As cases of monkeypox rise around the world, four pioneers of the AIDS activist movement watch with awe and a sense of nostalgia.
Some similarities between the two viruses speak for themselves. Like the strain of HIV that sparked the AIDS pandemic in the late 1970s, the current epidemic of monkeypox emerged from sub-Saharan Africa and was overwhelmingly detected in men who have sex with men living in the metropolises of the world. And while epidemiologists haven’t reached a full understanding of how the current monkeypox outbreak is spreading, recent research points to sexual transmission.
Four pioneering AIDS activists of the 1980s and 1990s argue that there are other consequential but less obvious parallels playing out in real time.
As at the start of the AIDS crisis, they argue, government messaging about the epidemic has been wrong, gay people have been caught off guard, and public health officials have failed to beat a serious disease that is rampant in the LGBTQ community.
“It’s like deja vu,” said gay rights campaigner Peter Tatchell, who was a leading member of the Gay Liberation Front in the UK. “The lessons of the AIDS and Covid crisis have clearly not been learned.”
Public health officials around the world were slow to tackle AIDS when it first appeared in men who have sex with men in the late 1970s. It wasn’t until June 5, 1981 that the United States published the world’s first government report on infectious disease in the Morbidity and Mortality Weekly Report, a government bulletin on troubling disease cases.
“Between October 1980 and May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at 3 different hospitals in Los Angeles, California,” the report states. “Two of the patients died.”
Three years later, the US government announced the development of an AIDS screening test, in addition to a vaccine, which never came to fruition. By 1985, about 12,000 Americans had died from the disease.
Likewise, campaigners say the global response to the taming of monkeypox has been too slow to stem the rise in cases – more than 20,500 cases of the current monkeypox outbreak have been reported worldwide in 77 countries and territories since early May, according to the Centers for Disease Control and Prevention.
No one has died from monkeypox outside of the 11 African countries where the infectious disease has become endemic since its discovery in 1970. However, a significant proportion of patients infected with monkeypox have been hospitalized with severe pain caused by sores resembling commonly developing pimples. .
Since the first cases were discovered in May, the United States has distributed nearly 200,000 Jynneos vaccines – a two-dose vaccine to prevent smallpox and monkeypox – to the population most at risk, which is well below its some 3.8 million homosexuals. In France, it is estimated that only 6,000 people have been vaccinated at more than 100 vaccination centers in recent weeks, French Minister of Social Affairs and Health Francois Braun said on Monday. And in the UK, health officials ordered 100,000 more vaccine doses last week to meet growing demand.
Last Saturday, the World Health Organization declared monkeypox a public health emergency of international concern, a designation reserved for the world’s most threatening outbreaks, after initially backing out of doing so last month. More than two months after the first U.S. case of monkeypox was detected in mid-May on Thursday, New York City public health officials issued a statement that the infectious disease poses an imminent threat to public health, and San Francisco officials declared a state of emergency.
“What’s interesting is that many scientists and clinicians who were trained during the AIDS epidemic or who were there at the beginning, people like Tony Fauci, know this story, but the response to monkeypox has been extremely slow and chaotic,” said Gregg Gonsalves. , who joined Act Up – the leading group fighting to fight AIDS – in 1990 and is now a professor of epidemiology at the Yale School of Public Health. “As an individual, it’s like, ‘Three strikes, you’re out, man.’ HIV, Covid and now monkeypox? How many times can you make the same mistakes over and over again?”
Representatives of the National Institute of Allergy and Infectious Diseases, which Dr. Anthony Fauci has headed since 1984, and White House officials, where Fauci is the president’s chief medical adviser, did not immediately respond to inquiries. from NBC News for comment.
Pictures of men wait in long lines outside clinics around the world to get vaccinated, technique problems with online vaccine portals and reports accusing the US government of developing a “wait-and-see” response to the outbreak – apparently calling for vaccine-only deliveries as cases surged in recent weeks – have piled up over activists’ fears that the public health response to monkeypox is shaping up to be a repeat of its flawed AIDS strategy.
Although the virus began to spread in May, the United States did not order more doses of monkeypox vaccine to add to its stockpile until June. Regulators had also not completed inspections of a key Danish facility making monkeypox vaccines until July, leaving 1.1 million ready-to-distribute doses stranded in Europe.
“Just like during the AIDS pandemic, it seems some governments don’t care as long as monkeypox only affects men who have sex with men,” said Tatchell, who was turned away from a London hospital that had run out of monkeypox vaccine. last Sunday. “What other explanation can there be? Governments should have implemented emergency vaccination programs for gay and bisexual men two or three weeks ago.
Some veteran AIDS activists also argue that, like during the AIDS crisis, messaging against monkeypox has not been tailored enough to reach the LGBTQ community.
Ron Goldberg, an early AIDS activist who joined Act Up in 1987, talks about the “America Responds to AIDS” public service announcement campaign, which the government launched at the height of the crisis in the late 1980s. Many advertisements featured heterosexual couples and displayed messages such as “AIDS is everyone’s problem.”
“At that time they were so scared to talk about gay sex, or something like that, that they had to stifle the message when they tried to give information,” Goldberg said. “If it’s happening within a certain population, you need to direct your message to that certain population.”
Activists have widely applauded efforts by public health officials not to directly link monkeypox to the LGBTQ community — as many believe it does with AIDS — and thus create the stigma. However, some argue that repeated statements by public health officials that “anyone can get monkeypox” mirror AIDS messages that “anyone can get the AIDS virus” and circumvent also efforts to alert demographic groups most at risk.
Research overwhelmingly suggests that the current epidemic of monkeypox is overwhelmingly driven by men who have sex with men. A study published last week in the New England Journal of Medicine found that of the 528 monkeypox cases analyzed, 98% involved men who identified as gay or bisexual. Another recent report from the British Health Security Agency found that of the 699 cases of monkeypox for which information was available, 97% involved gay, bisexual or other men who have sex with men.
“The numbers are there,” said Didier Lastrade, who founded the first French chapter of Act Up in 1989. “We shouldn’t be afraid of that. … We are big people, we are adults, we can The stigma goes both ways.
On Thursday, the WHO recommended that gay and bisexual men limit their number of sexual partners to protect themselves from monkeypox and contain its spread.
But compiled with two years of pandemic isolation and big summer events, like last weekend’s annual Pine Festival on Fire Island, some activists fear it may be difficult to get gay and bisexual men to lower their sexual behaviors.
“You want to be able to reach people in their 20s and 30s and say, ‘Look, this is not a joke. You’ve all seen the pictures. You’ve all had friends who got monkeypox. You don’t want it,” Gonsalves said.
More generally, according to Lastrade, the advent of pre-exposure prophylaxis, the HIV prevention pill (also known as PrEP), along with scientific evidence over the past decade that HIV treatment can prevent transmission, have caused gay and bisexual men to fall asleep. behind the wheel when it comes to their sexual health.
“The new generation has completely forgotten the history of AIDS. I keep writing AIDS books but no one reads them,” Lastrade said. “When that happens, they forget their reflexes that we had because it was a matter of life and death.”
Whatever the message, with a lackluster global vaccine rollout, activists fear the virus could become an infectious disease the LGBTQ community must live with permanently, as it did with AIDS decades ago.
“A lot of people are saying that we’ve passed the point of containment, that we’ve already missed our chance,” Gonsalves said. “If that’s true, that’s incredibly serious because this disease doesn’t necessarily kill people, but the enormous suffering and expense of all of this is going to take a toll on very many people, very many healthcare systems and very many communities, who have already been tormented.
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