The spread of monkeypox all over the world puts us all at risk

Opinion: Hoarding monkeypox vaccines in wealthy non-endemic countries while neglecting the spread of the disease and rising cases in endemic countries is a strategy doomed to long-term failure

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Monkeypox, a zoonotic infection linked to smallpox, got a lot of attention this month, and rightly so. The appearance of cases in many countries around the world where this has never been seen before is concerning, although not entirely unexpected.

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Blatantly, almost all the attention is on the cases in rich countries. The tragic deaths and growing burden of disease in poor parts of the world continue to be largely overlooked.

If we’ve learned anything from COVID, it’s that we’re globally interconnected and the spread of infectious diseases all over the world puts us all at risk. Apart from perhaps multi-billionaires who have more personal wealth than some entire countries, we are all, to some extent, in the same proverbial boat.

Against a backdrop of international neglect, the number of monkeypox cases and deaths in central and western parts of Africa has risen dramatically since the 1970s, when the first cases were diagnosed in the Democratic Republic of Congo. The number of cases has increased more than tenfold over the past 10 years. In 2017, after 40 years without any cases, monkeypox reappeared in Nigeria. Since January 2022, the World Health Organization estimates that in the Congo alone, at least 57 people have died and more than 1,200 people have fallen ill from monkeypox. Media around the world paid little attention to these deaths.

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The reasons for the increasing number of cases in Africa are likely to be linked to ecology, deforestation, civil unrest and poverty – which force more interactions between people and the rodents/animals which are the natural hosts of the virus. monkeypox. Combined with the cessation of smallpox vaccination in the 1980s and the subsequent decline in immunity, this means that populations are now more susceptible to monkeypox.

Monkeypox, although less infectious and less severe than smallpox, is closely related, and countermeasures such as vaccines and treatments already exist, in very limited quantities. In fact, the UK has rolled out vaccines for people identified as close contacts of active cases. Canada and many other rich countries could follow suit and have a stockpile of these countermeasures. But, again, hoarding vaccines in wealthy non-endemic countries while neglecting the spread of the disease and rising cases in endemic countries is a strategy doomed to long-term failure.

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The relative neglect of deaths and the growing number of cases in other parts of the world where the virus is endemic continue to be a problem. It is in our collective interest and our health security to ensure that access to care, surveillance, vaccination and therapeutic interventions reach the regions of the world most affected by this disease as a priority. This requires recognizing that we are a global community and that we must coordinate and cooperate in our response to emerging infections.

We would be deluding ourselves if we thought we could end the risks associated with monkeypox, COVID, avian influenza and other zoonotic diseases without addressing the drivers of infectious disease and fallout, including inequality, poverty, deforestation, climate change and our interactions with animals. as a global community.

Jan Hajek is an infectious disease specialist at Vancouver General Hospital; Victor Leung works in the Department of Pathology and Laboratory Medicine at the University of British Columbia; Srinivas Murthy works in the Department of Pediatrics at the University of British Columbia


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