimately to support a contextualized and effective epidemic response.

AUTHOR CONTRIBUTIONS
AT initiated the editorial with support from VB and GA. All authors provided input and approved the final version.

ACKNOWLEDGMENTS
The authors would like to thank all the contributors to this Supplement, particularly José Guilherme Cecatti as Guest Editor, as well as the researchers whose projects did not make it to this publication, for their work and efforts in the Zika virus outbreak response. They also wish to thank the team at CEMICAMP in Brazil, particularly Luis Bahamondes, José Guilherme Cecatti, and Vilma Zotareli for the support provided to the research teams during manuscript preparation. The work in

CONFLICTS OF INTEREST
The authors have no conflicts of interest.