Things are going viral again
As the COVID-19 pandemic is still alive and well, the outbreak of monkeypox has “gone viral” in high-income countries and in a matter of days has shifted from “an exotic disease that happens to others” to a common name. In a matter of weeks, the number of confirmed cases has reached hundreds in 50 of the countries on four continents, bringing the scientific and medical community to vigilance.
Because it can be a rare zoonotic disease, smallpox is a threat to public health. It has been on the rise in Africa for the past three decades, since our immunity to smallpox disappeared after vaccination programs were stopped. As the threat becomes global, there are concerns about the possibility that the virus may have mutated and become more contagious. At present, there are not many cases to suspect a radically different virus, but its modes of transmission are carefully analyzed, its potential reservoirs for wildlife are considered, and the theoretical possibility of airborne transmission is assessed.
Again cracks in our defense
With the outbreak in rich countries, we acknowledge that we know less than we should about a virus isolated half a century ago and growing over the past three decades. Outbreaks of monkeypox in Nigeria and Cameroon in 2017 and 2018 were among the newest learning opportunities that, if not missed by the West, would have made the current global response easier. However, the global health community consistently fails to support researchers in low-income countries through the challenges they face in publishing their research, often with limited or no funding, and thus fails to learn from their valuable experience. .
Reiterating their calls for a truly global health approach to epidemic preparedness, scientists warn that “attention is only paid when certain diseases hit high-income countries.” The latest outbreak, now global in size, serves as a powerful reminder that providing resources and access to medical innovation to those who can benefit the most is a matter of both health justice and global health security.
Many current cases of monkeypox have been identified, but not only, by men who have sex with men – a pattern not seen in previous outbreaks of monkeypox, but in line with how the virus usually spreads. This is where other serious cracks in our public health protection begin to emerge, where misinformation begins to drive the game, exacerbated by the mislabeling of the epidemic as a “gay disease” and further distorted by photos of lesions showing almost exclusively colored people. This leads to immediate branding of us against. themallowing stigma and discrimination to raise their ugly heads again.
To be clear, viruses do not discriminate. People do it. Monkeypox is no more a gay disease than any other infectious disease. None of them are. Nor is it a disease of colored people.
Lessons learned: communicate clearly, avoid stigma, confront 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 gay communities. This had a particularly strong negative impact on people of color and from economically deprived communities, including higher mortality rates. Discrimination and homophobia have diverted our attention from research and from providing help to those who need it most.
The COVID-19 pandemic taught us how important it is to communicate effectively against misinformed early stories that quickly turn into accepted wisdom; against vaccine hesitation and resistance to public health measures, even such simple ones as camouflage and distancing; against a targeted stigma that we first witnessed towards people of Asian descent, and then, with the Omicron variant, towards people from South African countries. Dr Tedros Gebreyesus acknowledged that “we are not only fighting the virus, we are also fighting trolls and conspiracy theorists”, and the World Health Organization has identified infodemia as one of the key challenges.
It is now obvious that public health professionals, civil society, the media, the authorities need it use clear, aligned messages and active combating misinformation, while being transparent in terms of evidence and recognizing the evolutionary nature of science. (Training politicians on how to deal with insecurity will bring significant added value.) In order to counter the growing discrimination against the smallpox outbreak, we must not allow infected people to be stigmatized. We must spread awareness about how the virus spreads, provide surveillance without alienating or negatively targeting communities,, 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 are causing to global ecosystems. If we want to respond to the coming, we must consider the health of the planet, humans and (other) animals as one, we must invest in public health as never before, applying a “one health” approach.with health justice at its core,, as a matter of global health security.
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