Hello, This is the case: The War on Zika When a Zika virus outbreak first made international news in early 2016, reporters from around the world flocked to Rio de Janeiro to get a handle on the story. It was a big news item with a tragic twistmosquitos were spreading an illness that caused mothers to give birth to babies with microcephaly, an abnormally small brain. Microcephaly is incurable and leads to a host of health problems ranging from seizures to learning challenges, and it could even be life-threatening in severe cases. With the Rio Olympics scheduled to begin in August 2016, the news stories had extra urgency and reporters asked tough questions: Would the government of Brazil respond effectively? Would visiting athletes risk-taking Zika home with them? Was this a harbinger of a much larger spread of the disease into other countries? After a few days, reporters ran out of material in Rio and headed to Recife, capital of the Brazilian state of Pernambuco. The state quickly became the center of the outbreaks story, with wrenching cases of distraught families with babies who faced huge challenges. The Zika outbreak was not only an inescapable news story; it was also a tale full of enormous personal tragedy. Behind the scenes, there was a dramatic story of government reform in action. One of the reasons why Pernambuco became the center of the Zika story is that its government detected the condition sooner than most governments in the region. As part of a major government reform initiative launched in 2007 by the states governor, the states health officials detected the problem quickly. Pernambuco had developed an advanced disease detection system, which provided quick feedback to government officials on the number of Zika cases and their impact. The process of creating this performance management system had also created a close relationship between the states doctors and public health officials. As microcephaly cases began emerging, doctors were puzzled. Where were they coming from? Doctors began doing their own sleuthing and concluded that the condition was the product of the Zika virus, that the virus was being transmitted from mothers to their unborn babies, and that the mothers were contracting Zika from mosquito bites. That meant that controlling the disease meant controlling mosquitos. Within forty-eight hours, state government officials worked with doctors to create a plan to combat the outbreak. Because of the broader performance framework that the state developed in the previous decade, the plan to address the outbreak focused not only on wiping out the mosquitos. It also included a comprehensive strategy to help families cope with the implications of microcephaly. This performance framework grew out of a strategy to solve three basic problems: How to achieve results for the citizens, How to ensure cohesion across the administration, and How to stimulate managers accountability for the results of the government.1 The governor focused on devising a strong center of government, integrating governmental plans, implementing those plans more effectively, developing a strong system to monitor performance, and then evaluating the results systematically. The comprehensive performance framework focused on four interlocking steps: doing, controlling, acting, and planning. When Zika struck, this framework helped the state respond more quickly and effectively than virtually any other government in the region. This performance framework built on clear priority goals and operational plans, so that top government officials could define what they wanted the government to accomplish. There was a data-based dashboard that provided quick feedback on what the plans were accomplishing. Armed with this feedback, government officials could fine-tune their plans, as well as how best to accomplish them. At the center of the performance framework approach was a clear definition of just who was responsible for what, as well as a mapping system to break down the governments big goals into specific operational steps in individual programs. Its cornerstone was accountability. In the performance frameworks first years, the accomplishments were remarkable. Students in the state improved their ranking on standardized tests from twenty-first to fourth place in Brazil. Dropout rates declined, with Pernambuco improving from twenty-sixth to first placethe lowest dropout rate of any state in the country. Violent crimes fell 27 percent from 2006 to 2015. All of these programs shared the same basic strategy: the states top officials defined their goals; devised strategies to achieve them; broke the strategies down to individual programs; tracked the programs and what they accomplished, with an up-to-date performance measurement system; and established broader program evaluation to assess how well the programs achieved the overall goals. One of the big challenges in many performance systems is buildingand sustainingpolitical support. Here, the performance management system paid off richly for its creator, Governor Eduardo Campos, who in a few short years become the most popular governor in Brazil. His successor, Paulo Cmara, continued the same strategyand shared the same results, winning 68 percent of the vote. Conventional wisdom often holds that good management is often not good politics. The officials of Pernambuco proved that it can be otherwiseand it can help the government respond to unexpected crises like a Zika outbreak. Questions 1. To the degree that you think the government should play some role in keeping the beaches safe, how much governmental control should there be? How much should government regulate behavior, compared with educating everyone involved? 2. What different political interests are involved in this issue? Consider fishermen, vacationers, hotel operators, restaurants, and environmental policy experts, among others. How does this constellation of political interests affect the way government approaches the issue?