As the World Health Organization convenes its emergency committee on Thursday to consider whether the monkeypox outbreak warrants being declared a global emergency, some experts say the WHO’s decision to act only after the disease has spread in the West could entrench the grotesque inequalities that have arisen between rich and poor countries during the coronavirus pandemic.
Declaring monkeypox a global emergency would mean the United Nations health agency considers the outbreak an “extraordinary event” and the disease risks spreading across even more borders. It would also give monkeypox the same distinction as the COVID-19 pandemic and the ongoing effort to eradicate poliomyelitis.
Many scientists doubt that such a statement will help stem the outbreak, as developed countries recording the most recent cases are already moving quickly to stop it.
Last week, WHO Director-General Tedros Adhanom Ghebreyesus described the recent outbreak of monkeypox identified in more than 40 countries, mostly in Europe, as “unusual and concerning”. Monkeypox has been making people sick for decades in central and west Africa, where a version of the disease kills up to 10% of people. In the outbreak beyond Africa so far, no deaths have been reported.
“If the WHO were really concerned about the spread of monkeypox, they could have convened their emergency committee years ago when it reappeared in Nigeria in 2017 and no one knew why we suddenly had hundreds of cases,” said Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory groups. “It’s a bit curious that the WHO only called its experts when the disease appeared in white countries,” he said.
Until last month, monkeypox had not caused significant outbreaks beyond Africa. Scientists have found no major genetic changes in the virus and a top WHO adviser said last month that the spike in cases in Europe was likely linked to sexual activity among gay and bisexual men in two raves in Spain and Belgium.
To date, the US Centers for Disease Control and Prevention has confirmed more than 3,300 cases of monkeypox in 42 countries where the virus has not usually been seen. More than 80% of cases are in Europe. Meanwhile, Africa has already recorded more than 1,400 cases this year, including 62 deaths.
David Fidler, senior global health researcher at the Council on Foreign Relations, said the WHO’s new focus on monkeypox amid its spread beyond Africa could inadvertently widen the gap between rich and poor countries. poor countries observed during COVID-19.
“There may be legitimate reasons why the WHO only sounded the alarm when monkeypox spread in rich countries, but in poor countries it feels like a double standard,” he said. said Fidler. He said the global community was still struggling to ensure the world’s poor were vaccinated against coronavirus and it was unclear whether Africans even wanted monkeypox vaccines, given competing priorities. such as malaria and HIV.
“Unless African governments specifically request vaccines, it might be a bit patronizing to send them because it is in the West’s interest to prevent the export of monkeypox,” Fidler said.
The WHO has also offered to create a vaccine-sharing mechanism to help affected countries, which could see doses go to wealthy countries like Britain, which has the biggest outbreak of monkeypox beyond the United States. Africa – and has recently expanded its use of vaccines.
To date, the vast majority of cases in Europe have been in gay or bisexual men, or other men who have sex with men, but scientists warn that anyone in close contact with an infected person or their clothing or his sheets are at risk of infection. , regardless of their sexual orientation. People with monkeypox often have symptoms like fever, body aches, and a rash; most recover within weeks without needing medical attention.
Even if the WHO announces that monkeypox is a global emergency, it’s unclear what impact this might have.
In January 2020, the WHO declared COVID-19 an international emergency. But few countries noticed it until March, when the organization described it as a pandemic, weeks after many other authorities did. The WHO has subsequently been criticized for its multiple missteps throughout the pandemic, which some experts say could lead to a faster response to monkeypox.
“After COVID, WHO doesn’t want to be the last to declare monkeypox an emergency,” said Amanda Glassman, executive vice president of the Center for Global Development. “It may not rise to the level of a COVID-like emergency, but it is still a public health emergency that needs to be addressed.”
Salim Abdool Karim, epidemiologist and vice-chancellor of the University of KwaZulu-Natal in South Africa, said the WHO and others should do more to stop monkeypox in Africa and elsewhere, but was not not convinced that a global emergency declaration would help.
“There is this mistaken idea that Africa is this poor and defenseless continent, when in fact we know how to deal with epidemics,” said Abdool Karim. He said stopping the outbreak ultimately depends on things like surveillance, isolating patients and educating the public.
“Maybe they need vaccines in Europe to stop monkeypox, but here we were able to control it with very simple measures,” he said.
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