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Head of UN health agency declares monkeypox a global emergency

By on July 23, 2022 0

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LONDON — The expanding monkeypox epidemic in more than 70 countries is an “extraordinary” situation labeled a global emergency, the head of the World Health Organization said on Saturday, a statement that could spur new investment in the treatment of the once rare disease and aggravate the rush. for rare vaccines.

A global emergency is WHO’s highest level of alert, but the designation does not necessarily mean that a disease is particularly communicable or deadly. Similar statements were made for the 2016 Zika virus in Latin America and ongoing efforts to eradicate polio, in addition to the COVID-19 pandemic and the 2014 Ebola outbreak in West Africa. .

WHO Director-General Tedros Adhanom Ghebreyesus has taken the decision to call monkeypox a global emergency despite a lack of consensus among experts on the UN health agency‘s emergency committee, saying that he had acted as “a tie-breaker”. It was the first time that a head of a United Nations health agency unilaterally made such a decision without the recommendation of an expert.

“We have an epidemic that has spread rapidly around the world through new modes of transmission, of which we understand too little,” Tedros said. “I know it hasn’t been an easy or straightforward process and there are differing views.”

WHO emergencies chief Dr Michael Ryan said the director-general had declared monkeypox a global emergency to ensure the world takes the current outbreaks seriously.

Although monkeypox has been established in parts of West and Central Africa for decades, it was not known to trigger large epidemics beyond the continent or to spread widely among people until in May, when authorities detected dozens of outbreaks in Europe, North America and elsewhere.

Last month, the WHO’s expert committee declared the monkeypox outbreak not yet an international emergency, but the group met this week to reassess the situation.

According to the US Centers for Disease Control and Prevention, more than 16,000 cases of monkeypox have been reported in 74 countries since around May. To date, deaths from monkeypox have only been reported in Africa, where a more dangerous version of the virus is spreading, primarily in Nigeria and Congo.

In Africa, monkeypox is mainly spread to humans by infected wild animals such as rodents in limited outbreaks that have generally not crossed borders. In Europe, North America and elsewhere, however, monkeypox is spreading among people unrelated to animals or who have recently traveled to Africa.

The WHO’s leading expert on monkeypox, Dr Rosamund Lewis, said this week that 99% of all monkeypox cases beyond Africa are in men and that of those, 98% involved men who have sex with men. Experts suspect monkeypox outbreaks in Europe and North America spread sexually at two raves in Belgium and Spain.

“While I am declaring a public health emergency of international concern at this time, this is an outbreak that is concentrated among men who have sex with men, particularly those who have multiple sex partners,” he said. Tedros said. “It means this is an epidemic that can be stopped with the right strategies.”

Britain recently downgraded its assessment of monkeypox after seeing no signs of widespread transmission beyond gay, bisexual or men who have sex with men and noting that the disease does not spread easily or does not cause serious illness.

The US Centers for Disease Control and Prevention said it “supports” the WHO’s emergency declaration and hopes it will galvanize international action to eradicate outbreaks. The United States has reported more than 2,800 cases of monkeypox and sent more than 370,000 doses of vaccine to US states reporting cases.

Some experts have questioned whether such a statement would help, arguing that the disease is not serious enough to warrant attention and that wealthy countries battling monkeypox already have the funds to do so. Most people recover without needing medical attention, although the lesions can be painful.

Michael Head, senior researcher in global health at the University of Southampton, said the WHO’s emergency declaration could help donors like the World Bank make funds available to stop outbreaks both in the West and in Africa.

In the United States, some experts have speculated that monkeypox may be on the verge of becoming an entrenched sexually transmitted disease in the country, like gonorrhea, herpes and HIV.

“The bottom line is that we have seen a change in the epidemiology of monkeypox where there is now widespread and unexpected transmission,” said Dr. Albert Ko, professor of public health and epidemiology at Yale University. . “There are genetic mutations in the virus that suggest why this may be happening, but we need a globally coordinated response to bring it under control.”

Ko called for an immediate scaling up of testing, saying there are significant gaps in surveillance.

“The cases we are seeing are just the tip of the iceberg,” he said. “The window has probably closed for us to quickly stop epidemics in Europe and the United States, but it is not too late to prevent monkeypox from causing enormous damage to poorer countries without the resources to deal.”

The WHO’s Tedros called on the world to “act together in solidarity” regarding the distribution of treatments, tests and vaccines. for monkeypox. The UN agency has previously said it was working to create a vaccine-sharing mechanism for the worst-affected countries, but gave few details on how it might work. Unlike the many companies that have made the COVID-19 vaccines, there is only one manufacturer of the vaccine used against monkeypox, Denmark’s Bavarian Nordic.

Dr Placide Mbala, a virologist who heads the global health department at Congo’s National Institute for Biomedical Research, said he hoped all global efforts to stop monkeypox would be equitable. Although countries like Britain, Canada, Germany and the United States have ordered millions of doses of monkeypox vaccine, none have gone to Africa.

“The solution must be global,” Mbala said, adding that any vaccine sent to Africa would be used to target those most at risk, such as hunters in rural areas.

“Vaccination in the West might help stop the outbreak there, but there will still be cases in Africa,” he said. “Unless the problem is resolved here, the risk to the rest of the world will remain.”

Jamey Keaten in Geneva and Mike Stobbe in New York contributed to this report.

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