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WHO declares monkeypox a global emergency

The World Health Organization said the outbreak of monkeypox in more than 70 countries is an “extraordinary” situation that now qualifies as a global emergency, an announcement Saturday that could spur more investment in treatments for the once-rare disease and worsen the scramble for scarce vaccines. .

Although monkeypox has been established in parts of central and west Africa for decades, it was not known to cause major outbreaks outside the continent or spread widely among humans until May, when authorities detected dozens of outbreaks in Europe, North America and elsewhere. Declaring a global emergency means that the monkeypox outbreak is an “extraordinary event” that could spread to more countries and requires a coordinated global response.

WHO has previously declared public health crises such as the COVID-19 pandemic, the 2014 West African Ebola outbreak, the Zika virus in Latin America in 2016, and ongoing efforts to eradicate polio. The emergency declaration mostly serves as a plea to draw more global resources and attention to an outbreak. Past declarations have had mixed effects, given that the UN health agency is largely powerless to force countries to act. Last month, a WHO expert committee said the global monkeypox outbreak was not yet an international emergency, but the panel convened 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 May.

To date, monkeypox deaths have only been reported in Africa, where a more dangerous version of the virus is spreading, mainly in Nigeria and the Congo. In Africa, monkeypox is mainly spread from infected wild animals such as rodents to humans, in limited outbreaks that usually do not cross borders. In Europe, North America and elsewhere, however, monkeypox is spreading among people who have no contact with the animals or recent travel to Africa.

WHO’s top monkeypox expert. Rosamund Lewis said this week that 99% of all monkeypox cases outside Africa involve men, and 98% of these involve men who have sex with men. Experts suspect the monkeypox outbreak in Europe and North America was spread through sex at two raves in Belgium and Spain.

Michael Head, senior research fellow in global health at the University of Southampton, said it was surprising that the WHO had not already declared monkeypox a global emergency, explaining that the conditions were arguably met just weeks ago. Some experts have questioned whether such a declaration would help, arguing that the disease is not serious enough to warrant attention and that rich countries battling monkeypox already have the funds to do so; Most people recover without needing treatment, although the lesions can be painful.

“I think it’s better to be proactive and overreact to the problem rather than wait until it’s too late to react,” Head said. He added that the WHO’s emergency declaration could help donors like the World Bank make funds available to stop outbreaks in both Western and African countries, where animals are potential natural reservoirs of monkeypox.

In the United States, some experts speculate that monkeypox is on its way to becoming a sexually transmitted disease like gonorrhea, herpes, and HIV in the country. “The bottom line is that we’ve seen a shift in the epidemiology of monkeypox where there are now widespread, unpredictable infections,” said Dr. Albert Ko, a professor of public health and epidemiology at Yale University.

“There are some genetic mutations in the virus that suggest why this might be happening, but we need a coordinated global response to bring it under control,” he said. As in the early days of Covid-19, there are significant gaps in surveillance, calling for an immediate acceleration of testing.

“The cases we’re seeing are just the tip of the iceberg,” he said. “The window is probably closing for us to quickly stop outbreaks in Europe and the US, but it’s not too late to stop monkeypox from wreaking huge havoc on poor countries without the resources to manage it.”

In the United States, some experts estimate that monkeypox may enter the country as a new sexually transmitted disease, with officials estimating that 1.5 million men are at high risk of becoming infected. Dr. Placide Mbala, a virologist who directs the global health division of Congo’s Institute of National Biomedical Research, hopes that any global effort to end monkeypox will be justified. While Britain, Canada, Germany and the United States have ordered millions of vaccine doses, none have gone to Africa.

“The solution needs to be global,” Mbala said, adding that any vaccine sent to Africa would be used to target those at highest risk, such as hunters in rural areas. “Vaccination in the West may help stop outbreaks there, but there will still be cases in Africa,” he said. “Unless the problem here is solved, there will be risks for the rest of the world.”

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