As rare as a zoonotic disease can be, monkey pox is a threat to public health. It has been on the rise in Africa for the past three decades, since our smallpox immunity weakened after vaccination programs were discontinued. As the threat becomes global, concerns are being raised about the possibility that the virus may have mutated and become more contagious. As it is, the cases are still not enough to suspect a radically different virus, but the ways in which it is transmitted are carefully analyzed, its possible wildlife reservoirs examined, and a theoretical possibility of being transmitted into the air evaluated.
Cracks in our defense again
As the outbreak in rich countries unfolds, we acknowledge that we know less than we should about a virus that was isolated half a century ago and has been on the rise for the past three decades. Outbreaks of monkey pox in Nigeria and Cameroon in 2017 and 2018 were among the most recent learning opportunities, which, if not missed by the West, would facilitate the current global response. However, the global health community has consistently failed to support researchers in low-income countries through the challenges they face in publishing their research, which is often limited to zero funding, and therefore fails to learn from their valuable experiences. Reiterating their calls for a genuine global health approach to epidemic preparedness, scientists warn that “attention is only paid when certain diseases affect high-income countries”. The latest outbreak, now on a global scale, serves as a strong reminder that providing resources and access to medical innovation to those who can benefit most is a matter of both health equity and global health insurance. Many of the current cases of smallpox in monkeys are detected, but not limited to, in men who have sex with men – a pattern not seen in previous cases of smallpox in monkeys, but in the way the virus spreads normally. There begin to appear other serious cracks in the defense of our public health, where misinformation begins to dominate the game, reinforced by the misdiagnosis of the epidemic as a “gay disease” and further distorted by photographs of the lesions showing almost exclusively colored people. This leads to an instant branding us vs. theirallowing stigma and discrimination to raise their ugly heads again. To be clear, viruses do not discriminate. People do. Monkey pox is not more of a gay disease than any other infectious disease. None of them are. Nor is it a disease of people of color.
Lessons learned: communicate clearly, avoid stigma, deal with inequalities
We must not forget how the labeling of HIV infection as a homosexual disease during the HIV / AIDS pandemic in the 1980s led to indescribable suffering in homosexual communities. It has had a particularly strong negative impact on colored and economically disadvantaged communities, including higher mortality rates. Discrimination and homophobia have distracted us from research and from helping those who need it most. The COVID-19 pandemic has taught us how critical effective communication is against misinformed early narratives that quickly turn into accepted wisdom. against vaccine reluctance and resistance to public health measures, even as simple as cover-up and distancing; of South Africa. Dr. Tentros Gebregesos acknowledged that “we are not just fighting the virus, we are also fighting trolls and conspiracy theorists” and the World Health Organization has identified computer science as one of its key challenges. It is now clear that public health professionals, civil society, the media, the authorities must use clear, aligned messages and actively combating false information, while being transparent in the facts and recognizing the evolutionary nature of science. (Educating policymakers on how to deal with uncertainty will add significant value.) To address the growing discrimination in monkeypox outbreaks, we must not allow infected people to be stigmatized. We must dissemination of awareness about how the virus spreads, ensure surveillance without alienating or negatively targeting any community, and actively oppose racism and homophobia. Finally, we now understand that global health challenges, from infectious diseases to antimicrobial resistance, have their roots in the destruction we cause to global ecosystems. If we want to respond to the future, we must see the health of the planet, humans and (other) animals as one, we must invest in public health as never before, applying it “One health” approach.with health justice at the core, as a global health insurance issue.
